End of Life Concerns The Dying Process How to Make Difficult Life-Prolonging Healthcare Decisions By Angela Morrow, RN Angela Morrow, RN LinkedIn Angela Morrow, RN, BSN, CHPN, is a certified hospice and palliative care nurse. Learn about our editorial process Updated on March 19, 2020 Fact checked Verywell Health content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication. Learn more. by Sheeren Jegtvig Fact checked by Sheeren Jegtvig Shereen Lehman, MS, is a healthcare journalist and fact checker. She has co-authored two books for the popular Dummies Series (as Shereen Jegtvig). Learn about our editorial process Print Throughout most of our lives, medical decisions are quite easy. If we get sick, we go to the doctor and get treated. We listen to the doctor and do what he suggests because it can only make us better. As one gets older, however, these decisions become less cut and dry. People are living longer and often with several long-term illnesses. Treatments begin to offer only limited benefits and often come with painful or burdensome side effects. Now the benefits and burdens of treatments have to be weighed and decisions made based on personal goals. JohnnyGreig/E+/Getty Images Adding to the difficulty of these decisions is the advancement of medical care. Ventilators, CPR, and feeding tubes have all helped people survive serious accidents and illnesses that wouldn’t have had a chance years ago. Because people with chronic disease or life-threatening illnesses have much less chance of benefiting from this technology, it is important for them to discuss life-prolonging treatments with their families and their doctor. Goals of Health Care The place to begin when considering life-prolonging treatments is to identify the intended goals of care. There are three possible goals for medical care: Cure. This is the standard we are all used to. Nearly all health care is directed towards this goal. We get sick, we go to the doctor for treatment, and hopefully, we are cured. Stabilization. Sometimes we can’t be cured. Many diseases are incurable but can be stabilized with proper medical treatment. Diabetes is a good example of this. There is no known cure for diabetes but a diabetic patient can monitor blood sugars and take insulin injections and function very well. Someone with chronic lung disease may be on continuous oxygen therapy and take several medications to help them breathe but still maintain a level of functioning that is acceptable to him. Comfort Only. This is the palliative care or hospice approach to care. This is usually the goal of care when a patient or their designated healthcare decision-maker decides that aggressive treatment no longer has any lasting benefit. The quality of life trumps quantity and the focus becomes comfort rather than cure. This is the beginning of preparing for a comfortable and dignified death. Sometimes these goals of care can coexist. The life-limiting illness may be incurable but another illness can arise which can be easily treated. A person who is on hospice care for incurable cancer may still be treated to cure a urinary tract infection or pneumonia, for example. What Does Quality of Life Mean to You? The quality of life means something different for everyone. It is a very personal decision to make when treatments no longer contribute to the quality of life but actually take away from it. Some people are willing to sacrifice their comfort and enjoyment for the chance to live a few more months, even if that time is spent in the hospital. Others may decide to spend their final months at home with their loved ones, even if it means they may die a bit sooner. There is no "right answer" for everyone, only a "right" answer for you. Plan Ahead — But Be Flexible Establishing a goal of care early on and making your choices known is important. You can use an Advance Directive and appoint a Durable Power of Attorney for Health Care to make decisions for you if you become unable to. Equally important is reassessing that goal as things change. Early on in a serious illness, your goal may be to do everything possible to find a cure. As your illness progresses, that goal may change and you may want to modify any legal documents to reflect those changes. Unfortunately, even with a clear goal in mind, decisions are rarely cut and dry. Difficult healthcare decisions are not made only with our logical minds. Our emotional and spiritual sides have a great impact on making difficult decisions as well, which can sometimes muddle an otherwise clear choice. Difficult decisions are so-called because that is exactly what they are, difficult. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 1 Source Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Lum HD, Sudore RL. Advance Care Planning and Goals of Care Communication in Older Adults with Cardiovascular Disease and Multi-Morbidity. Clin Geriatr Med. 2016;32(2):247–260. doi:10.1016/j.cger.2016.01.011