• Are you at home, or in the hospital?
• Is your family with you?
• Are you trying to keep working?
• Is being physically active most important to you?
• Is being in bed most of the day acceptable to you?
• Would you be willing to live in a nursing home?

• Who will you want to be with you? 
• Is being out of pain important? 
• Is being able to talk with family and friends most important? 
• Is being home your priority, or is being in the hospital acceptable? 
• Are there any cultural or religious needs that will be important for you at the end of your life? 
• How would you like to be remembered? What stories, recipes, values, or hopes do you want to give to others?

Use this short worksheet to write down your answers or talk through them with loved ones. It’s a great way to start a conversation with your family, friends, or healthcare team.

View the Values Worksheet (PDF) »

CPR may be used when your heart or breathing stops. Below is an overview of what CPR is, how it may help, and what to consider if you choose not to have it.

What it is
Providers may try cardiopulmonary resuscitation (CPR) when your heart or breathing stops. CPR includes deep pushing on your chest to keep the blood flowing through your body. CPR also includes the use of a breathing tube in your windpipe to help get oxygen into your body. Electric shocks to the heart or medications may also be used.

How might CPR help?
If CPR is successful, you may return to the health you were at before your heart or breathing stopped. CPR works best if your body is healthy and if CPR is started right after your heart stops. CPR is less likely to be successful if you are weak, elderly or have a chronic illness.

How might CPR cause harm?
Even if CPR is successful, you may experience complications including:

• You might need a breathing machine (ventilator) because of weakened lungs.
• You might have broken ribs from the chest compressions.
• You might have brain damage if your brain did not get enough oxygen while you were unconscious.
   

What if I choose not to have CPR?
If your heart or breathing stops and you do not receive CPR, you will die naturally.

A ventilator may be used when an illness or condition makes it difficult or impossible to breathe on your own. This section explains what it is, when it may help and what to consider if you decline this option.

What it is
A physical condition or illness may make breathing on your own difficult or impossible. If you have a breathing problem, your choices may include:

• Taking medicine
• Inhaling oxygen through a tube in your nose or mask over your mouth
• Being put on a machine (ventilator)

Ventilators push a mixture of air and oxygen in and out of your lungs. The machine connects to a tube that goes through your mouth and down your windpipe at the back of your throat. When the tube is in place, you cannot talk or swallow. You will receive medicine to help stay calm when the tube is in place.

When might a ventilator help?
 A ventilator works best if you:

• Have a breathing problem that can be cured
• Need help with breathing for a short time while recovering from surgery or a sudden illness

When might a ventilator not work well?
 A ventilator machine will not work as well if:

• Your illness cannot be cured
• Your body is not able to tolerate the high-pressure flow of the oxygen in and out of your lungs

What if I choose not to have a ventilator?
If you are not able to breathe on your own and decide you do not want a ventilator, you will die naturally. If this is your choice, you will still get other medical care you need. Other treatments can keep you comfortable, manage pain and control symptoms.

Tube feeding may be used when you have trouble eating or swallowing. This section describes what it involves, how it may help, and possible risks.

What it is
Artificial nutrition and hydration is a treatment to provide food and water when you have difficulty swallowing or are too sick to eat on your own. It is also known as tube feeding.

The options for feeding tubes are:

• An NG tube, which is placed into your nose and goes to your stomach
• A PEG tube, which goes directly into your stomach through your skin

How might a feeding tube help?
A feeding tube might help in some cases (such as a stroke) where swallowing is affected. The tube might be inserted temporarily if recovery is expected. If it is expected that the ability to swallow will not improve enough to return to normal eating and drinking, the tube may be placed permanently.

How might a feeding tube cause harm?
Some potential side effects of tube feeding:

• Inserting the tubes can be uncomfortable, and the tubes may need to be replaced from time to time
• Tube feeding can cause stomach distension and discomfort, and too much fluid in the body

What if I choose not to have a feeding tube?
If you can swallow, you will be fed carefully with a spoon. If you cannot swallow, moist swabs will be used to help if dry mouth occurs. Most people near death do not feel hunger or thirst. You also will still get other medical care you need. Other treatments can keep you comfortable, manage pain and control symptoms.

Dialysis may be used if your kidneys stop working. This section outlines what it does, when it helps and what to expect if you do not choose it.

What it is
Dialysis is used when your kidneys are no longer working. Dialysis helps to remove toxins and extra fluid that can build up when your kidneys don’t work. It usually requires being connected to a machine for several hours, multiple times per week. During dialysis, blood is slowly pumped out of the body, filtered by the machine, and then pumped back into the body.

How might dialysis help?
The potential benefits of dialysis include the possibility of living longer, feeling better, and being more mentally alert. For many people, especially for older and sicker people, dialysis is likely to be a lifelong treatment.

How might dialysis cause harm?
Dialysis cannot completely replace normal kidney function, so some people with kidney failure on dialysis may still feel sick and tired. In older people, especially those with other serious conditions, dialysis may not even help them to live longer.

What if I do not want dialysis?
If your kidneys are no longer working and you do not get dialysis, you will die naturally. If this is your choice, you will still get other medical care you need. Other treatments can keep you comfortable, manage pain and control symptoms.