Caring Advocates: to plan and honor end-of-life decisions

» Home » Books & Resources » Articles & Questionnaires » Severe Brain States Survey

Survey on severe brain states: definitions & options

Thanks for agreeing to participate in our survey. It's different from other surveys. First of all, we don’t expect anyone to know all the answers. No one will be grading your responses, which will depend on your background and experience.

This survey has two goals:

1. To assess what people with various backgrounds know about severe brain states; and then,
2. To survey people’s opinions and choices.

---

Your answers for Part 1 and Part 2 will NOT be submitted until you click SUBMIT SURVEY on the final page of this survey.

Part 1 of 2

As you fill out this form, do not be overly concerned about distinguishing between two adjacent choices; for example, Sometimes versus Infrequently. But do be frank if you do not feel you know enough about a severe brain state to venture a guess. (You can also not answer a question to indicate you’re not sure.)

To advance to the next question, either use the TAB button on your keyboard or click outside the answer box to scroll with your mouse or scrollbar.

Use the choices below to respond to each question on this page. For certain states, the words Not Impossible though similar to Never may be more appropriate.

• Don't know enough to guess
• Always (Yes)
• Usually
• Sometimes
• Infrequently
• Rarely
• Never (No)
• Not Possible for patients in this state

• Does "I never want to be a vegetable" apply to this condition?
• "Brain Dead" — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Coma — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Vegetative State (PVS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Alzheimer's / any dementia -- progressed to end-stage — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Minimally Conscious State (MCS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Depression with zero interest in food & fluid — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Does patient require a respirator (ventilator) to breathe?
• "Brain Dead" — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Coma — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Vegetative State (PVS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Alzheimer's / any dementia -- progressed to end-stage — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Minimally Conscious State (MCS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Depression with zero interest in food & fluid — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Is a feeding tube required for hydration and nutrition?
• "Brain Dead" — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Coma — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Vegetative State (PVS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Alzheimer's / any dementia -- progressed to end-stage — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Minimally Conscious State (MCS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Depression with zero interest in food & fluid — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Does patient need assistance to eat and drink by mouth?
• "Brain Dead" — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Coma — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Vegetative State (PVS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Alzheimer's / any dementia -- progressed to end-stage — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Minimally Conscious State (MCS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Depression with zero interest in food & fluid — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Are patients aware of their environment?
• "Brain Dead" — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Coma — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Vegetative State (PVS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Alzheimer's / any dementia -- progressed to end-stage — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Minimally Conscious State (MCS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Depression with zero interest in food & fluid — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Can patients experience fear and frustration?
• "Brain Dead" — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Coma — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Vegetative State (PVS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Alzheimer's / any dementia -- progressed to end-stage — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Minimally Conscious State (MCS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Depression with zero interest in food & fluid — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Can patients experience pain?
• "Brain Dead" — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Coma — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Vegetative State (PVS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Alzheimer's / any dementia -- progressed to end-stage — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Minimally Conscious State (MCS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Depression with zero interest in food & fluid — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Can patients communicate by some means other than talking?
• "Brain Dead" — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Coma — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Vegetative State (PVS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Alzheimer's / any dementia -- progressed to end-stage — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Minimally Conscious State (MCS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Depression with zero interest in food & fluid — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Can patients talk intelligibly?
• "Brain Dead" — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Coma — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Vegetative State (PVS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Alzheimer's / any dementia -- progressed to end-stage — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Minimally Conscious State (MCS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Depression with zero interest in food & fluid — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Can patients' function improve?
• "Brain Dead" — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Coma — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Vegetative State (PVS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Alzheimer's / any dementia -- progressed to end-stage — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Persistent Minimally Conscious State (MCS) — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state
• Depression with zero interest in food & fluid — Choose one — Don't know enough to guess Always (Yes) Usually Sometimes Infrequently Rarely Never (No) Not Possible for patients in this state