Videos: How patient education promotes VA’s life-sustaining treatment decisions

Veterans have the right to plan for their VA health care. Having these patient education discussions with your care team about your care preferences is important in case you lose the ability to communicate your preferences during a future care event. If you have a serious illness, knowing the specifics about certain types of life-sustaining treatments can help you clearly identify and communicate your preferences.

You can learn about specific life-sustaining treatments, including CPR, mechanical ventilation, dialysis and feeding tubes in a new five-part educational video series. Each video in this series provides an overview of the treatment with simple, visual imagery to increase understanding, and another video introduces Veterans with serious illnesses on how to set and align their treatment plans with goals.

Each of these videos was developed with input from VA doctors who specialize in helping Veterans make decisions about treatments. Watching these videos does not replace a conversation with a health care provider, but rather supports ongoing discussion about what matters most to you and your treatment preferences.

Setting health care goals

If you have a serious illness, or are at risk for developing one, it’s important to consider what matters most to you. Different people want different things and what matters to you should guide your health care.

Cardiopulmonary Resuscitation (CPR)

When the heart stops, it’s called a cardiac arrest. A person’s heart and breathing can stop as an expected part of the dying process, or it can happen unexpectedly, like in an emergency. CPR has several steps and each step has an important role to play in trying to restart your heart and breathing.

Feeding Tubes

A feeding tube is sometimes used if you have a serious health problem that keeps you from swallowing or from eating enough to get proper nutrition. A feeding tube can deliver nutrition, fluids and medications directly into your stomach or intestines.

Dialysis

Kidneys remove waste products from your blood. If they fail, you may start having symptoms that make you sick. Dialysis can help to filter your blood, help your body to get rid of extra fluid, and may help you to feel better.

Mechanical Ventilation

If you have trouble breathing, it could lead to respiratory failure, where your lungs can’t keep up with the hard work your body is performing. If this happens, you have two choices about mechanical ventilation treatment: non-invasive and invasive. With non-invasive mechanical ventilation, a machine pushes air through a mask that you wear over your nose and mouth. With invasive mechanical ventilation, a machine called a ventilator is used to push oxygen through a tube into your lungs.

Your doctor and health care team may share these videos with you at a clinical appointment or they may send them to you in advance of a scheduled appointment to introduce the treatments they would like to discuss with you.

For questions related to the Life-Sustaining Treatment Decisions Initiative, please contact the National Center for Ethics in Health Care at vhaethics@va.gov.

Several people from the Gulf Coast Veterans Health Care System, VHA Innovators Network, National Center for Ethics in Health Care, and the VHA Employee Education System contributed to this story.