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DNR doesn't cover our EOL situation

Discussion in 'End of life care' started by sueorbell, Aug 14, 2016.

  1. sueorbell

    sueorbell Registered User

    Mar 15, 2010
    92
    California, USA
    Mum has been in EMI care since 2010. We signed DNR etc. However when her end of life moment came it didn't help. Got a call from care home August 5 to say she was end of life after a stroke overnight. Flew home, said goodbye, cried, sang hymns, told her to let go we would be OK etc.

    However 4 days later she was hanging in there, no food of water for 4 days, no apparent pain, and strong pulse. It seemed like her eyes were more focused and tracking us and grip was still strong.

    She had a respiratory infection, and a stoke (no one saw it, no hospital visit to confirm), and my sister and I still hadn't seen GP. GP who declared stroke and end of life was vacation coverage doctor.

    So GP comes in on Tuesday, and in the absence of an advanced directive from Mum (of a detailed sort) we all decide to treat respiratory infection and give IV fluids to check if she is fighting back. After 72 hours with care home antibiotic and IV treatment via hospital at home it is decided she is not able to fight back so we are back on end of life again.

    It was so difficult to make the decision without Advance Directive, which we would have had to discuss 10 years ago with Mum, prior to dementia

    So DNR is all well and good but doesn't cover the half of it, in our experience.

    Poor Mum, we are praying for a quick and peaceful passing for her, but her body was strong before this incident so who knows.

    Just wanted to share, because this situation was a surprise to sis and I who thought we were so well prepared!

    Sue
     
  2. jaymor

    jaymor Volunteer Moderator

    Jul 14, 2006
    12,556
    Female
    England
    My understanding of DNR is that it is an instruction that no intervention is used to resuscitate the person after the heart has stopped beating or the breathing has stopped. It does not rule out trying medication.
     
  3. sueorbell

    sueorbell Registered User

    Mar 15, 2010
    92
    California, USA
    That is exactly the problem. We had no idea if Mum would have wanted antibiotics and fluids given her situation. So hard. Sue
     
  4. lemonjuice

    lemonjuice Registered User

    Jun 15, 2016
    1,535
    England
    I think you'd find that she'd be administered antibiotics and fluids anyway these days. Everyone is so afraid of being accused of 'assisting someone's death'.

    One of the first things we did many years ago was to get the purple forms for DNR, but as you so rightly point out they are only useful if the person has a heart attack. So not really much use as we watch our LOs struggle with all the other slow ways of dying.
     
  5. cragmaid

    cragmaid Registered User

    Oct 18, 2010
    7,942
    North East England
    In the UK, along with the DNR we have the EHCP....Emergency Health Care Plan....which is decided along with the GP. We had one for Mum because she was in a CH and not Nursing home, if she needed IV ABs she would have to go to the A&E. We stated that in the even of a need for Emergency treatment, Mum would only be taken to A&E in the event of a physical Trauma i.e skin damage or broken bones.

    This was backed up by the LPA which permitted me to act in Mum's best interests.

    It might be worth enquiring if such a plan is available where you live.
     

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