Do Not Resusitate

[babypie]

Hi

Dad is 88,is in a care home. has A.D and multiple health issues,advanced congestive heart failure, Artrial fibrillation, one kidney completely not working and barely able to walk now.
He is doubly incontinent, has lost many stones in weight and looks a pitiful sight who keeps saying he wants to die.

I had a phone call the other day, I was on my first holiday in 8 yrs as Mom had dementia now Dad and I could not have gone on holiday and left them before.
Basically the GP has been into Dad 3 times in 3 days and now want me to put a DNR in place. It was a shock and I could tell she felt really awkward asking me. She said the doctor has asked them to ask me what I wanted to do.

What does it all mean..I do not mind brutally honest answers. Have the doctors noticed his Sats .pulse..BP and things going down or could he go on many months (yrs) still? My mind is in a turmoil.

I spoke to Dad today to put my mind at rest..

Me... (after Dad said again I know Im dying)..Dad would you prefer to live another few years in here or be with Mom?
Dad..Does being with Mom mean I am dead?
Me..yes
Dad..then I want to be with Mom.

So sad and heartbreaking. The carers have said he has gone really religous praying lots and is convinced Mom is with him.

Any experiences would be greatly appreciated
BP x

 

[marionq]

The religious thing I wouldn't worry about - after all what are you going to cling to when all else is gone. I will be praying a lot too when I face the unknown. Your Dad is at the stage where he needs to be comforted and comfortable and you are doing that for him. This is all you can do and is in fact a great thing to do for a loved one.

When my bachelor brother in law was dying in hospital he hung on until husband and I got there and died twenty minutes later and I am sure it was so someone of his own was at his side.

Good wishes at this trying time to you all.

 

[susy]

DNR means do not resuscitate. I'm not sure exactly what that means. I would not want anyone jumping on my mum or dad's chest and try starting their hearts. But if they were deteriorating I would want them to be comfortable. I would want them to be given sips of water if tolerated. I'm not sure about a drip. I think they can prolong life, but being dehydrated isn't comfortable, but it does mean someone putting a needle in reasonably often as the veins don't like foreign bodies in them for too long and react against them, making that area sore. I guess the medication that he might also be on would be looked at too.
I think first of all you need clarification of what this actually means.

I'm so sorry that this has happened whilst you are on a much needed holiday!! Surely this should have been dealt with before hand.

Best wishes xx

 

[jan.s]

Hi Babypie, I am sorry to hear about your dad. It is a hard decision to take.

I have just agreed to a DNR for my husband who is 66, with severe dementia. I spoke at length with the senior nurse about the implications of this and was advised that to resuscitate would not be in his best interests.

The process, I understand, is quite violent and can cause physical damage, such a broken ribs. I often only prolongs life for a short period. I have there asked that should such a situation arise, that I would prefer his end of life to be calm, peaceful and pain free.

That is my understanding of DNR, and I hope being blunt doesn't cause upset.

I found this a difficult aspect to deal with, but know I have made the right choice for his benefit.

Jan x

 

[Mun]

I'm a nurse & myself & my family have agreed a DNR for my 91 year old dad who has end stage AD/VasD. He has been deteriorating mentally & physically for the last 8 months & had a significant downturn in the last couple of weeks,resulting in him collapsing @ home last Mon & needing hospital admission,which I didn't really want,if I'm honest,I'd wanted his last few days,weeks,months to be spent in familiar surroundings,surrounded by his family & not being subjected to any invasive procedures such as iv cannulaes,multiple blood tests,urethral catheters :-(( but sadly that was not to be.
He's being cared for brilliantly on a specialist dementia ward,he has pneumonia now,but after a long & soul searching discussion with dad's consultant,he is not having antibiotics & all other invasive interactions have been withdrawn. He has a sub-cut cannula in,which is a minute needle placed just under the skin,not in a vein & through that pain relief & sedation can be given.
Dad is able to take sips of water & some ice-cream or similar.
He looks comfortable,I don't know how long my dear dad will be with me,but knowing now how well he is being cared for,for the first time in 5 years as his main carer,I feel @ peace.

PS: CPR for my dad was not an option,having performed it myself on many patients over the years,it it something that I did'nt want him subjected to,considering his frailty,quality of life & worse still,his potential quality of life if he did survive post arrest,which the statistics show are poor in the elderly.

 

[susy]

That last sentence of yours Mun was very reassuring and comforting. Thank you. Also, thank you for describing the subcutaneous approach to rehydration & going of medication. That has helped set my mind at rest too.

 

[Wolfsgirl]

A young man I vaguely know suffered a heart attack on a football pitch a few months ago, the ambulance crew tried to keep him alive until his partner arrived. He was black and blue by the time she arrived - sadly he did not make it. I would not want this for my Mum she is too frail already.

 

[WILLIAMR]

Sadly my step mother was suffering with a blocked intestine, pulmonary fibrosis and all sorts of other problems.
The doctor did say if I had been suffering with a blocked intestine he said they would have operated as I was likely to have a good quality of life after at 63.
He advised the son and myself that it was best not to intervene when this happened to my step mother as she was unlikely to survive the operation and if she had her quality of life would have been worse.
We could only agree and she died a few hours later.


William

 

[jan.s]

I have actually witnessed some trying to resuscitate someone, and I agree it's not a pretty sight, and certain not something I would wish for either myself or my husband.

