Life Sustaining Treatments

Artificial Hydration

What is Artificial hydration?

Artificial hydration is giving water and salt to someone who is too sick to drink water.

It may be given through:

• An IV in a vein
• A tube placed through the nose into the stomach
• A tube place by surgery through the skin into the stomach.

Who does artificial hydration help?

This depends on what is wrong with the person. Talk about this with your doctor.

Artificial hydration can be helpful if:

• You only need hydration for a little while.
• You are not at the end of your life.

Some people can use artificial hydration for years.

Artificial hydration may NOT be helpful if you are near the end of your life.

• The body often cannot use the water and salt.
• Water can build up in the lungs and cause problems breathing.
• When someone is near the end of life, NOT drinking water may decrease the person’s pain.
• NOT drinking water may decrease the need for a tube to drain your bladder
• NOT drinking water may decrease swelling in your body.

How do I decide if I want artificial hydration?

Talk to your doctor about:

• How long you might need it.
• How long you might live with it.
• How using it would change your lifestyle.

Some people want to live as long as they can. These people may want to try artificial hydration, even if it causes other problems.

Some people want to die as naturally as possible. These people may not want to try artificial hydration.

What are your feelings?

CPR

What is CPR?

CPR is trying to re-start the heart and pumping blood to the body.

• When someone has stopped breathing and the heart stops beating or,
• Has a type of heartbeat that leads to no pulse and death.
• The chest is pushed in two inches 100 times each minute
• A mask and bag are put over the mouth to pump air into lungs
• Electrical shocks may be given to the chest

Who does CPR help?

That depends on the reason the heart stopped and if they are healthy or sick. The longer amount of time the heart has been stopped before CPR the less it will help. Talk about this with your doctor. CPR can be helpful if:

• You are young and fit
• You have no major health problems
• You have CPR started a few minutes after your heart stops

About 15 % of all people who have CPR live. If you have CPR in a hospital it is 20% who live.

CPR may NOT be helpful if you are near the end of your life, old or frail.

• Half of people will have brain damage
• Almost all will have ribs broken
• Most will get breastbone broken
• Some may have lung damage and bleeding in the chest
• Some may have damage to the windpipe
• Older people are less likely to have a heart that can recover and keep beating

How do I decide if I want CPR?

Talk to your doctor about:

• Your chances of living through CPR
• How using it would change your lifestyle.

Some people want to live as long as they can. These people may want to try CPR even if it causes other problems.

Some people want to die as naturally as possible. These people may not want to try CPR.

What are your feelings?

Tube Feeding

What is Tube Feeding?

Tube feeding is giving liquid food to someone who is too sick to eat on their own or unable to swallow.

It may be given through:

• A tube placed through the nose into the stomach for short term
• A tube placed by surgery through the skin and into the stomach for long term

Who does Tube feeding help?

It depends on what is wrong with the person. Talk about this with your doctor.

• You have difficulty swallowing due to injury
• You have experienced cancer treatment and it is hard to eat
• You are not at the end of your life

A feeding tube may not be helpful if you are near the end of your life.

• It is normal to stop eating at end of life
• The body cannot use the food and may cause
  • Stomach pain and diarrhea
  • Water buildup on the legs
  • Water buildup on the lungs making it hard to breathe
• In late stage dementia a feeding tube may cause:
  • Agitation
  • Be uncomfortable
  • Trying to pull out the tube
  • Fluid swallowed into the lung
  • Lung infection from swallowed fluid

How do I decide if I want tube feeding?

Talk to you doctor about:

• How long you might need it
• How long you might live with it
• How having it would change your life

Some people want to live as long as they can. These people may want to try a feeding tube even if it causes other problems.

Some people want to die as naturally as possible. These people may not want to try a feeding tube.

What are your feelings?

Ventilator

What is a Ventilator?

A ventilator does the work of breathing if you are too sick to breathe on your own. You are connected to a breathing machine through a tube placed through your mouth into your windpipe. Medicines are often given to make you sleepy so there is less discomfort. Doctors may need to make a hole in the windpipe and insert a tube connected to the breathing machine.

Who does a ventilator help?

That depends on what is wrong with the person. Talk about this with your doctor.

• You will not use a ventilator to cure or treat lung problems
• You may be helped if you have a breathing problem, a brain and nerve disease, or suffer brain or spinal cord injury.
• You are not at the end of your life

Even with the ventilator, some people may get worse and die. Some people can use a ventilator for years.

A ventilator may NOT be helpful if you are near the end of your life.

• It is easy to get lung infections that may be hard to treat
• The ventilator can cause damage to lungs
• The breathing tube can damage the throat and make it hard to swallow
• The breathing tube can damage vocal cords and make it hard to speak
• Chronic illness such as heart, lung, kidney or liver disease reduces the help of a ventilator
• Dementia (memory loss) or cancer also reduces the help of a ventilator

How do I decide if I want to try a ventilator?

Talk to your doctor about:

• How long you might need it
• How long you might live with it
• How using it would change your lifestyle

Some people want to live as long as they can. These people may want to try a ventilator even if it causes other problems.

Some people want to die as naturally as possible. These people may not want to try a ventilator.

What are your feelings?