After a Stroke: Navigating End-of-Life Planning and Care

There’s no way around the fact that a stroke is a life-threatening event. A stroke occurs when there’s an interruption of blood flow in your brain, depriving your brain of essential nutrients and oxygen. Depending on the extent of the stroke and how quickly you receive treatment, a stroke may cause significant brain damage.

Having a stroke can affect your lifespan. In fact, stroke remains the fifth leading cause of death in the United States. While we always hope for a full recovery, you and your loved ones should also know how to prepare for the worst. Here’s what you need to know about end-of-life planning and care.

Prepare your paperwork

If you are in a position where you’re unable to make decisions for yourself, your caregivers will have many decisions to make on your behalf, such as choosing a care setting and whether to pursue life-extending treatments. There are a couple of forms that help you retain control over your medical care and specify what types of treatments you want if you become seriously ill. These forms can assist with treatment planning:

• Advance directive: This legal document helps guide your care team and loved ones should you become unable to make decisions about your medical care. You typically prepare an advance directive with a lawyer while you’re healthy. There are two types of advance directives:
  • Living will: This document provides instructions for your medical team about what kinds of treatments you want or don’t want and under what conditions.
  • Durable power of attorney for healthcare: This document names a person who can make healthcare decisions for you if you’re unable to make them on your own. You can choose this person, called a proxy, instead of or along with a living will.
• Physician Orders for Life-Sustaining Treatment (POLST) form: A POLST form is a written medical order that provides guidance for your healthcare team about several specific medical decisions. You and your doctor should discuss the form together so that your doctor can explain how the options in the form relate to your medical needs. The POLST form should go with you to whatever healthcare setting you are in, be it the hospital, assisted living or a nursing home. A POLST is an important document, but it is not a replacement for an advance directive or living will.

End-of-life care options

Your advance directive helps provide guidance about the type of care you want and in what setting. It’s important to know what your care options if you are severely ill.

• Palliative care: This is a specialized type of medical care for people with serious illnesses. Palliative care focuses on improving your quality of life and managing symptoms. You may also receive treatments intended to help you recover or extend your lifespan. You may receive palliative care in a hospital, nursing home, other extended care facility or at home.
• Hospice care: Hospice care may be the best option if it’s not possible to cure your illness or if you do not want to continue treatment. You may qualify for hospice care if your medical provider determines that you have six months or less left to live. You receive care designed to make you as comfortable as possible but do not receive treatments intended to cure your illness or extend your lifespan. Hospice care may be available in a nursing home, hospital, hospice center or at home.

Speak with your doctor about your care options and preferences. They can help you understand your chances of recovery and what resources are available to you.