Resource Center

Here is a library of resources and information on various topics.

  • Unconsciousness — coma and vegetative state: What is it?

    A coma is a state of unconsciousness in which you look like you’re sleeping. If you’re in a coma, you don’t move much. You usually show no signs of pain or distress.

    Some people who are in a coma move into another state of unconsciousness known as a vegetative state.

    If you're in a vegetative state, you may open your eyes and look like you're awake. But you're actually unconscious because you don’t have any sensation or awareness. If you're in a vegetative state, you may make movements like yawning, smiling, or pulling back your arms or legs. Or, you may look like you’re watching something or responding to someone. These movements are reflexes. They’re not under your control.

    According to expert medical opinion, a person who is in a coma or a vegetative state:

    • Does not feel pain or any other sensations.
    • Has no awareness of their surroundings.
    • Cannot interact in any way with the world around them.

    People who've come out of a coma or a vegetative state usually say that they don't have any memory or awareness of the time that they were unconscious. These people usually say that they don't remember any pain or discomfort.

    If you were in a coma or a vegetative state, you'd probably be cared for in a hospital or nursing home. This is because other people would need provide all of your personal care, including:

    • Feeding you through a tube.
    • Cleaning up your body wastes.
    • Turning you every few hours to prevent bedsores.

    Some patients in a vegetative state are cared for at home by their loved ones.

    It would be very hard to predict what would happen to you after you went into a coma.

    • Some people wake up and recover completely.
    • Other people never wake up.
    • Other people come out of the coma but with permanent brain damage

    In general, the longer you stay in a coma, the higher the chance that you won't come out of it. If you stay in a coma for a long time, you have a higher chance of severe brain damage.

    If you stay in a vegetative state for a long time, experts refer to this as a permanent vegetative state. This occurs after:

    • More than three months (when your vegetative state is caused by illness).
    • More than a year (when your vegetative state is caused by injury). At that point, your chances of recovery are nearly zero.
  • Dementia: What is it?

    Dementia is a condition in which you lose your mental skills, such as:

    • Memory
    • Thinking
    • Talking
    • Problem solving

    It's normal to lose some mental skills with old age. But if you have dementia, this loss is severe enough to interfere with your daily life.

    Anyone can get dementia. Dementia is more common in older people. By age 85, nearly one out of every seven people has dementia.

  • Dementia: What will happen?

    The most common kinds of dementia get worse over time.

    An example is Alzheimer's disease. The problem usually starts with minor memory problems. Over time, your memory problems would get worse. You might get new problems, such as difficulty concentrating or getting confused easily.

    As your condition worsens, you might have major personality changes:

    • Some people lose interest in things around them.
    • Other people become agitated.
    • Other people seem happy almost all the time.

    Eventually, you'd need help with your daily activities, like dressing and bathing. Later, you might become less active and less talkative, although you might continue to enjoy other people's company. In the final stages of Alzheimer's disease, you'd lose your ability to speak, walk, control your bladder and bowels, and swallow.

    In the final stages of Alzheimer's disease, you'd lose your ability to speak, walk, control your bladder or bowels, and swallow.

    If you had dementia, you might be aware that you had a problem at first. As the dementia worsened, you would become totally unaware of your problem.

  • Dementia: Can it be treated?

    Some types of dementia can be treated and even cured. An example is dementia that's caused by thyroid problems. However, most types of dementia get worse over time and never get better.

    If your dementia couldn't be treated, it might take many years for you to lose your mental skills. Or, you might lose them more quickly. With Alzheimer's disease, severe dementia usually occurs within five to 10 years after the first memory loss. Severe dementia generally leads to death from complications, such as infections

  • CPR: What is it?

    CPR stands for cardiopulmonary resuscitation. It's sometimes used in an emergency when someone's heart has stopped beating adequately. Cardiac arrest is another term for when the heart stops beating.

    If you're in cardiac arrest, blood stops flowing through your body. This means that oxygen can't get to your brain. Your brain can survive without oxygen for only about five minutes. After that point, you'd have permanent brain damage.

