Everyone should know that if there is no plan to take extreme measures to prolong life, they should not call the ambulance. They should call their local hospice organization. Medicare will cover 24 hour nursing, and a load of stuff the patient might need to be comfortable (given the patient qualifies, of course, but it's not real hard to qualify if the patient is really on the way out). The hospice teams deal with this all of the time and are usually really good at it. Last week my dad realized they just couldn't fix him this time; in and out of the hospital many times, and various systems teetering on the edge. Luckily he knew what was going on and was able to make the decision himself, along with my mom. I'm sure it would be harder if the advance directive had to be used. Anyway, after a few days of hospice at home, he left us. No beeping, not connected to a bunch of machines, in his own bedroom, no excitement, just family and the hospice nurse.