What decisions do you need to make about care at the end of life?
You will face many hard decisions as you near the end of
life. Those decisions will include what kind of care you'd like to receive,
where you'd like to receive care, and who will make decisions about your care
should you not be able to make decisions yourself.
Hannah Kalil is 83 years old, and lives by herself in upstate New York. She
has aides who help with her caregiving throughout the day. But the
responsibility of managing her finances, health care -- both mental and
physical -- and long-term living situation falls to one person: her daughter --
and my mother -- Eleanor.
It's almost a full-time job. Making sure my grandmother is happy and not
feeling lonely means daily visits. Her never-ending stream of medical issues
means weekly -- if not...
Curative treatment, which is any medical treatment that is given to cure your disease or to try to help you live longer.
Palliative care, which helps to provide relief from pain and any other symptoms you may have with your disease. The palliative care team will help coordinate your medical care with other doctors and help you with medical decisions. Palliative care also provides emotional and spiritual support for you and your loved ones.
Hospice care, which provides palliative care for people who are close to the end of life.
No one knows
when his or her time may come. So it's a good idea to spend some time planning
what you want at the end of life. To be prepared:
Decide what kind of health care you want or don't want. For
example, you can decide whether you want
CPR if your heart or breathing stops.
Let others know what you've decided. Consider writing an
advance directive that includes a
living will and a medical power of attorney (also
durable power of attorney). A living will is a legal
document that expresses your wishes for medical care if you are not able to
speak or make decisions for yourself. A medical power of attorney lets you choose a health care agent. Your health care agent will have the legal right to
make treatment decisions for you, not only at the end of your life but anytime
you are not able to speak for yourself.
Decide whether you'd like to donate your organs.
Will you have to choose between types of care?
One thing to think about is what type of
medical care you want. Some people ask their doctors to do everything possible
to keep them alive. This is called curative treatment.
palliative care, which does not try to cure your
illness. It looks at ways to make you more
comfortable. For example, palliative care may include giving you medicines to
help with pain or with the side effects from treatment. Palliative care team members may also provide physical therapy or help you if you are having problems such as anxiety or loss of appetite from chemotherapy.
have both types of treatment. You can get palliative care to help keep you
comfortable, and you can take medicines or other treatments that might cure
A time may come when you decide to stop curative treatment if it is very clear that your illness
can't be cured. You will still see your
doctor and get excellent care. And if your condition changes, you can start
curative treatment again. But if your illness is expected to get worse, you may want to plan ahead for that time by talking with your doctor. He or she will be the one to refer you for hospice care.
Hospice care is for people who are close to the end of life and are not likely to live for more than 6 months.