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Quality of Life Inquiry

This Quality of Life Inquiry will help our team understand your desires in living a quality of life and making your biggest life decisions.

LIVE FULLY. PLAN INTENTIONALLY. DEFINE YOUR FINAL CHAPTER

I could adapt to not being able to feed myself but get nutrition through a feeding tube.

I could adapt to requiring full physical assistance from someone else to feed me by mouth, as long as I can still swallow and enjoy the taste.

I find feeding myself essential to my quality of life.

Engaging in conversation and being able to communicate is essential to quality of my life.

I could adapt with help from a gesture board or writing (no vocalizing)

I could adapt to not being able to speak or write

Being able to breathe freely is essential to my quality of life.

I could adapt to permanent reliance on a ventilator to live.

I could adapt to requiring a ventilator (breathing machine) for a period of time.

I find managing my own toileting completely essential to my dignity.

I could adapt to needing help with toileting and managing incontinence, provided it is done privately and respectfully by trusted caregivers.

I could adapt to permanent medical interventions like a urinary catheter or a colostomy bag if it sustains my life.

I could adapt to needing help with walking, transferring or moving for a period of time.

I could adapt to not being able to walk and having total assistance with moving.

Being able to walk and move on my own is essential to my quality of life.