"Even if he did recover, the doctors indicated that he would not be able to function in any meaningful way and have no real quality of life, Polansky said. "We were quite confident from our knowledge of him as a person that he would not have wanted to live on a respirator."
Polanksy's mother died later, from endometrial cancer that required treatment that made her so sick and weak it greatly diminished her quality of life. She knew that her disease would eventually kill her, and wanted to live out her remaining days as best she could, so she made the decision to stop treatment and die at home.
"She struggled with giving up the chance of living longer, that was a big unknown and no one could know that. It was weighing a doubt against a certainty," Polanksy said. "She could take all the rounds of chemotherapy and still die in a few months. But one thing was certain, had she continued with the chemotherapy, those next few months would have been misery."
Wright said end-of-life conversations can present "a unique opportunity where patients can have better quality of life ... and have better outcomes for their families."
Polanksy agrees, and said his mother's decision to die at home made coping with her death much easier for his siblings and the rest of the family.
"I can say with complete confidence that she completely maximized the quality of life during the days that she had remaining. And if we could all achieve that when we near the point of death in our own lives, that would be quite a success," Polansky said.
Riley is putting off her own end-of-life decisions until they need to be addressed. In the meantime, she is focusing on living life and keeping an open dialogue with her doctor.
"We all have end of life eventually, so I expect that my quality of life that I treasure will be compromised at some point," she said. "My life has been full of wonderful things, and I'd live to have a few more so while I'm still here, I'm going to do everything I can to really live."
When the time comes, it is important for physicians to inform patients of their choices, Wright said.
"You know, we teach them a lot about side effects, we teach them a lot about risks and benefits of procedures, but we don't teach them a lot about the things that really matter a the end of their lives," she said.