Advance Care Planning
Advance care planning is a process through which you can make decisions ahead of time about what type of medical care you would want if you were seriously ill or injured and not able to make or communicate your wishes, and then let others know about your preferences. These preferences are often put into an advance directive, a legal document that goes into effect only if you are incapacitated and unable to speak for yourself. https://www.nia.nih.gov/health/advance-care-planning-healthcare-directives
Comfort care is anything that can be done to soothe you and relieve suffering while staying in line with your wishes. Comfort care includes managing shortness of breath; limiting medical testing; providing spiritual and emotional counseling; and giving medication for pain, anxiety, nausea, or constipation. https://www.nia.nih.gov/health/advance-care-planning-healthcare-directives
CPR, or cardiopulmonary resuscitation, might restore your heartbeat if your heart stops or is in a life-threatening abnormal rhythm. It involves repeatedly pushing on the chest with force, while putting air into the lungs. Electric shocks, known as defibrillation, and medicines might also be used. Often, CPR does not succeed in older adults who have multiple chronic illnesses or who are already frail. https://www.nia.nih.gov/health/advance-care-planning-healthcare-directives The success rate of CPR near the end of life is extremely low. (https://www.merckmanuals.com).
A death doula or death midwife is a person who assists in the dying process, much like a midwife or doula helps with birth. The role can supplement and go beyond hospice. Practitioners perform a variety of services, including but not limited to creating death plans and providing spiritual, psychological and social support before and just after death.They often help with planning funerals and memorial services. https://en.wikipedia.org/wiki/Death_midwife
Do Not Resuscitate
Also called a DNR, this is an order placed in your medical record by a doctor that informs the medical staff that CPR should not be attempted in the event of cardiac arrest. DNR is a narrow order and does not mean "do not treat." For example, medical staff would help a patient who was choking even if there was a DNR. https://www.reliasmedia.com/
If you are not able to eat, you may be fed through a feeding tube that is threaded through the nose down to your stomach. If tube feeding is still needed for an extended period, it may be surgically inserted directly into your stomach. Studies have shown that artificial nutrition toward the end of life does not meaningfully prolong life. https://www.nia.nih.gov/health/advance-care-planning-healthcare-directives
Goal Concordant Care
Medical care during serious and chronic illness that is consistent with the patient's values, goals and preferences.
Hospice care is end-of-life care provided by a team of health care professionals and volunteers who give medical, psychological and spiritual support. The goal of the care is to help people who are dying have peace, comfort and dignity. Usually, a hospice patient is expected to live 6 months or less. Hospice care can take place at home, at a hospice center, in a hospital or in a nursing facility. https://medlineplus.gov/hospicecare.html
A living will is a written document that tells doctors how you want to be treated if you are dying or permanently unconscious and cannot make your own decisions about emergency treatment. Not all states recognize a living will as legally binding. https://www.nia.nih.gov/health/advance-care-planning-healthcare-directives
Palliative care is specialized medical care for people living with serious illness. This type of care is focused on providing relief from the symptoms and stress of the illness and improving quality of life. It is not curative treatment, but can be provided along with curative treatment. https://www.capc.org/about/palliative-care/
POLST - Physician Orders for Life Sustaining Treatment
Also called Medical Orders for Life-Sustaining Treatment (MOLST), Physician Orders for Scope of Treatment (POST), Medical Orders for Scope of Treatment (MOST) and Transportable Physician Orders for Patient Preferences (TPOPP). POLST orders are drafted by the doctor and document the decisions that people with advanced or end-stage illness make about their treatment. POLST and similar programs do not exist in every state . https://www.merckmanuals.com
Ventilators are machines that help you breathe. A tube connected to the ventilator is put through the throat into the trachea (windpipe) so the machine can force air into the lungs. Putting the tube down the throat is called intubation. If you are expected to remain on a ventilator for a long time, a doctor may perform a tracheotomy, inserting the tube directly into the trachea through a hole in the neck. https://www.nia.nih.gov/health/advance-care-planning-healthcare-directives