Delicate post. DNR.

[SugarRay]

It's a bit of a delicate one, and I'd hate to upset anyone on here with it... but I have a question around DNR - do not resuscitate.
How did people go about it?
How do you feel about it?
I ask as I know CPR is extremely physical and Mum managed to crack her ribs again just closing her curtains. We are no way near end of life but I was just wondering, do we or don't we.
Thanks. SR

 

[Spamar]

Gp first asked me about whether I wanted DNR for OH and I was happy to tell him my thoughts. I do need to let everybody else interested about it.
If mum is over 70, I think, the chances of her recovery after CPR are very slim, less than 1%. It's painful, often pneumonia results, followed by death a few days later. It is quite a brutal procedure.
Get in touch with her GP and tell them what you want. The GP will probably be relieved, as introducing this subject is not always easy. Have you discussed this with mum, or have you got LPA health and well being?

 

[Canadian Joanne]

Because of the potential physical damage and the very low success rate for CPR - see this, my sister and I decided against it.

We have opted for care that can be given in the nursing home and no removal in hospital. When the time comes, we would prefer our mother to be with people who know and understand her.

 

[SugarRay]

Hi, yes we have all the POA's in place and Mum is 85 next week. I'm aware that it's brutal and have opted for her to have end of life at the care home. When she first went in to the home it was all a bit rushed etc and only now have I realised that it's not in place. I'll have a chat with my brother and speak with the GP. It's not a pleasant discussion to have but as a family over the last 12 months we've had to have loads of them. Thank you. SR

 

[canary]

Mum filled in a DNR form some time ago - before she got dementia. Now she is in a CH she too will be cared for in the home.

I fully support this.

 

[love.dad.but..]

We have DNR for dad...we know pre dementia this is what he would have wanted. Dad recently underwent an op his risks were very high but fortunately the surgeon and 2nd anaesthetist...1st declined...both agreed with us it was quality of pain free life more important than the risks with dementia only heading one way. We were quite rightly questioned many times pre op as to why we had DNR and our explanation understood and accepted each time. It was carefully explained to us the circumstances during and post op when DNR would be implemented. Huge responsibility signing the consent form but no doubts whatsoever even if dad had not made it. We have poa health and welfare. Dad is recovering well back in the NH but we know having DNR is what dad wanted and we found the medical staff fully respected that.

 

[Adcat]

Evening.
I'm glad you have highlighted this issue as a discussion point and I hope my view below helps you.
From professional experience my personal choices for my father would be DNR for the following reasons;
He is 87.
He has underlying cardiac problems.
He has mixed dementia - no cure, therefore terminal illness.
I don't want him or me to endure any further unnecessary suffering. This illness is just hideous. Currently I am sitting with my dad watching TV and he is asking me if I'm upstairs and he now wants to look for me.
Dad has had a good life. He is dearly loved and well looked after 24/7 at home by me with the help of a carer paid for privately. Long may this continue. In reality, it won't because his money will run out and I will have to sell the house and find a roof over my head whilst he ends up in care because I can't do this on my own. The local authority will only provide 4 visits a day. Dad needs 1:1 supervision.
The only benefit I can see would be for some one to practice resuscitation techniques and my father is not being used to practice on.
Take care x

 

[cold feet]

Mum had a DNR and I had no doubts. At some point, we all have to die. And the heart stopping is a sure way for that to happen. When you have had a good life, but are in serious decline physically and mentally it seems just cruel to go to great efforts to prolong a life of poor quality. Luckily (?) Mum and I had had discussions on the subject over the years so I know how she felt about it, but even without that I would have thought the same.

 

[Not so Rosy]

I put a DNR in place for my Mum, my Husband and now my Dad.

 

[MrsTerryN]

DRN in place for my mother as well. This was discussed with her brother and my son. I am an only child. Mum is so tiny and fragile now I just cringe at the thought of resuscitation.

 

[99purdy]

I was asked exactly the same question by the Doctor who was treating dad for suspected sepsis. I just could not answer to be honest. However the Doctor said they thought CPR was so invasive and could cause Dad more injury and therefore they would advise against it. Luckily it was not needed. I think every case should be viewed individually and everybodies thoughts taken into account. I don't believe there is one straight answer and respect the views of everybody. Every case is different and should be treated as such. X

 

[betsie]

I was asked this in A&e tonight my dad was rushed in he has pneumonia ( his gp said there was nothing wrong with him yesterday when the home called him out).
I did not have to sign anything just said did not want him resuscitated if he stopped breathing all other meds given (IV antibiotics) and on oxygen and fluid drip. The Dr asked if he had a ? Life plan ( can't think of the wording now presumable some people refuse meds at this stage as well but I couldn't do that).