    CPR enables a small amount of blood and oxygen flow to your brain while doctors or emergency medical personnel try to get your heart to beat normally again. This helps prevent brain damage.

    CPR may include:

    • Chest compressions (someone pushing up and down on your chest with their hands).
    • Artificial breathing (someone breathing from their mouth into yours, also referred to as mouth-to-mouth, or someone using a small bag attached to a mask to push air into your lungs).
    • Medication (someone giving you drugs to stimulate your heart).
    • Defibrillation (a machine giving you a quick electrical shock to your chest).
    • Intubation (someone putting a tube into your windpipe).

    If CPR gets your heart to beat normally again, but you don't start breathing on your own, you might be put on a breathing machine (i.e., a mechanical ventilator).

  • CPR: When would you need it?

    Cardiac arrest can be expected or unexpected. Cardiac arrest is a normal part of the dying process or could happen unexpectedly if you had a heart problem or if you were in critical condition because of a sudden illness or injury.

    If you're in a hospital and you go into cardiac arrest, hospital staff will automatically perform CPR, unless you have a do-not-attempt-resuscitation (DNAR) order. This is sometimes referred to as a DNR. A DNAR order tells doctors, nurses, and emergency medical personnel not to perform CPR if you go into cardiac arrest.

    If you have cardiac arrest, you'll lose consciousness and pass out quickly. Once you pass out, you won't feel anything. If you don't receive CPR, you'll die in approximately five to 10 minutes.

    When CPR works, you may recover completely and may live for many years. This outcome typically occurs more often when you have a cardiac arrest due to an easily treatable rhythm problem with your heart and CPR is begun very soon after the cardiac arrest. In other cases, however, CPR is far less effective. CPR is not very effective when cardiac arrest is caused by a serious illness that cannot be reversed or when CPR is not started within five minutes after a cardiac arrest. Some people have serious complications because they didn't get enough blood to their vital organs while their hearts weren't beating adequately.

    Some people who survive after getting CPR recover completely. Others have serious complications because they didn't get enough blood to their vital organs while their hearts weren't beating adequately.

    CPR can save lives, especially when it's given to a young, healthy person right after cardiac arrest. When CPR is successful, it may return the person to the same health that they were in before their heart stopped. The person generally isn't aware of the procedure because the person isn't conscious during CPR.

    CPR can be unsuccessful, especially when it's given to someone who has a very serious or incurable disease. Many hospitalized patients are seriously ill, and so only about one in six patients who receives CPR in the hospital will survive their hospital stay. After CPR, some people have a sore chest or broken ribs because of the chest compressions. Some people also have permanent brain damage because they didn't receive enough oxygen to their brain despite receiving CPR.

  • Dialysis: What is it?

    Dialysis is a medical procedure that filters your blood to remove waste products when your kidneys can no longer do the job. Dialysis is a type of life-sustaining treatment. There are two main forms of dialysis: hemodialysis and peritoneal dialysis. In hemodialysis, your blood circulates outside of your body into a machine that removes waste products. A needle is inserted into one of your blood vessels. The needle is attached to a tube that carries a steady flow of your blood into the machine. After the machine removes waste products, your blood returns to your body through a second needle that is inserted into another blood vessel nearby.

    In peritoneal dialysis, your blood is filtered by the blood vessels in the lining of your abdomen (peritoneum). A fluid is washed in and out of your abdomen to help to filter your blood. The fluid flows through a tube that's inserted into a hole made on your abdomen. You usually can receive peritoneal dialysis at home.

    Hemodialysis is the more common type of dialysis. Peritoneal dialysis isn't an option for everyone. To have peritoneal dialysis at home, you must be able to do it yourself or have someone who can do it for you.

  • Dialysis: When would I need it?

    People who have severe problems with their kidneys use dialysis. If your kidneys stop working, waste products build up in your bloodstream.

    This will make you feel sick to your stomach, tired, and weak. You'll have little appetite and will experience swelling. You might also have difficulty breathing or thinking clearly. Dialysis helps relieve these symptoms.

