DNAR / LPA health & welfare

Discussion in 'Health and wellbeing' started by yogamumma, Jul 30, 2019.

  1. yogamumma

    yogamumma Registered User

    Apr 17, 2017
    6
    Hi, can anyone help I have already completed and registered for my mum a LPA for finances, and we now want to sort out health and welfare (legally). What is the difference between DNAR and the LPA health & welfare, which should we make sure we do?
     
  2. Cat27

    Cat27 Volunteer Moderator

    Feb 27, 2015
    10,167
    Merseyside
    Do both.
    H&W LPA allows the donor to write down their wishes ie do not prolong treatment etc & you as the attorney to make sure their wishes are followed if possible.
    DNAR just says to medical staff that they can’t resuscitate.
     
  3. nitram

    nitram Registered User

    Apr 6, 2011
    18,895
    Male
    North Manchester
    DNAR is a legal document where the person states that in the event of their heart stopping they do not want any attempt to be made to resuscitate them ie brought back from the dead.

    A H&W LPA gives the attorney power to make decisions as if they were the donor, there is a specific section about prolonged treatment.
     
  4. Palerider

    Palerider Registered User

    Aug 9, 2015
    536
    Male
    North West
    Its important to note if you hold LPA for health and welfare and the person you care for has lost capacity then you can help decide their resuscitation status. The final decision is legally a medical one, however doctors should take on board your view point in respect to the person you care for in their best interests.
     
  5. Lemondrizzle

    Lemondrizzle Registered User

    Aug 26, 2018
    22
    We didn't have the LPA for welfare (long story) for my MIL but the hospital asked my husband his views and recorded the DNAR as agreed with him. In the very final days there was a discussion about withdrawing treatment and a fully informed decision made to discontinue life prolonging treatment and move to palliative care only. Although we were asked about LPA a few times, in reality the hospital discussed everything with us and my OH was allowed to make decisions. The only rather bizarre thing was the housekeeping staff kept bringing my MIL meals because she hadn't been put on nil by mouth! I gave up labouring the point about the waste of NHS funds on the third day to concentrate on just being there for MIL.
     
  6. Bikerbeth

    Bikerbeth Registered User

    Feb 11, 2019
    176
    Bedford
    I think I was also told the LPA takes precedence over the DNAR so also ensure the LPA states the same as the DNAR
     
  7. Lemondrizzle

    Lemondrizzle Registered User

    Aug 26, 2018
    22
    Yes that is the legal position but ultimately it is a medical decision as already mentioned. We had that discussion with the staff as we were worried that invisibles might step in and try to encourage resusitation but the doctor reassured us they would not do it on anyone's say so if it was not medically the best course of action. We did worry at times (needlessly as it turned out) that we might be overridden so you are right and it is a good idea to get this watertight while still possible.
     
  8. Bikerbeth

    Bikerbeth Registered User

    Feb 11, 2019
    176
    Bedford
  9. Sirena

    Sirena Registered User

    Feb 27, 2018
    1,496
    Female
    I have finance LPA for my mother but not H&W. Last year I was asked by the care home to decide on DNAR as next of kin, I did so and this was then ratified with the GP, there were no problems. There are no other relatives to challenge it.
     
  10. Beate

    Beate Registered User

    May 21, 2014
    11,695
    Female
    London
    The health LPA is most definitely more important than a DNR, as it covers a lot of other scenarios where you can make decisions about a donor's wellbeing. A DNR only deals with resuscitation, nothing else. So get the LPA as a matter of urgency, and discuss the DNR when the time comes.
     
  11. Banjomansmate

    Banjomansmate Registered User

    Jan 13, 2019
    1,082
    Female
    Dorset
    I have been asked for copies of the H & W LPA on several occasions by hospitals also the GP, Social Services, Care Firms and Care Home.
    The Banjoman has an Advance Directive which sets out whether or not he should receive treatment in certain situations.. This gives what appears at first to be simple instructions but turns out to be rather more problematic in practice but I can call upon it if required.
     
  12. Philbo

    Philbo Registered User

    Feb 28, 2017
    665
    Male
    Kent
    My wife was recently admitted to hospital via A&E towards the end of her 2 weeks in respite, whilst I was on holiday. She had a bit of what they described as a "seizure" (which turned out to be possibly due to a UTI) and when her sister arrived at A&E, she was asked if my wife had a DNAR in place. Of course she wasn't sure and in the event, it wasn't needed but when I got back and my wife was back in the respite unit, I asked the manager there about DNARs.

    I showed her my wife's registered LPA (H&WF), which indicated that her attorneys could make the DNR decisions. She explained that this is fine if we were present if and when an incident occurred but we would need a DNAR notice, issued by either a GP or hospital doctor, for situations where we could not be contacted.

    As my wife was readmitted the following day, I took the opportunity to ask the consultant and she wrote out the form straightaway. Legally, it cannot be copied and it is placed in the patients file and transferred with them when they move locations. So it was sent with her to the respite unit, where she is now on a 6 week assessment to determine her ongoing care needs.
     
  13. DesperateofDevon

    DesperateofDevon Registered User

    Jul 7, 2019
    669
    The Gp will hold a copy of the DNAR from hospital but who informs paramedics, lifeline, carers etc as this has been an issue I’ve recently experienced.
     
  14. nitram

    nitram Registered User

    Apr 6, 2011
    18,895
    Male
    North Manchester

    The model Resuscitation Council (UK) form clearly says 'DO NOT PHOTOCOPY'.

    This is to guard against anybody with capacity changing their mind and a, now invalid. photocopy being used. Arguably, dependent on entry in section 5, a person with H&W LPA could also do this.

    In my wife's case the LPA was laminated and accompanied her wherever she went, whilst she was at home there was an obvious note giving its location.
     
  15. TNJJ

    TNJJ Registered User

    May 7, 2019
    339
    My mum has her own copy at home and her GP has his.Mum's is in her cupboard where I know it is.So I would have to inform paramedics on the phone where it is.I have told mum to move it so people can see it but she won't.
     
  16. Louise7

    Louise7 Registered User

    Mar 25, 2016
    1,148
    There's a 'Message in a bottle' scheme which provides a plastic container, a form and stickers, and is widely available for free from GP surgeries, pharmacies, Age UK, carers groups etc: https://www.lions105d.org.uk/projects/miab.html

    The form contains space for details such as health issues, medication, NOK and GP details and whether there is a DNAR in place. It is kept in the fridge and stickers are left in prominent places so that the emergency services know about it.
     
  17. TNJJ

    TNJJ Registered User

    May 7, 2019
    339
    Thanks.Mum did have one and moved it.I will get one
     
  18. Lawson58

    Lawson58 Registered User

    I know t
    I know things are different here but there are certified copies of my Advanced Care Directive (which I believe is a more effective document than just a DNR) with my decision makers, my GP and our hospital. It forms part of my medical records which are part of our government's online health record system. My decision makers cannot make the decision about DNR without consultation with the doctors and the doctors cannot over ride my instructions in the directive. I have also POAs for Health and Welfare in place but that does not give anyone the power to make decisions about DNR.

    I also believe that most doctors are becoming fairly realistic about frail aged and questions of intrusive treatment in serious illnesses.
     
  19. TNJJ

    TNJJ Registered User

    May 7, 2019
    339
    I believe so.Dad is very frail plus cannot walk on his own .Mum has heart failure and getting worse so in realistic terms I think the doctor won’t make any unrealistic decisions.
     
  20. Lawson58

    Lawson58 Registered User

    You certainly have a lot on your plate. I wish you strength as you move through what is ahead.
     

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