Advance Care Planning—Glossary of Terms

Here you can quickly access medical terms and definitions through an alphabetized listing.

A

Advance care planning (ACP)

Advance care planning is a process by which you can remain actively involved in your own healthcare should you become unable to speak or make decisions for yourself.

This process can include:

  1. Choosing your health care proxy or decision maker
  2. Identifying your values regarding health care
  3. Having a conversation about these values with your loved one’s/ health care proxy
  4. Completing an advance directive
  5. Giving your Wishes to your Primary Care Physician (PCP) and your health care proxy
The process results in the completion of an advance directive.

Advance directive (AD)

A formal document that is the result of advance care planning process. Physicians use it to guide treatment if a person becomes incapacitated and cannot make an informed decision that gives instructions about future medical care. The term “advance directive” basically encompasses both “living wills” and “medical powers of attorney.”
Each state regulates the use of advance directives differently.

Artificial nutrition and hydration or "tube feeding"

Artificial nutrition and hydration are used to either supplement or replace ordinary food and drink. It is when food or drink are given through an intravenous (IV) tube placed directly into the stomach, the upper intestine or a vein. If a patient chooses not to have IV fluids, food and fluids are offered as tolerated using careful hand feeding.

C

Capacity

Capacity refers to the ability of a person to take in information, understand its meaning and make an informed decision using the information. Capacity can vary by task. The capacity to choose a trusted individual as an appropriate health care agent differs from the capacity to agree to a medical procedure or treatment.

Comfort measures

Comfort measures are medical care and treatment provided with the primary goal of relieving pain and other symptoms and reducing suffering. Reasonable measures will be made to offer food and fluids by mouth. Medication, turning in bed, wound care and other measures may be used to relieve pain and suffering. Oxygen, suctioning and manual treatment of airway obstruction will be used as needed for comfort. Generally considered the opposite of “heroic measures” (see below for definition).

Cardiopulmonary resuscitation (CPR)

Cardiopulmonary resuscitation (CPR) is a group of treatments used when a person’s heart and/or breathing stops. CPR is used in an attempt to restart the heart and breathing. It may consist only of mouth-to-mouth breathing or it can include pressing on the chest to mimic the heart’s function and cause blood to circulate. Electric shock and drugs also are used frequently to stimulate the heart.

D

Do-not-resuscitate (DNR) order

A DNR order is a physician’s written order instructing healthcare providers not to attempt cardiopulmonary resuscitation (CPR) in case of cardiac or respiratory arrest. A person with a valid DNR order will not be given CPR under these circumstances. Although the DNR order is written at the request of a person or his or her family, it must be signed by a physician to be valid. A non-hospital DNR order is written for individuals who are at home and do not want to receive CPR.

H

Healthcare proxy/agent/decision maker

The person named in an advance directive who will make healthcare decisions on behalf of a person who is no longer able to make medical decisions for themselves. Another term used is "medical power of attorney."

Heroic measures

Term used to describe any emergency interventions normally intended to save life and restore health but seen in the context of impending death as actions that just prolong the dying process. Measures may include CPR, forced intubation and certain surgeries. These measures themselves are likely to cause pain and trauma.

Hospice

Considered to be the model for quality, compassionate care for people facing a life-limiting illness or injury, hospice and palliative care involve a team-oriented approach to expert medical care, pain management, and emotional and spiritual support expressly tailored to the person's needs and wishes. Support is provided to the persons loved ones as well.

I

Intubation

Refers to "endotracheal intubation," or the insertion of a tube through the mouth or nose into the trachea (windpipe) to create and maintain an open airway to assist breathing.

L

Life-sustaining measures

Treatments (medical procedures) that replace or support an essential bodily function (may also be called life support treatments). Life-sustaining treatments include CPR, forced intubation, mechanical ventilation, dialysis, and other treatments.

Living will

Another term for an advance directive.

M

Mechanical ventilation

Mechanical ventilation is used to support or replace the function of the lungs. A machine called a ventilator (or respirator) pushes air into the lungs. The ventilator is attached to a tube inserted in the nose or mouth and down into the windpipe (or trachea).

Ventilators are used when a person cannot breathe on his or her own or cannot breathe effectively enough to provide adequate oxygen to the cells of the body or rid the body of carbon dioxide.

O

Organ and tissue donation

Allows organs or body parts from a generally healthy person who has died to be transplanted into people who need them. Commonly, the heart, lungs, pancreas, kidneys, corneas, liver, and skin are donated. There is no age limit for organ and tissue donation. You can carry a donation card in your wallet. Some states allow you to add this decision to your driver's license. Some people also include organ donation in their advance care planning documents.

P

Palliative care

A comprehensive approach to treating serious illness that focuses on the physical, psychological, spiritual, and existential needs of the patient. Its goal is to achieve the best quality of life available to the patient by relieving suffering and controlling pain and symptoms.

Physician order for life sustaining treatment (POLST) or “portable medical orders"

A POLST is a form designed for seriously ill patients to give them more control over their end-of-life care, including medical treatment, extraordinary measures (such as a ventilator or feeding tube) and CPR. It is printed on bright pink paper, and signed by both a patient and physician, nurse practitioner or physician assistant. A POLST can prevent unwanted or ineffective treatments, reduce patient and family suffering, and ensure that a patient’s wishes are honored. This form is for people in later or end stages of illness. Also referred to as a MOLST in some states, medical orders for life-sustaining treatment. In CA and AZ, a POLST is used. Arizona does not stipulate the use of this form.

R

Respiratory arrest

The cessation of breathing — an event in which an individual stops breathing. If breathing is not restored, an individual's heart eventually will stop breathing, resulting in cardiac arrest.

W

Withholding or withdrawing treatment

Forgoing life-sustaining measures or discontinuing them after they have been used for a certain period of time. This usually results in the person reaching their end of life.
Back to top