 

[Mun]

susy,thank you,I hope that my experience with my dad is of some help to others who have to make the life changing decision of a DNR. It's not a decision to be taken lightly & that decision if we decide against it,will stay with us for the rest of our lives. My dad is the most precious person in my life,but I wouldn't want him to be put through the trauma of such "an assault" on him,when the outcome has a real possibility of making his life even worse than what it is now & that isn't great.

 

[cragmaid]

There is both an ECHP (emergency care health plan) in place for my Mum, meaning that unless she suffered trauma...e.g a fall resulting in a broken hip, or an injury requiring stitches, Mum would simply be treated at home in the CH, and there is a DNR which states that, due to Mum's age and frailty, CPR will not be performed in the event of a cardio incident ( heart attack or similar).

It's almost a year since the DNR was put in place and it will be reviewed in September, but since Mum is one year older and weaker and at least two stones lighter, I have no doubt that it will stand.

We have all watched the trauma programmes such as Casualty, ...I have no wish to see my poor little Mum subjected to anything that will prolong her pitiful life as it is now.

There is a time for what they used to call "Heroic Measures", and my Mum has passed that time now.

 

[babypie]

Hi

I want to thank you all so much for taking the time and effort to reply to my post, it means alot.

I saw the GP, new to me as Dads doctor changed when he went into the home. She was so,so lovely. Explained everything and said Dad had asked her about being able to die on the same day the home phoned me. I got SO much comfort from this as basically he has decided himself.

She is undecided about withdrawing antibiotics for the chest infections as they are not working anymore. She is having a meeting with a colleague today about it .

I relayed my recent conversation to her with Dad and she put it all in his notes.

I will wait and see the outcome today of the withdrawal of meds and I m off to see Dad later.

Thak you all once again

BP x

 

[CJW]

I actually asked the GP to put a DNR in place for mum and was astounded when she said we would have to think about it and she would have to talk to Mum. Poor Mum is very bonkers and I dont know how she planned to get a sensible answer from her or even think that Mum could understand the question. My feeling was that she thought I couldn't wait to get rid of Mum when in fact all I wish for her is an easy death. She has a condition that will mean a painful and unhappy end of life and end stage dementia would be no fun either. As far as i'm concerned a heart attack would be a blessed relief for her and ressuscitation would condemn her to a living hell. I think this decision is actually about putting aside our feelings and really thinking about what they would want and ultimately being as kind as possible.

 

[2197alexandra]

My mum had MS and during her earlier healthier stages she had insisted on being resusitated. This was clearly noted in her medical file. However as the disease profressed this was never changed and the last 3 months of my mother life was inhumane.

In the final 24 hours of her life she was resusitated 4 times. As her family we had to just stand back and watch because of the decision my mum had made. It was the most heart breaking thing to watch and I swear that witnessing the whole drama it has left me unable to grieve for my mother. She was beaten black and blue in order to give her a few more hours of agony. It was a sin. Its took me a couple of days to pluck up the courage to reply to this thread as its such a raw subject for me. But I know that if she had realised what would of happen she would never of said to resus.
In the end we called her doctor to one side and begged for them not to resusitate again but they said if we told them she had gone then they HAD to. So the doctor quietly told me and my dad that if we accidently left it longer than five minutes the next time before we told them then she would be gone peacefully.
The next hour was amazing she removed her wedding ring and placed it on my fathers finger took off her oxygen mask and drifted away.

When me and dad arranged his health and welfare POA he left me full control to make all medical decisions for him and we agreed I would put a DNR on his medical records.

Its a tough decision for you to make I can only offer my experience of the DNR process from the other side when the decision is took out of your hands.

xxxx

 

[copsham]

This i so sad. All we want it a peaceful end and in so many cases it just is not.

I have been consulted about DNR for my mother on three ocassions always on the phone and quite insensitively. I agree with the DNR - my mother is clear that she wants to die saying "If I were a dog they would put me down" I hope she fades peacefully at some point but what is the chance of this happening??

 

[sammielou]

just my thoughts on the matter

a DNR can be the kindest option sometimes, CPR is a violent procedure and with your dads conditions it is unlikely he would survive. a DNR would allow him to pass peacefully and with dignity.

at my place of work whenever a patient looks like they might pass they are made as comfortable as possible and their space made as relaxing as possible, if no family are known we also sit with the resident and reassure them so that they are not alone. im sure that the home would do the same for your father.

i mean this with so much empathy for your situation although its hard to hear over a computer!

 

[Mun]

sammielou,very eloquently put x

 

[di65]

When my parents went into care (at different times), I was asked right at the beginning whilst all the forms were being filled out if we wanted DNR activated. Although this initially took me by surprise, it would have been better than having to make a decision when they were at the later stages of their illnesses. This is standard practice in this Rest Home, and they are lovely caring people who I couldn't fault.

Keep strong

 

[babypie]

Thank you all

I want to say thank you to everyone who replied to this thread.

Dad is really unwell now and I saw him in his underwear the other day and I almost fainted how thin he is. I asked about his weight and he has lost 6 kilos in a month. Its so upsetting. He has now stopped eating but is drinking still when prompted.

I think the end is looming but he keeps saying he wants to be with Mom (passed) so I have to respect his wishes now I think.
God bless to everyone fighting this terrible evil disease and all those caring for them,

BP x

 

[Mun]

babypie, thinking of you @ this sad time,my dad is,I think @ the same stage as your dear dad