    If your kidneys stop working completely, and you don't receive dialysis, you die, usually within a week or two. First, you feel sick. Then you probably feel sleepy or become short of breath. In the end, you go into a coma and aren't aware of anything around you. Eventually, your heart stops.

    If your kidneys stop working and you don't receive dialysis, you'll receive care to keep you as comfortable as possible.

    To get hemodialysis, you have to be in a hospital or travel to a dialysis clinic on a regular schedule, usually three times per week. If there's someone who can be trained to give you hemodialysis, there's a small chance that this person can give it to you at home. Each session usually lasts about four hours.

    With peritoneal dialysis, you can receive treatments at home, at work, or even while traveling. You need to have the equipment with you. Fluid from a bag flows into your abdomen through a tube. It stays there for several hours, then drains out through the tube and is thrown away. Normally, this process is repeated several times each day.

    Dialysis usually prolongs your life.

    Dialysis can allow you to lead a near-normal life. You should be able to go back to work and participate in many activities that you enjoy. Dialysis can also relieve many of the uncomfortable symptoms that are associated with kidney failure.

    If you are eligible for a kidney transplant, dialysis can keep you alive while you wait for a donor.

    Dialysis can't do as good a job as your kidneys. As a result, waste products and fluids build up in your body between dialysis sessions. At times, you may not feel well.

    The time you spend on dialysis may interfere with your daily or weekly routine (e.g., your ability to travel).

    You'll have to be careful about the types of food you eat. You may also be more likely to get infections, bleeding, and other medical problems. You may get tired easily.

  • Feeding Tube: What is it?

    A feeding tube carries liquid nutrition and fluids into your stomach or intestines. One kind of tube goes into the nose, through the throat, and into the stomach. This is called a nasogastric tube. It's about one-eighth of an inch in diameter.

    Another kind of tube goes through your skin into your intestines. This tube requires minor surgery. The operation is quick and safe. You won't feel much discomfort. Once the tube is in place, it's usually painless.

  • Feeding Tube: When would I need it?

    A feeding tube is sometimes used when people have trouble swallowing enough food and water. If you're having trouble swallowing, you'll usually eat less and therefore you won't receive proper nutrition. You might have trouble swallowing if you're very sick, have brain damage, or have a medical problem that affects your nerves or muscles. There is also a danger that food can “go down the wrong pipe.” This means that you inhale food into your lungs.

    If you don't get enough nutrition, you lose weight, feel weak, and are more likely to get sick. If you don't receive any fluids or nutrition at all, you die, perhaps within three weeks. At first you might feel hungry or thirsty. But this feeling usually lasts for only a few days. You'll probably be given ice chips and mouth swabs to keep your lips moist. Eventually, you'll go into a coma. After that, you're not aware of what's going on and in a few days you'll die.

    If you're awake and aware of what's going on, having a tube down your nose and throat is somewhat uncomfortable. It's usually not painful, and many people get used to it over time. The tube through your stomach wall isn't painful, either, and you can hide it under your clothes. When liquid is flowing through the feeding tube, it makes it harder for you

    A feeding tube might prolong your life and let you live for years. This depends on your condition.

    A feeding tube can provide all the fluid and nutrition your body needs. With proper nutrition, you're less likely to get bedsores and other complications.

    You don't need to be in a hospital to receive fluid and nutrition through a feeding tube.

    If you have advanced cancer or severe dementia, a feeding tube probably will not prolong your life and could even shorten it due to complications.

    You might inhale liquid into your lungs with a feeding tube. This would cause pneumonia.

    You would have a tube attached to your nose or your stomach.

  • Invasive Mechanical Ventilator: What is it?

    Invasive mechanical ventilation uses a machine to help you breathe. The machine can be called a ventilator or a mechanical ventilator, breathing machine, or artificial respirator.

    A ventilator works by pushing air and oxygen into your lungs. A tube is placed in your windpipe, either through your mouth or nose or through a hole in your neck (called a tracheotomy). The tube is about three-fourths of an inch in diameter, which is about the size of a dime.

  • Invasive Mechanical Ventilator: When would I need it?

