There is a range of medical care available that can prolong life for people in the end stages of an illness. When and whether to use these measures depends on the type of medical care the person has specified. Or, if they have not left directions, the best decision based on the person's values and desires. The following are some of the measures that commonly need to be addressed.

Cardiopulmonary Resuscitation, or CPR, is a group of treatments used to restore function when a person's heart and/or breathing stops. 

CPR:

• May be painful and traumatic for the person.
• May leave the person in a worse condition.
• May not prolong life.
• Many experts do not recommend it when a person is in the end stages of an illness, and individuals often do not want to make such decisions when they are able to.

A "Do not resuscitate" (DNR) or “Do not attempt resuscitation” (DNAR) order tells medical professionals not to perform CPR if the person's breathing or heartbeat stops.

Feeding tubes are sometimes suggested if a person has a hard time eating or swallowing, which is common in the late stage of dementia. Tube feeding has not been proven to benefit or extend life. It may result in infections and can be uncomfortable for the person. However, sometimes, it is considered for a fixed time period. Talk to your healthcare team about any specific plans for the use of feeding tubes.

Intravenous (IV) hydration is liquid given to a person through a needle in a vein. Not being hydrated or having enough fluid in your body is a normal part of the dying process. It allows for a more comfortable death over a period of days. Using IV hydration can draw out the dying process longer. It may also burden the person physically. If IV use is being considered, there should be specific goals, with a limited time period that you and the health-care team agree to.

Antibiotics may be prescribed for common infections but may not improve the person's condition.

Source: Arcand & SPA-LTCteam(2020). Comfort Care at the End-of-Life for Persons with Alzheimer's Disease or other Degenerative Diseases of the Brain(Accessed May 24, 2024 https://spaltc.ca/wp-content/uploads/2022/02/ComfortCareBooklet_EN.pdf

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Clinical ethicist Gary Goldsand discusses the most common ethical decisions friends or family members may have to make at the end of life and explains the concept of a “good death.”

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