End of life care and withdrawal of NIV
Considering the withdrawal of NIV
Consider this scenario: your patient has become nearly completely dependent on non-invasive ventilation (NIV) as they are using NIV for more than 20 hours a day. You think they might want to consider withdrawal.
Write down a few things that you might consider before you go and speak to them. What would be their concerns or worries? How might you approach them?
Some things you might consider include the patient’s concerns
surrounding the ethics and legalities of withdrawal
around dying with uncontrolled symptoms like breathlessness
surrounding where withdrawal will take place
about upsetting their family members.
The video below provides a patient’s account of their decision to withdraw NIV.
What key concerns did Julie and Russ have and how might you address them?
How might you implement this guidance into your practice? Which will be the most difficult?