What You Should Know When Making End-of-Life Decisions

Making end-of-life decisions for another person can be extremely difficult, even if you have the full legal power to do so. Experts who guide people in these choices often suggest this exercise: Imagine the person standing next to you, looking down at himself or herself in bed. What do you think he or she would want to have happen? Can you recall anything he or she once said about a friend or relative in similar straits? Which did he or she seem to prize more: life itself or quality of life?

If you have power of attorney for healthcare decisions, be prepared for these tough choices:

Whether to authorize (or refuse) a particular treatment

  • Feeding tube

  • Oxygen or other breathing assistance

  • Pain medication

  • Hospice care

Whether to authorize (or refuse) the withdrawal of a particular treatment

  • Feeding tube

  • Catheters

  • Medications

  • Life support

Paula Spencer Scott

Paula Spencer Scott is the author of Surviving Alzheimer's: Practical Tips and Soul-Saving Wisdom for Caregivers and much of the Alzheimer's and caregiving content on Caring. See full bio

almost 4 years, said...

I am in the same similar situation. My mom needs full total care.nshe is starting to sleep more and is having a hard time swallowing at times. I sold for an hour tonight giving her a bite of food and a drink of water afterwards to get it down. My brother insists on us keeping her a live as long possible. She know life she doesn't even know who I am. I know mother would not want to live like this because she doesn't want a feeding tube or anything. My heart breaks everytime I have to do this. I wish my brother would let her go because that is what she would want. She still is at home. I've had to give up time with my family to help take care of her and I don't think she would want this. How do you tell a person enough is enough.

about 4 years, said...

My parents made those decisions them selves with advanced directives. Dad passed 2 years ago and it was a blessing for him. He was not happy and in a constant state of depression. A fall made that decision and though he had some dementia, he was quite with it at times and we spoke just a few hours before he passed. Mom on the other has late stage alzheimers but is happy, happy, happy. I've been her primary care giver for the last 5 years and have been over seeing everything for some 13 years. She is dependent for all care, I have pulled all non essential medications and has just thrived. I had hospice here but due to the lack of decline have exited. I WILL follow there directive to the tee... as it is about what they wanted and expected not what I want and need... Again, peace, love and hugs to everyone of us in this situation.... Roger

over 4 years, said...

We've been on this road for 10 years. My moms wishes were not to be here at this point. She is non-interactive and relies on us for all daily life chores. So not inserting a feeding tube is a no brainer, my quandary is if / when to stop feeding. She is still chewing, and we feed her all meals. I just started thinking the next step is baby food and drink thickeners and I am wondering WHY go there if the next step is a tube.

over 5 years, said...

Thank you for sending me an email reminder about this deeply sad subject. My mother has been in a stable state for 20 months now, but needs to be fed pureed food, given all her drinks and medications, she can't walk or stand up and has to be hoisted out of bed, into wheelchairs and other chairs and can't be left alone during the day. She is turned every few hours at night as she can't move herself and is doubly incontinent. Mercifully she is quite calm and generally happy. I'm not sure what I will do when faced with all the issues mentioned. My mother is still "herself" in essence but is really like a small baby, dependent on everyone for everything. She has very little speech or understanding left and often sleeps most of the day and night but then rallies and is quite bright. But I know that God knows the time allotted for her to die and I am praying that we as a family will know the best way for her to die peacefully. Th tube feeding etc can be really distressing, and was for my aunt and father-in-law but I hope my Mum dies peacefully in her sleep and does not have to endure all this.

over 5 years, said...

This article was very brief and to the point but very good. The question: Which did he or she seem to prize more: life itself or quality of life? is particularly helpful to consider when faced with these awful decisions. Thank you for being such a good resource for us.

over 6 years, said...

This is very helpful because it has forced me to face decisions that I and my sister will have to make fairly soon. At the moment our mother, who is suffering from end stage alzheimer's with vascular dementia, is in a stable happy condition but because of her heart condition, she is quite likely to suffer another vascular mini stroke at any time. She has had dementia for at least 8 years and has been in a care home for nearly 3 years. We have lost our mum in reality but now and again, she is still the same lovely person.