Prepare for your appointments
by writing down your questions and concerns and taking this paper to your
appointment. This will help you remember to address the important issues.
As your illness progresses, you may become too ill to continue seeing
your doctor at a clinic or to talk on the telephone. If you wish to be at home
as you die, it is helpful to designate only one family member or friend to
communicate with your doctor. Choosing one reliable person to relay messages
will help avoid the confusion caused by several people trying to communicate
with your doctor.
Aggressive life-sustaining medical treatment
Discuss with your loved ones and doctor how you feel about life-sustaining
Tough choices include whether you want cardiopulmonary
resuscitation (CPR) performed on you if your heart stops. If you stop
breathing, a ventilator or respirator may be used to mechanically breathe for
you. Although mechanical ventilation can prolong your life, your remaining days
may be spent in the intensive care unit of a hospital connected to life-support
equipment. You may not be fully alert and may not be able to speak.
Talk to your doctor about your illness, specific treatment options, and
chances for recovery. Your family is a key part of this process. Discuss your
options with them and clearly state your wishes. Some people who are facing
death have strong and definite feelings about CPR, and the decision for or
against life support may be easy. For other people, this decision is extremely
For more information on this decision, see:
- Should I Receive CPR and Life Support?
Artificial hydration and nutrition
important treatment issue to consider is whether you want intravenous, or IV,
lines or feeding tubes to be used if you are no longer able to take food or
fluids by mouth. This is known as artificial hydration and nutrition. An IV is
a needle placed in your vein through which fluids, liquid nutritional
supplements, or medicines can be given. A feeding tube can be either a tube
inserted into the stomach through the nose (nasogastric, or NG, tube) or a tube
surgically inserted through the abdomen into the stomach (gastrostomy or PEG
tube, or g-tube). As with an IV line, liquid nutritional supplements, fluids,
or medicines can be given through a feeding tube. A third form of artificial
hydration, hypodermoclysis, involves the injection of fluids directly into
tissues beneath the skin (subcutaneous).
Changes in your body in
the final weeks of life reduce your need for food and water. You will likely
not be thirsty or hungry. You may feel better without artificial hydration or
Talk to your doctor if you
are considering artificial hydration and nutrition. Making a plan for IV fluids
and feeding tubes early in the course of your illness may be helpful if you are
faced later on with the decision to pursue or forgo these treatments. Remember
to communicate your wishes clearly with your family and your doctor.