Who Decides? You do…
It is best to make your wishes known to your loved ones before
the stress of an illness or hospitalization occurs. However, if you
become ill, you are the decision-maker with the support of your family
and the health care team.
If you become unable to express your health care wishes, an Advance
Directive can communicate on your behalf. An Advance Directive can take
two forms: an explanation of your wishes written on paper; or a proxy
directive, which explains who will convey your wishes to the health care
team. They can be difficult to write precisely – we can suggest some
resources freely available on the World Wide Web. One good place to
start is: http://www.advancecareplanning.ca/
If you do not write anything down, try to have some open discussions
with those who will be your decision makers if you are too ill to make
them for yourself. There is a legal framework in Ontario to decide who
makes health care decisions on behalf of another – it's all in the
Health Care Consent Act. You can appoint a specific Power of Attorney
for Personal Care – the Act recognizes this. We can give you more
information if you wish.
Plan for End of Life Care
It rarely feels like the right time to talk about end of life
plans, but the best time is when there's no crisis. We should all
discuss our end of life care plan with our loved ones and our health
care providers.
These are tough conversations that take a lot of thinking and some
courage. Let your family, friends and caregivers support you. Discuss
your wishes in the event that a decision needs to be made pertaining to
your end of life care.
What is CPR?
Cardiopulmonary Resuscitation (CPR) is an emergency procedure
that is done when a person stops breathing or their heart stops beating.
It includes mouth-to-mouth breathing (artificial respiration) and chest
compressions to manually restart heart pumping from outside of the body
(artificial circulation).
In the hospital, CPR may lead to other treatments, such as medication
or electric shock (defibrillation) to restart the heart, and tubes or
machines (intubation) to help a person breathe. If successful, CPR
restores both breathing and heartbeat.
Does CPR Work?
CPR was intended for use in emergency situations to treat
sudden, unexpected death in otherwise healthy people due to heart attack
or drowning.
CPR was not intended for people who are terminally ill, who have very
complex diseases or those with progressive degenerative diseases. There
is little evidence that CPR will benefit these people.
Talk with your family and health care team about your feelings toward
CPR. Ask your health care team about your condition and whether CPR
would be a suitable treatment for you.
Make your Wishes Known
A "No CPR" order means that if no signs of life are present,
nature is allowed to take its course and no medical intervention is made
in an effort to prolong the person's life.
Should you request a "No CPR" order, full medical, nursing and
supportive care will continue during your stay to ensure you are kept
comfortable and without pain or other unpleasant symptoms. In addition,
some lab work and tests may continue to be done to monitor and determine
whether or not there are any further treatment needs and/or options.
If further treatment options become available you can always change your mind or cancel the "No CPR" order at any time.