Advance Care Planning Glossary
Artificial ventilation is the mechanical technique of breathing for patients unable to breathe on their own. This requires a tube to be inserted through the nose or the mouth into the trachea (windpipe). The patient will be unable to speak, eat or drink. If artificial ventilation is necessary for more than two weeks, a tracheotomy often is required. A tracheotomy is an incision through the neck into the trachea into which a tube is inserted. The tube can be used for both artificial ventilation and to suction fluids which might interfere with breathing. A ventilator is a machine that artificially controls or assists respirations (breathing) when patients are unable to breathe adequately on their own.
Brain death is the absence of all brain activity. When this occurs, the patient cannot recover and is considered legally dead, even though other vital organs may continue to function.
Cardiopulmonary resuscitation (CPR): If your heart stopped beating (cardiac arrest), you would die within a very few minutes unless immediate action is taken. CPR was developed to help the heart begin to function again. It generally consists of chest compression, artificial ventilation, medication and electrical shocks to the heart.
Hydration and nutrition: If you are unable to take liquid or food by mouth, or if you are unable to digest your food properly, you may receive fluids and/or nutrition by one or more of the following techniques:
- Intravenous (IV): IV solutions are used to provide you with fluid, vitamins, salts, minerals and medication. A small tube is inserted into a vein in your arm or hand. The amount of calories that you can receive through this method is not enough to keep you alive for long periods of time.
- Total parenteral nutrition (TPN): TPN is a special IV solution containing enough vitamins, salts, minerals and adequate calories to sustain life. This technique requires a special IV line, different from that described above, and is generally used in situations when you are unable to take food by mouth or digest it properly.
- Tube feeding: Liquid food can be given through a variety of tubes inserted into the stomach of a patient capable of digesting food. A nasogastric or feeding tube may be inserted through your nose into your stomach. If you need to be fed artificially for a long time, a special tube may be surgically inserted into the stomach.
No Code – Do Not Resuscitate (DNR) is an order written and signed by the physician instructing staff not to begin CPR or another life-sustaining treatment if the person’s heart or respirations (cardiac or respiratory arrest) have stopped. This order is usually written when someone is terminally ill or near death. Only a physician can authorize a No Code or Do Not Resuscitate order. Before a physician authorizes such an order, he/she will discuss with the patient and/or family the situation and terminal condition.
Supportive Care is providing for the comfort and dignity of the patient whatever decisions are made concerning life-sustaining treatments. Appropriate medical and nursing care will be continued to provide comfort, hygiene and dignity, but not to prolong life. The use of medications, with the intention of easing pain, is permissible even if the medication may hasten death.
Terminal illness is the end stage of a disease process, injury or illness that is incurable, irreversible and will result in death within a foreseeable, but uncertain, time period.