Thinking of saying ‘no’ to NIV

What to consider if you are thinking of saying no to NIV

Making your decision about NIV can take some time. Do discuss and reflect upon your options with your family and care team. Whilst starting NIV early offers the most benefit, you can also start it later too. Saying “no” now need not be “no” forever – you can remain flexible.

Often people have concerns about using NIV and living with it day-to-day. Some people’s worries are allayed when they find out more about what is involved. Other people may still feel unsure, or decide that NIV is not an option that suits them. It is a very personal choice.

Invasive ventilation, vis a tracheostomy is another option. This is not commonly used in the UK, and requires more care and support. But this can be considered, for example if you really struggle with using a mask or have a lot of secretions.

There are treatments other than ventilation that can help to ease some of your symptoms. However, it is important to understand these treatments don’t improve your breathing and gas exchange (oxygen in, carbon dioxide out) like ventilation can do.

Some treatments help support a weakened cough and reduce secretions (mucus and saliva). See Keeping Your Chest Clear to learn more about these. There are also medications that can help reduce feelings of breathlessness.

You may wish to read about how these treatments can support you as you move towards end of life with respiratory failure, in the section Staying Comfortable (please note this link takes you to content about end of life care).