Table 3 Values clarification exercise
Select the most important items (up to 5) “My loved one might consider stopping treatment to extend life (and choose comfort measures only) if, for a few months or more, they …” | |
|---|---|
Were not able to talk, but could still engage in non-verbal communication | ☐ |
Had difficulty thinking of words or understanding others | ☐ |
Were not able to breathe without the help of a machine | ☐ |
Were not able to participate in important hobbies, social, or religious activities | ☐ |
Had difficulty thinking clearly or making decisions (e.g. needed help managing finances) | ☐ |
Needed help from another person to eat, bathe, or take care of basic bathroom needs | ☐ |
Were not able to live on their own or take care of themselves | ☐ |
Needed a walker or wheelchair to move around | ☐ |
Had to stay in bed constantly | ☐ |
Needed a feeding tube to get nutrition | ☐ |
Had a lot of discomfort or pain | ☐ |
Had to stay in a nursing home or rehabilitation facility | ☐ |
Could not move one side of their body | ☐ |