Questions for your doctor

Doctor, what is the long term prognosis (future clinical condition) like?

Knowing the future of a critically ill patient will help families make decisions in terms of planning for care, expenses and helping the patient with their wishes. This first step of honest communication can go a long way in establishing a good support system for the patient’s needs. Palliative care specialists and clinical psychologists are well trained to do this.

 

How do you arrive at this conclusion doctor? “How can you predict the future?”

Well, no one can with absolute certainty. However, as doctors, we can predict immediate events like:

  • The patient may require ventilatory support/ critical care and life support

  • “In present times, the chances of the patient’s survival are… (days to weeks/ weeks to months/ months to years)”

The doctor will use clinical experience with the present scientific data on the medical condition to assess how critical the patient is.

 

What are the medical options available for my patient/ for me?

Please understand the medical condition of the patient and the medical options available before taking a decision. The challenge is not to rush into a decision and not delay it for too long. Caring for a critical patient can be stressful, and we do not function well under stress. Please ensure that the existing medical options are understood by the key decision makers before taking the decision. Understanding the risks and benefits helps in making the best decision for the patient. Remember, medicine is an art and a science- the doctors can do their best if they are at ease and they know that the patient’s team is backing them up to do their best.

 

Should my loved one be put on a ventilator/ life support?

Life support is a very valuable tool in critical care- it has helped save many lives. However, if a patient is actively dying, even a ventilator/life support option does not help. It is called “futile care”. We know death is inevitable- and in patients who are actively dying (see next), the ventilator/ life support becomes a sore issue because of some common events:

  • The patient spends his or her last days isolated from loved ones

  • There is a huge financial burden that it may impose on patients and families

  • Having a loved one on life support/ ventilator can be mentally stressful

 

What is active dying?

A patient in the last days of life is said to be actively dying. It is an irreversible process, and it is natural.

It is not a medical event that can be corrected by “treatment” or “medicines” or “surgery”.

 

What does palliative care mean?

Palliative care specialised care given to a person and the family of the person who is suffering from a serious illness. Palliative care concentrates on preventing and alleviating suffering, improving the quality of life and helping the patient and the family cope with the stress and the burden of illness. A patient can be provided with palliative care at home or in a hospital or even at a care facility. Involving palliative care teams early helps to plan the overall care of the patient better and improve the patient’s quality of life and reduce suffering.

 

What does end of life care mean?

Care can be received by patients at any time and at any stage of an illness. Patients with advanced and incurable illnesses should receive high quality care measures like pain relief, reducing physical suffering etc. This can be done by a trained general physician, or a team at home or by a specialist palliative care team in a hospital depending on the needs of the patient.

Frequently asked questions

 

What is the purpose of this website? 

The purpose of One Little Wish is to encourage conversations amongst people about end-of-life care, to provide them with information regarding palliative care and also to get them acquainted with our ongoing efforts to get a legal framework put into place which will give people legitimate rights when it comes to making decisions about their last days.

 

Why should I talk about dying? Isn't it morbid?

We understand that talking about death might not be an easy conversation to have. Yet, it is an important and inevitable part of our lives. It's necessary to have these conversations with our loved ones because what is difficult today might ease the pain tomorrow. It could be a family member or perhaps a good friend; just have a conversation, make them aware about your thoughts and opinions, and listen to theirs. Because it's only by talking that we will be able to know each other's wishes and honour them when the time comes.

 

What are the topics to cover while having the talk?
Mentioned below are a few topics you can talk about.

  • Where would you wish to be when the final time is approaching?

  • Who are the people you would want around you for support?

  • What kind of medical assistance do you wish/not wish to have?