When you learn that you have an illness that is probably going to shorten your life, your doctor may talk to you about receiving care that will help you stay comfortable without prolonging your life. Your doctor may also talk to you about your desire to be revived (resuscitated) when your illness reaches its last stages and your heart and breathing stop.

CPR

If you choose to receive CPR when your breathing or heart stops, someone will push air into your mouth and push down very hard on your chest with their hands. CPR stands for cardiopulmonary resuscitation. If you are in the hospital when your breathing or heart stops, a team of doctors, nurses, and others will respond.

In the hospital, the team may use a device called a defibrillator to apply an electrical shock to your heart. The shock may restart your heart. You may also get medicine—through your vein (I.V.) or down a breathing tube—to help your heart beat again.

Life support

After CPR has been started, you will be connected to a machine called a ventilator or respirator. A tube is placed down your throat and then connected to the ventilator. The ventilator pumps oxygen through the tube into your lungs. Being placed on a ventilator is referred to as "being put on life support."

When a person's heart stops, CPR may work to start it again but often only for a short time.

But CPR, life support, or both may work for some people. If you are generally healthy, CPR and life support may offer you the chance to return to your normal activities.

Even when a person has a long-term fatal illness, death can happen suddenly. If you choose to have CPR and life support, you may be able to live a little longer—sometimes a few hours, or even a few days or more.

If you are very ill, you may feel that CPR would just prolong the dying process. On the other hand, if you feel that you need to do everything you can to live in spite of the limits caused by your illness, you may choose CPR.

• CPR doesn't always work to resuscitate people, or "bring them back." And the older and sicker you are, the less likely it is to work.
• Pressing on the chest during CPR often breaks the person's ribs.
• People who do survive after their heart has stopped may have brain damage. This can affect your ability to talk, recognize loved ones, dress yourself, or manage your bathroom needs.
• With CPR and life support, you may live longer than you would without life support. But your remaining time may be spent in a hospital connected to machines.
• If you don't make your wishes known, your doctor and loved ones may face some tough decisions. In an emergency, you would probably receive CPR. Then you could be placed on life support, even if you didn't want it. Your doctor and family may have a hard time deciding how to continue your medical care. Also, it may be very hard for your loved ones to decide when to stop life support.

If you do not want to have CPR and life support, make it very clear to your doctor and family.

Many states require a doctor's order to release paramedics and others from their duty to start CPR. Ask your doctor about a "Do Not Resuscitate" order.

Be specific about your wishes. Share your feelings about not wanting to prolong your life. This time can be a chance to share memories, nurture your relationships with others, and say good-bye. If your death happens quickly and unexpectedly, your family may feel assured that you received the medical care you wanted.

An advance directive is your personal statement of how medical care choices should be made and who should make them if you become unable to speak for yourself. A medical power of attorney, which appoints someone to make treatment decisions for you, and a living will, which describes how you want to be cared for at the end of your life, are types of advance directives.

You can also write an advance directive for a Do Not Resuscitate (DNR) order. It tells hospital workers that you don't want CPR if your heart stops or you stop breathing. Your doctor can put the DNR order on your medical chart for everyone to see.