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Care at the End of Life - Important Decisions

Aggressive life-sustaining medical treatment

Discuss with your loved ones and doctor how you feel about life-sustaining treatment.

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 difficult.

For more information on this decision, see:

dplink.gif Should I Receive CPR and Life Support?

Artificial hydration and nutrition

Another 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 nutrition.

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.

For more information on this decision, see:

Should I Have Artificial Hydration and Nutrition?
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WebMD Medical Reference from Healthwise

Last Updated: July 06, 2012
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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