Copyright © The Regents of the University of California, 2016. 220205
Quality of life differs for each person at the end of life.
What would be most important to you?
Pennsylvania Advance Health Care Directive
Part 2: Make your own health care choices
Your Name
9
AT THE END OF LIFE
Some people are willing to live through a lot for a chance of living longer.
Other people know that certain things would be very hard on their quality of life.
• Those things may make them want to focus on comfort rather than trying to live
as long as possible.
At the end of life, which of these things would be very hard on your quality of life
?
Check as many as you want.
Being in a coma and not able to wake up or talk to my family and friends
Not being able to live without being hooked up to machines
Not being able to think for myself, such as severe dementia
Not being able to feed, bathe, or take care of myself
Not being able to live on my own, such as in a nursing home
Having constant, severe pain or discomfort
Something else
OR, I am willing to live through all of these things for a chance of living longer.
If you want, you can write why you feel this way.
What experiences have you had with serious illness or with someone close to you
who was very sick or dying?
• If you want, you can write down what went well or did not go well, and why.
If you were dying, where would you want to be?
at home in the hospital either I am not sure
What else would be important, such as food, music, pets, or people you want around you?