DNR Notice

[Tabithascat]

Hi Alzheimer's Society,

I need some help with a problem relating to my friend with dementia and cannot find any reference to it on the forum.

After several years of independent living with this condition my good friend moved into a high dependency unit. I have POA on the finances by the way but not on health.

Although prior to this he had agreed with a DNR notice when he was admitted to the home he went against this and had maintained that position. His doctor does not agree and is asking the home to get me to write and say that the DNR notice should apply.

Although I believe his former self wouldn't have wanted to be resuscitated its obvious that he can no longer make this decision for himself. He had been a priest all his life and always said he wanted what God had planned for him and that didn't include human intervention.

So, apparently I have to write something... But which way to go, I really don't know.

 

[canary]

Its a difficult decision tabithasact and no-one can tell you what to do here - you will have to go with your heart.

If it is any help I had to do the same for mum recently. She had always said she didnt want to be artificially kept alive, so I signed the DNA form on her behalf as Im sure that is what mum would really want if she understood the situation. But you dont have to do the same.

 

[Lavender45]

Its a difficult decision tabithasact and no-one can tell you what to do here - you will have to go with your heart.

If it is any help I had to do the same for mum recently. She had always said she didnt want to be artificially kept alive, so I signed the DNA form on her behalf as Im sure that is what mum would really want if she understood the situation. But you dont have to do the same.

Please do not think me disrespectful. I totally think you are doing the right thing for your mum and being honest I'd like to think I'd do the same for my mum, though it must be one of the hardest things imaginable to do.

Can Tabithascat make a decision on behalf of her friend if she does not have POA on health? Please don't think me rude. I'm learning so much from the forum and I definitely need to learn as i knew next to nothing.

 

[Lindy50]

Hi tabithascat and welcome to TP

It is my understanding that the doctor should make the DNR decision, not you, and he should do this in the patient's best interest, and in consultation with next of kin or nearest relative ( as you have POA this may be you in this case - or if there is close family, they should be consulted if possible.)

I think that unreasonable pressure is being put on you in this case. The doctor should discuss it with you, not ask second-hand for you to 'write something'.....and then it is the doctor's decision to make.

For example, I was consulted as above when my mum was admitted to hospital. The DNR form was completed 'patient not consulted as lacked capacity due to dementia'. Then the doctor gave two reasons for the DNR:

1 procedure if successful would lead to poor quality of life
2 patient has previously said to daughter that she wished it would all end

So I gave my view of what mum would want, but it was the doctor who made the decision. By the way, I have finance POA and not H & W , like you.

Don't be bullied into feeling it's you making a decision. Tell the doctor what you know of the situation, and it's up to them to reach a conclusion.

There's lots about this on the web, too.

Hope this helps

Lindy xx

 

[canary]

I thought I might clarify my post

I hold CoP (finances only) for mum and she is in a CH. It is my understanding that the CH asks all residents family to fill in a form on their family members behalf on end of life decisions (I cant remember the name of the form) so that it can be filed in the residents file ready for when it is required. I was told that this was done routinely so that the wishes were there in advance and would cause less stress when the time came.
Perhaps this is not the case in other CHs? My post was based on the assumption that it was.
I had also assumed that as the friend was a priest, then perhaps he has no family now and that tabithascat held PoA. If there is indeed family, then I agree - it should be their choice, but in that case I am surprised that she was asked. If there is no-one else to make that decision on his behalf and she does not wish to make it, then I should imagine that this too is a valid choice.

 

[Lindy50]

Hi Canary

Well, it may be me who has misunderstood But I do think that a doctor has to agree or sign a DNR form. A relative or POA can say what the person would want, but that's surely helping the doctor, not taking the responsibility as such? Maybe there are different rules for care homes than hospitals?

My OH says I salami slice things too much and if I've caused confusion I'm sorry

Lindy xx

 

[jeany123]

Yes the doc signed and filled in my husbands DNR form after talking to me,


Sent from my iPad using Talking Point

 

[canary]

I dont know what happened to mums form after I had signed it Lindy, but I assumed that, like Jeany, her doctor signed the form to say he agreed. I think its so that in an emergency eg a sudden heart attack they would know what to do as there wouldnt be time to contact anyone.

 

[Lindy50]

I dont know what happened to mums form after I had signed it Lindy, but I assumed that, like Jeany, her doctor signed the form to say he agreed. I think its so that in an emergency eg a sudden heart attack they would know what to do as there wouldnt be time to contact anyone.

I'm sure that's why they want these forms already on file, Canary, and I agree with that

My point about the doctor signing was meant to reassure Tabithascat that whatever she / he said, the final decision, legally, would belong to the doctor. So although what we as carers can contribute has huge importance, we shouldn't be made to feel responsible for the life or death of our loved one in this way. Depending on circumstances, the decision should at least be shared, and in the last resort, made by the doctor.

That's my understanding, anyway. Others may differ....it's an interesting question, to say the least.

Lindy xx

 

[LYN T]

Pete's GP phoned me to talk about DNR. The CH were concerned that there were no directions in his file. I said pain relief only- no invasive procedures. This was based on a conversation when we were discussing Pete's Mum (she also had AD). He said 'if that happens to me shoot me'. He was serious. The GP said he thought that I had made the right decision.

I also only had LPA for Finance.

A difficult situation Tabitha-it's difficult to know what to advise

Take care

Lyn T XX