If I start using IMV, can I stop using it later?

Because having a trach and IMV can make it hard to speak — or prevent you from speaking at all — it’s important to talk to your loved ones and your ALS care team about your wishes for end-of-life care before you start IMV. You can also document your wishes by creating an advanced directive. A Physician/Practitioner Order for Life-sustaining Treatment (POLST), also called a Medical Order for Life-Sustaining Treatment (MOLST) in some states, is a specific type of advance directive that tells doctors whether you want to receive life support. 

To learn more about advance directives, explore resources from Five Wishes.

You can choose to stop using IMV at any time. However, it’s important to understand what will happen if you choose to stop.  

If someone stops using IMV, they will have to work harder to breathe. This can lead to respiratory failure (failure of the lungs) and other life-threatening health issues. Depending on the person’s ALS symptoms, these changes can happen quickly after stopping IMV. 

If you choose to stop IMV, you can do so at home or in a health care facility. Your ALS care team can help you make the decision that’s right for you. A palliative care specialist or hospice team may also be available to support you during this time.