Life support

Life support is the term used to describe any combination of machines or medications that keeps a person’s bodily organs functioning when they would otherwise stop working [1]. In the case of brain injury, this may be a ventilator to help with breathing and other basic life functions.

Many things can happen when a person is on life support. In some cases, it can be used to help with surgeries, give a person time to heal, or extend a person’s life. Depending on their brain function, life support may just be extending a person’s life until their quality of life can be confirmed.

When your friend or family member is on life support due to a severe brain injury, it will be shocking and difficult. You may be put in the position of decision maker. If that is the case, you will need to prepare to talk with doctors and other family members who would be closely associated with the person. The information provided by the doctor will inform next steps.

Topics in this section include:

Going on life support

If the person is put on life support, it’s because it’s a matter of necessity. In the case of brain injury, it may be due to organ failure or a lack of brain function. Life support may be used temporarily to stabilize the patient until normal functioning can resume.

Doctors and nurses are the ones who generally make the decision about putting a patient on life support. The only exceptions are if the person has written medical instructions that says they don’t want to go on life support, or the person who has control over medical decisions for the patient declines it [2].

Transitioning off of life support

Whether or not a person will be able to come off life support will be determined by the doctor. If the person is able to transition off of life support, they will tell you about the process. They will then transition to the next stage of healing and recovery.

There is no set of rules for transitioning off life support, meaning that doctors can’t determine how long a person will need it. Factors such as the severity of the injury, the complexity of the person’s needs, and time all play a part – and they are also outside everyone’s control. As frustrating and scary as this is, the medical team is doing everything they can for your loved one. And if you have questions, don’t be afraid to ask. They will give you as much information as they can.

Removing life support after brain injury

You may be in a position where the doctor says there is nothing more that can be done for the person with a brain injury and they would not be able to survive off life support.

Removing life support after brain injury is an incredibly emotional and difficult decision. Any decisions will need to take into consideration the information by the doctor, the other family members, and ultimately any written wishes the person has left.

If you are faced with making this decision, it may be beneficial to consult with a trusted loved one, a therapist, or someone in your religious community (if you are religious).

There may also be support groups available made up of people who are (or have been) in your situation. Do some research on the Internet or ask the medical team if they know of anything.

Ultimately, the decision will be up to you. It’s a lot of responsibility, but remember that your loved one made you the medical power of attorney for a reason – they trusted you.

How to make decisions surrounding life support

Consult the person’s living will

The person on life support may have a living will that lays out plans for what to do in this situation. This may include whether the person wants to go on life support; how long they want to stay on life support; what conditions would need to be in place for them to be taken off life support; and what their wishes are in the event that they are taken off life support.

If a person does not want to be put on life support, the doctor will comply with those wishes. In the absence of any orders, the decision will be up to a family member or designated life guardian.

Talk to other family members

Other family members will have strong feelings and emotions surrounding the situation. It’s important to take their feelings into account, but also communicate the doctor’s findings to them.

Having a loved one on life support could make for some difficult conversations and family disagreements. Try prefacing conversations with the statement that any decisions need to be made for the person with the brain injury, not for you or others. Speak calmly and use the information the doctor has provided, and refer to any written wishes the person may have.

Consult with the doctors and other medical professionals

The person’s doctor will be able to provide the best recommendations when it comes to continuing life support or stopping it. Their advice may not be what you want to hear, but in some provinces and territories, the final decision does rest with the doctor in terms of supplying life support. The College of Physicians & Surgeons in your province/territory would have more information.

Ultimately, the doctor wants what’s best for the person on life support, the same as you and other family members.

Coping with feelings around life support

You may be feeling a lot of emotions in relation to your friend or family member being on life support, along with the pressures of being a decision maker. It is normal to feel a mixture of sadness, guilt and grief. Understanding these emotions can help you during the process.

Remember: your loved one trusted you. Even if you don’t have any formal medical power of attorney or wishes, they believed in you and your judgement. It’s an impossibly hard situation to be in: lean on your supporters, talk to the doctors, and most importantly, trust in yourself and the information you have received.