The goal of comfort care is to improve the quality of life of seriously ill people and their loved ones.
The person is kept comfortable by controlling pain and other sources of distress.
Kōkua Mau believes that care when you are seriously ill should be compassionate and should help with your emotional and spiritual needs, as well as controlling pain and treating physical problems (such as shortness of breath, constipation, nausea or skin problems).
The goal of comfort care is to give the best quality of life for the person and family during the time of illness, dying, and grieving.
If your goal is quality of life, comfort care can help you and your loved ones. It can be added to your medical care plan early in the course of serious illness rather than waiting until the very end. As part of your medical care plan you may also be making decisions about CPR, artificial nutrition and hydration, and dialysis. Comfort care does not mean “no treatment”.
Questions you may want to think about:
- How can I get comfort care?
- When should I begin comfort care?
- Who offers comfort care?
- What will comfort care give me?
- Will I still get any medications for pain?
- Will I be able to stay at home?
Medical Conditions Associated with Serious Illness
Despite medical advances, the goals of medicine – curing disease, restoring health, and relieving symptoms – do not always happen. People with the following conditions may be kept alive for months and years by machines and measures that extend life, but will never get well. While comfort care may not extend life, the quality of life is improved to the best extent possible and is a choice you may want to discuss with your doctor.
Advanced Cancer
Common problems in people with advanced cancer include nausea, weakness, weight loss, pain, and breathlessness.
Advanced Heart or Lung Disease
Over time such conditions progress to the point that a person with chronic lung disease becomes dependent on oxygen for minimal physical activity or even rest. Shortness of breath becomes nearly constant with difficulty talking, swallowing, and sleeping. Failure of the heart also results in shortness of breath, inability to perform physical activities, and fluid retention.
Dementia
Dementias such as Alzheimer’s Disease involve a slow and permanent loss of mental abilities, such as talking, making decisions, and thinking. In end-stage dementia, people are completely dependent on others. They become unable to speak, walk, or move and unable to control bowel and bladder functions; they have less appetite and trouble swallowing and eating and they do not recognize loved ones.
Persistent Vegetative State (PVS)
People with PVS are not aware and cannot interact with the world around them. People may have open eyes, yawn and appear to sleep but they have very little brain activity and are capable only of involuntary and reflex movements. To confirm someone has PVS requires many tests that take several months. Unlike people with other types of coma, persons in PVS never become aware or get better. People in PVS have no awareness of hunger, thirst, or pain.
Questions you may want to think about:
- What will comfort care offer in these conditions?
- Would I want life support to extend my life under these conditions?
- Who should I talk to about my wishes?
- What are the benefits and problems of aggressive medical
procedures for people with these conditions? - How do I know when comfort care is better than aggressive
medical treatments?
Our 16-page booklet “A Guide to Advance Care Planning: Making Life Decisions” by Kōkua Mau is designed to help you make informed advance care planning decisions for when you are seriously ill. More here