He looks absolutely awful like a bag of bones. I just want him to be comfortable and not in pain. Managed to get a very large sweet cup of tea down him before I left and he was fast asleep. As much as we want this horrible journey to end the panic and stress you feel when you think this could be it is awful and you just want them to be ok and live.

 

[Lawson58]

It always makes me feel a little sad when I read posts here that say such negative things about CPR and I do hope that we all understand that there are many times when it is a viable option for many patients.

My husband had been a cardiac patient for many years when at the age of 74 he had a cardiac arrest at home. He had a shocked look on his face, wasn't breathing and was going blue and you didn't need to be an Einstein to know he was in big trouble.

It was just him and me. So what was I supposed to do? Sit there and hold his hand while he died while waiting for the paramedics to arrive? I think not! I couldn't begin to tell you the chaos that was going on inside my head and no one could prepare you for that but I had to do something.

I gave him CPR for 9 minutes until help arrived. After about the first 6 compressions, I heard a huge crack and I knew that I had broken one or more of his ribs. The paramedics used a portable defibrillator on him to get his heart started and then transferred him to hospital. At that stage, the paramedics didn't think he would survive but one of them took the time to tell me that everything I had done was right.

Following his admission to ICU, the Director came and talked to me, explaining that my husband might not wake up, that he might not be able to breath on his own, and a lot of other things. We discussed DNR and he went through all the implications and explained the processes that would be put in place.

CPR has been described as being 'brutal' and it was but my husband was completely out of it and has no memory of the experience. Yes he was bruised and I had broken his ribs but he survived and in spite of now having AD and some other health problems, he is still enjoying life and is glad that I was able to do something to save his life.

By the same token, had he not woken up or been able to breath on his own I would not have had a problem with a DNR.

The survival rate for cardiac arrest patients is greatly increased if someone gives them CPR at the time of the event. So please don't disregard it out of hand. It has its place in our world just as DNR does.

 

[Saffie]

I think that most people on TP have faced this question and there are a number of threads concerning the matter. It took 3 times of asking for me to agree. I did it because the consultant said that with my husband's multiple serious health problems - quite apart from his dementia - he was very unlikely to survive it.
I still felt like a traitor signing it. He was my husband and I was supposed to be caring for him, not signing his life away.

I wouldn't have signed for dementia reasons alone as at that time he was not at the severe stage.
Certainly I wouldn't have done so simply because he was over 70 so probably wouldn't survive CPR.
I find it frightening that anyone thinks that being over 70 means that CPR would not be successful.
I hope my daughters don't think like that!

 

[Neph]

I think it depends on what stage you are at, I have had one in place for my mum for a while as she is now so frail that I think she would just crumble. It certainly wasn't a decision I took lightly but now it's for the best.

Best person to talk to is her GP who will give you all the information and then even if you wanted one they wouldn't do it unless they thought it was the correct thing to do.

 

[LYN T]

The first time I was asked this by Pete's MH Consultant-I burst into tears. I was so shocked as Pete was only just 65. I couldn't speak. The next time was two years on-thing had changed. Pete was at severe stage and was experiencing the physical decline that can go with AD. I also remembered Pete saying to me 'if I ever get Dementia just shoot me!' This time I agreed that a DNR should be placed on his file. I already have my DNR in place! I don't want my daughter having any doubts about what she should do.

Take care

Lyn T XX

 

[RedLou]

Incredibly useful thread - thank you for having the courage to post it. I have to discuss this with my brother and then my father's doctors. I don't think I would want a DNR of someone under 80 with only mild dementia, as Lawson has indicated. And as for someone of 65!! But this is why it's useful we take the decisions - we know our loved ones; we're not going to write them off simply because of a milestone birthday; we know if they are enjoying life on the whole despite cognitive impairment. My father is 89, frail, miserable, and guilty as I will feel talking to the doctors about it, I think I have to clench my teeth and stop avoiding the subject.

 

[stanleypj]

I have no problem with DNR per se. But I do wonder how CPR can be quite so useless, brutal and damaging to the ribs when it is taught to schoolchildren, and almost anyone is praised for trying it on people whose condition they know little about. Is this particular argument being 'oversold' perhaps?

 

[sistermillicent]

you are right, stanleypj, the possibility of a few broken ribs is not the reason to have a dnr.


Defibrillators are the thing these days, every care home should have one, CPR would then be minimal.

But that said, I would probably have a DNR for mum if it was down to me to decide, and I would come out with all the stuff about it being a kindness and she'd suffered enough. Which would possibly be true, but I question myself as to whether that would be 100% of the reason for my decision.

Luckily it is not my decision so I am able to sit here and write about something of which I know nothing.

 

[SugarRay]

Thank you all for your comments - Mum is 85 with underlying cardiac and eye problems, BUT still active and enjoying life at the mo. It's just something we as a family have been talking about and it's good to get outside opinions. Thank you all. SR