Certain treatments can help sustain life when you have a serious illness. But as your illness progresses, there may come a time when the treatments are no longer a benefit. You must then decide whether to continue or stop them. It can be hard for you and your loved ones, but know that you're not alone. Your doctor and health care team will guide you through these decisions. They will also help answer any questions you may have.

Life-sustaining treatments help keep you alive if a vital body function fails. These treatments may include cardiopulmonary resuscitation (CPR) and the use of machines to help heart, lung, or kidney to function. They can also include using tubes to deliver food, fluids, blood, and medicines to the body. Blood transfusions and antibiotics are also types of life-sustaining treatments.

These treatments may help extend your life, but not cure your illness. If you are near the end of your life, you may find it hard to handle the side effects and problems that these treatments can cause. In this case, they may be too much of a burden on your body. They may cause more harm than good. They may also disrupt the natural dying process and prolong suffering.

If these treatments are stopped, the focus will shift to comfort care. This involves doing things to control pain and other symptoms you may have. They are not meant to cure your illness or help you live longer. Instead, they are meant to improve your quality of life during the time you have left. If you are in the end stage of your illness, you may be referred to hospice by your doctor. Hospice provides end-of-life care. This includes emotional, spiritual, and social support for you and your loved ones.

Your doctor and health care team will talk with you about the treatments that are part of your care plan. If you want, you may include family and friends in these meetings. Here are some questions to think about or ask your health care team:

• Is there a chance that my illness will improve? Or will it continue to get worse?
• What are my goals of care? Do I want to extend the time I have left? Or do I want to focus my care on comfort and managing symptoms?
• How will stopping or continuing these treatments affect my health? Will they make my comfort and quality of life better? Or will they cause more problems?

Consider your own values or faith. And ask for advice from those who share your values.

Once you've made your decision to continue or stop specific treatments, you can tell your doctor directly. It's best to also put your treatment wishes in writing. Advance directives are legal forms related to health care decisions. Laws about advance directives vary from state to state. Ask your doctor about what forms are needed to make sure your wishes will be followed. Some common forms include:

• A durable power of attorney for health care or a health care proxy form. This form lets you name a person to make treatment decisions for you when you can't. This person is often called a health care proxy, medical or health care power of attorney, or agent.
• A living will. This form tells others the kinds of treatment you want or don't want if you become too ill or injured to speak for yourself.
• Orders for life-sustaining treatments. These are actual doctor's orders that must be followed by other medical providers. The form belongs to you, not to the doctor or hospital. They are legal forms obtained from your doctor or the hospital that document your wishes. The forms are known by different names depending on the state. Common names include:
  • MOLST (medical orders for life-sustaining treatment).
  • POLST (physician orders for life-sustaining treatment).
  • MOST (medical orders for scope of treatment).
  • POST (physician orders for scope of treatment).
  • TPOPP (transportable physician orders for patient preferences).

Keep in mind that you can change or cancel an advance directive at any time. Make it a practice to review your decisions each time there is a change in your health or goals of care. Also, be sure to tell your health care proxy and loved ones of any changes in your decisions.

The decision to stop treatment is best made with the person's consent. But the person may not be capable of making decisions and has no advance directive. Then the decision falls to their health care proxy or another adult. If you need to make a decision about stopping treatment for a loved one, start by talking with their doctor. Review the goals of care and the benefits and burdens of treatments on your loved one's health. Also think about your loved one's wishes and values. If needed, seek advice from other health care team members, like a social worker or spiritual adviser.