Choices at the End of Life

by Judy Horvath

Of one thing every one of us can be sure, our life as we know it on earth will eventually end. How the end comes, of course, is not usually our choice. Most of us will have the opportunity to make certain choices to determine how our end of life will be. Recently, reading about the lady “Sweetie” who is 106 and continues to root for her beloved Warriors, inspires all of us to make good life choices.

We all have some of those choices to make and to make them sooner rather than later is definitely a plus. There are policies and procedures that we can all put into place to make sure our wishes are followed. There are Advanced Directives that detail how we want our end to take place, and our thoughts on machines and how much usage of those machines we wish to make. These Advance Directives must be made available to the medical personnel. A website will walk you through all of the steps in advanced care planning.

There are also other avenues out there that we can make use of. Each of our Physicians in California should have access to the POLST (Physician’s Order for Life Sustaining Treatment) Document. In this two page document each person can detail their wishes for their end of life care. Each person needs to fill this out and sign it and have their physician sign it as well as a witness. This then becomes an active Physician’s Order on end of life treatments, including the various resuscitation measures, how much or how little, artificial nutrition for various periods of time, signature of both physician, patient or legally recognized decision maker. You can ask your physician about this or download the form,


There are also other choices on types of care selected once a patient is diagnosed with a life limiting illness such as cancer, COPD, Dementia, CHF, or Failure to Thrive.

  • The patient may choose to have full medical treatment for each of these diseases.
  • The patient may choose to have Palliative Care or Comfort Care, forgoing some of the more difficult medical treatments. The patient may still choose to continue to have curative treatment. (Ask your physician about this avenue.)
  • The patient may choose to have Hospice Care if there are six months or less of life expectancy. The patient chooses to forego curative treatment. If they outlive this time period they can be readmitted to Hospice Care or can be graduated from Hospice Care.


Judy Horvath, CSA, Certified Senior Advisor, is the Founder/Director of Tender Heart Home Care. They would be happy to assist with any needs for Seniors. Tender Heart is an In-Home Caregiver Referral Agency established in 2003 and headquartered in San Ramon. Please call 925 838 4444 or visit website for further information.