The Dreaded Question

[snoggy1one]

My mum's health has been very up and down and I have been asked to think about whether Mum should be resuscitated should she become worse and whether we would like further intervention to be given in order to keep her alive should she have to be hospitalised. My friend's mum is in the same care home and has also been asked the same question. Is this normal procedure for residents when admitted to a care home? I don't know how to react, what to do or decide or how to feel? and at what stage is it the correct decision to say leave a loved one to slip away naturally. Is it it ever the right decision when your parent cannot decided for themselves? I feel awful today just thinking about the enormity of such a massive decision when my instinct wants mum to carry on and on and on forever. Am I being selfish for thinking this way or is it sometimes kinder to not prolong things? Can anyone help with advice or comments please ?

Thanks xx

 

[Aisling]

Hi

am guessing that this question is asked but I could be wrong.
My OH goes into respite and I was asked the same question. I was so shocked and still thinking about it.

Lots of hugs

Aisling/ Ireland

 

[Moonflower]

I'm not an expert but am going through this process with my mum's care home at the moment.
We already had a DNAR in place - so that, for example, if mum had a heart attack they would not attempt CPR.
What we are now discussing is the next step, as it were. I have made it clear that I don't want her to be in pain, or frightened. I would rather any end of life care takes place at the care home rather than in hospital - mum finds hospital very difficult, as do many AZ patients. If she has a chest infection, she will receive antibiotics at the care home but I would not want her hospitalised for intravenous antibiotics.
To be honest, if such a decision was needed during the day when I'm around, then deciding this in advance wouldn't be necessary. I could be at the care home in 15 minutes and have POA. But if a crisis happened when I'm working away from home, or in the middle of the night with a locum doctor called out, then they might hospitalise if there isn't a note on file saying not to.
I think also although its a horrible conversation to have, I'm probably coping better with it now when there isn't a crisis than I might when there is one.

 

[jaymor]

I think it is important that we do think about it, hopefully way before something happens when a decision may be needed in a hurry. The importance was brought home to me this week..

Approximately two years ago my husband had an infection that affected him so badly he was put on end of life care. I spoke at length with his doctor plus several other professionals involved in his care and a DNAR was put in place after the whole family was consulted. We chose how we wanted it worded and what we would allow and what we would not. It was placed in my husband's care plan. Thankfully he improved though was left completely unable to do anything for himself. It has accompanied him to hospital 4 times.

This week whilst I was at the nursing home he needed the paramedics and they came. They had his care plan and asked had I ever thought of what I would want for My husband regarding treatment if they needed to give resusitation. I told them there was a DNAR in place. He said it was not in my husband's care plan where it should be. It had not been returned with his paperwork when he returned from the hospital a couple of weeks ago. Now he has a serious heart problem and had he arrested and I had not been there then the would have done what none of the family wanted.

It is important to think about it and think hard but please don't leave it until a decision is needed and you don't have the chance to think about it in depth. It is a difficult and hard decision to make and it needs to be right for both carer and cared for.

 

[snoggy1one]

Thanks for all responses. My head is buzzing, but it is reassuring to hear other peoples experiences and points of view. xx

 

[Witzend]

We weren't asked about DNR or other intervention by the care home until our mother had been there a couple of years - she was already 89 when she went in, and her Alzheimer's was pretty bad.

By the time they did ask, she was frankly in a pitiful state - incontinent, not able to hold any sort of conversation, and no longer knew any of her own family. She was also well into her 90s and so we thought it would be kinder not to intervene, if Nature were trying to let her go. She was not apparently enjoying life at all any more, and we knew that if we had been able to ask her former self, she would have said, 'For heaven's sake, just let me go.' She would have been so appalled and horrified to see the state she was in. In the event, the question was irrelevant - she deteriorated quite suddenly and was gone within 48 hours.

I think it may be helpful to ask oneself what the person's former self would have said, if they could have seen how they are now. A lot will of course depend on whether the person is still enjoying life at all, regardless of their stage of dementia.

However, regarding DNR - I gather that the actual process of resuscitation - re-starting the heart if it has stopped - can have very painful after effects, cracked ribs and so on. Our elderly neighbour was resuscitated after a heart attack, and he told me it was so painful afterwards, he wished they'd just let him go. He did in fact die not many months afterwards.
I must say I am glad we had ruled out any question of this sort of experience for our poor mother.