- No single word responses (at least 70+ words in each response)
- Give the questions some thought and answer honestly
- What will be important to you when you are dying? (2 points)
- How do you feel about the use of life sustaining measures in the face of terminal illness? Permanent coma? Irreversible chronic illness, such as Alzheimer’s disease? (2 points)
- Do you have strong feelings about particular medical procedures? Some procedures to think about include: mechanical breathing (respirator), cardiopulmonary resuscitation (CPR), artificial nutrition and hydration, hospital intensive care, pain relief medication, chemo or radiation therapy and surgery. (2 points)
- What limitations to your physical and mental health would affect the health care decisions you would make? (2 points)
- Would you want to be placed in a nursing home if your condition warranted? (2 points)
- Would you want to have financial matters taken into account when treatment decisions you would make? (2 points)
- Would you prefer hospice care with the goal of keeping you comfortable in your home during the final period of your life, as an alternative to hospitalization? (2 points)
- In general, do you wish to participate or share in making decisions about your health care and treatment? (2 points)
- Would you always want to know the truth about your condition, treatment options and the chance of success of treatments? (2 points)