    A ventilator breathes for you if you can't breathe well enough on your own. You may need it if you have:

    • Severe lung problems
    • Brain damage
    • Spinal paralysis
    • Severe weakness of the muscles in your chest

    You might need a ventilator for a few hours, a few days, or the rest of your life. At first, it may be impossible to tell how long you might need it.

    Some people with life-threatening illnesses choose not to use a ventilator to prolong their lives. Instead, they choose to let nature take its course. If you choose not to use a ventilator, you'll receive care to keep you as comfortable as possible. You'll be offered medications to help you relax so that you don't feel like you have to struggle for breath. If your lungs fail and you decide not to use a ventilator, or if you're on a ventilator and decide to remove it, you'll probably die within minutes. However, you may live for several hours.

    You generally can't talk if you have a tube down your nose or mouth into your windpipe. If you have a tracheotomy, you can learn to talk although it's not easy.

    Most patients on a ventilator can't get out of bed and are in a hospital. Usually, they're in an intensive care unit. Other patients on a ventilator can go to a nursing home or be cared for at home. If you're not awake or alert, you might pull on the tube. To prevent this from happening, you might need to take medication to make you sleepy or have your hands restrained.

    Some people who use a ventilator can get around in specially equipped wheelchairs and live long and productive lives

    A ventilator often prolongs your life when you might otherwise die.

    You might need it for only a short time. For example, you may need a ventilator only while your body recovers from a serious illness.

    If you're awake and aware of what's going on, a ventilator is uncomfortable. However, it usually isn't painful and many people get used to it over time.

    In some cases, it can relieve the discomfort of feeling breathless.

    Some people who need a ventilator live for years and lead productive and satisfying lives.

    You might need the ventilator for the rest of your life.

    You might not be able to talk.

    You might have to stay in bed.

    You'll have a tube attached to your nose, mouth, or throat.

    You'll need a lot of help. For example, someone will probably need to suction your lungs to keep them clear of mucus. This help might come from family members, close friends, nurses, or home health aides.

  • Non-invasive Mechanical Ventilator: What is it?
    Non-invasive mechanical ventilation helps you breathe by pushing air through a mask that is placed over your nose and mouth. Straps keep the mask in place. A machine pushes air and oxygen through the mask. One type of non-invasive mechanical ventilation is called CPAP (continuous positive airway pressure) and another is called BiPAP (bi-level positive airway pressure).
  • Non-invasive Mechanical Ventilator: When would I need it?

    CPAP or BiPAP might be considered if you need some help breathing. This type of non-invasive mechanical ventilation might be considered if you have a long-standing lung problem (e.g., chronic lung disease, trouble breathing when sleeping) or a life-threatening problem, such as a lung infection like pneumonia or a flare-up of a chronic lung disease like emphysema.

    You might need this treatment for a few hours, a few days, or the rest of your life, depending on your condition. It might be hard to predict how long you would need it.

    Some people with chronic or life-threatening lung problems choose to not use CPAP or BiPAP, hoping instead to improve their lung function through other treatments. However, some people choose to forego CPAP or BiPAP and let nature take its course. In this situation, you will receive care to keep you as comfortable as possible. You will be offered medications to help you relax so that you don’t feel like you are struggling to breathe. If your lungs fail and you decide not to use non-invasive mechanical ventilation, you’ll probably die within several hours.

    Most people who use CPAP or BiPAP feel less short of breath. Often the mask needs to be taken off for short periods of time to speak clearly or eat. Most patients receive this treatment while either sitting in a chair or lying in bed. Non-invasive mechanical ventilation can be used at home or in the hospital.

    CPAP or BiPAP might make it easier for you to breathe.

    It is easy to put on and take off.

    It might help you breathe while you recover from a serious illness.

    It might prolong your life, depending on your condition. Some people live for years using non-invasive mechanical ventilation.

    You could remove the mask if needed.

    You would be able to eat and drink.

    You may experience anxiety or claustrophobia by having the mask over your face.

    You may have a dry nose and sore throat, and you may get nosebleeds.

    It may irritate your eyes and the skin on your face.

    You may have abdominal bloating that causes discomfort or nausea.

    You may need to bring equipment with you when you travel or leave the house.