If you understand how specific treatments may affect your quality of life, you can decide which ones you'd choose or refuse. You may want to talk to your doctor about the possible benefits and risks of treatments. The chance of good results from these therapies varies based on each individual clinical situation. They can be very hard to predict. Medical treatment, if your life is in danger, falls into three main categories.

• This care keeps your heart and lungs going when they can no longer work on their own.
• CPR is a resuscitation measure that may restart your heart and lungs if they stop working.
• A respirator (or ventilator) is a machine you are connected to that delivers oxygen and keeps you breathing. Air is pumped into your lungs through a tube that's put into your windpipe.

• This care may keep you alive longer when you have an illness that can't be cured (terminal).
• Tube feeding or TPN (total parenteral nutrition) provides food and fluids through a tube or I.V. (intravenous). It is given if you can't chew or swallow on your own.
• Dialysis is a kidney machine that cleans your blood when your kidneys can no longer work on their own.

• This care controls pain and discomfort, such as nausea or trouble breathing. This type of care is not designed to prolong your life, but to enhance comfort and quality of life. Nothing is done to keep you alive longer.
• Hospice care is comfort care. It might provide food and fluids by mouth or help with bathing. Hospice care is given during the last stages of a terminal illness.
• Strong pain medicine can be given to help keep you comfortable.

Would you want CPR if your heart stops while you're a patient in a hospital or nursing home? If not, talk to your doctor about issuing a DNR (Do-Not-Resuscitate) order.

DNRs and advance directives may not apply during anesthesia, in emergency rooms, or when emergency medical teams respond to a 911 call unless DNR has been documented in your medical records. Also, a DNR will not prevent you from getting other kinds of needed medical care, such as treatment for pain, or bleeding. Ask your doctor how you can make sure your wishes will be followed. Talk to your doctor about completing a POLST form, which may have different names depending on the state in which you live. POLST stands for portable medical orders and is designed to honor your wishes in all settings from home to when you are out in your community. For more information about POLST, see the National POLST website at www.polst.org.