My mother has the full slate of estate and trust documents, including the health care proxy and living will. I am the POA, executor, trustee, health care proxy, etc.
The only document on which my only sister is listed is the living will. My mother's wishes are that my sister and I need to decide, mutually, whether to remove life support. It's a very detailed living will, so we will follow my mother's wishes.
There is no DNR. I have been asked many times, at the nursing home, at hospitals, in the emergency room, etc., whether she has a DNR, and when I say "no" they ask if she wants one. I always say "no." And, that she does not want one.
The reason I say "no" is because I know that it would be devastating for my sister if my mother had a cardiac event or other event and nobody tried to revive her because of a DNR and my sister did not get to say good-bye and touch my mother before my mother was declared legally dead. My father did not have a DNR, and he had sudden cardiac arrest, the paramedics revived him, but he ended up in a vegetative state in ICU. He had a living will, and we waited 7 days before removing the life support. But it gave time for people to go see him, while he was still breathing. He was not in any pain. Also, miracles sometimes do happen. That's what the living will is for.....removing life support, when 2 doctors have declared there is no hope.
Anyone else out there have this issue? DNR, or no DNR?
I talked with my sister. Turns out that she has such bad memories of watching my father in a coma in the ICU that she actually wants a DNR for my mother;
withholding or withdrawing of cardiopulmonary resuscitation (artificial ventilation, cardiac compression, endotracheal intubation and defibrillation)
So, I was wrong!
BUT........it is my mother's decision. We will talk with her together.
Personally, I think when someone refuses to sign a DNR for someone else it’s not for the patient ‘s benefit, it’s because they can’t face the person’s death. Maybe educate yourself and /or your sister about death, hospice probably can recommend reading material. Is it kind to put someone thru prolonged suffering because their family can’t accept the unchangeable end result ? Imo that’s not loving.
When my father had a sudden cardiac event, at home, only my mother was there, and she did not know how to do CPR, and it took the paramedics about 10 minutes to get to him. As I said in my original post, they revived him and took him to ICU. He did not need to be on a vent. He was just hooked up to lots of monitors. But he was brain dead (sorry, awful term, but true). My sister has told me that she blames my mother because she did not know CPR and might have been able to save my father if she did.
The living will is very comprehensive. Generally, I would never sign a DNR unless my mother said she wanted a DNR and, even then, I would have her sign it, not me. And, I don't believe that my mother's memory is good enough anymore to be able to remember if she signs a DNR now, which is why I have not approached the subject with her since her memory started fading. Even if I sat down with her and my sister, and my mother said Yes, let me sign it, I am sure that she will not remember doing it the next day, and that makes me very uncomfortable. I did raise the issue with my sister, and sent her the living will, so that she could see my mother's wishes about not being kept alive artificially. The living will was signed over 10 years' ago, when my mother's cognitive issues were fine.....she sat with her lawyer (not with me) to do all her estate documents. So I know that my mother understood what it meant. When I sent my sister the living will, I asked my sister to call me and discuss a DNR if she thought it was a good idea. She has not asked me to discuss it.
I would feel different if my mother was in the hospital and sick and miserable with no chance of getting better.....but not at death's door. In that case, I could see myself using my healthcare proxy and POA to sign a DNR (if I were allowed to do that), because I would not want her to be going back and forth to the hospital.
My mother is in a nursing home. At the next plan of care meeting, this month, I will ask them to give me the DNR form and I will show it to my sister, and then see if my sister wants to talk with me and my mother, together, about it.
I am concerned about my sister, but I would follow my mother's wishes first.
The EMTs asked the Rabbi "does your dad have a DNR?". (He did). The Rabbi said to me "I lied; I told them no; I couldn't see losing my father over a piece of unchewed meat". They were able to suction and get the dad breathing again.
The Rabbi said he then told the EMTs, "I'm sorry, I lied to you. He DOES have a DNR". They patted him on the back and said "it's okay, we would have suctioned him even WITH a DNR. DNR only means specific forms of resuscitation, not general life saving stuff (or something like that).
So, as CW says, it doesn't mean they won't try to save her; it means that they won't prolong her life artificially with a full code.
And now a few comments and this is just personal opinion here.
CPR works great on TV
CPR may work great on a young healthy person
but...
CPR will probably break several ribs
CPR will probably break the sternum
even then CPR itself may or may not work bringing the heart back to rhythm.
The amount of pain from broken ribs and sternum would be incredible and most likely pneumonia would follow since breathing would be compromised.
Please do your Mom a favor and get a DNR or better yet a POLST signed.
Oh, and I found this out when my Husband broke his hip..they will "suspend" a DNR during an operation, the idea is if a person is able to have surgery they don't need the DNR and according to the dr.."no one dies on the table" they may die in recovery but not on the table.
And if you call the Paramedics even with a DNR they will do what they can it is their job and you called them.
One last thing if you do not have the DNR with you or if your Mom dies not have it with her when something happens ...it does not exist so everything will be done until that document is produced. (Example.. if you have a DNR at the facility and you take Mom for lunch and you are in an accident they will do what they can until the DNR makes it's way to the emergency room.)
So again do Mom a favor and get a DNR or POLST signed but make sure you carry a copy with you and make sure Mom has a copy on her at all times.
You are very right about the POLST. In the POA that my inlaws completed 20 years ago, they designated my husband as POA. That form also included the DNR instructions that indicated they did not want intubation or CPR etc. However, now that they are in memory care, we had to complete an updated POLST form, which spells out that we want to do comfort care only. If they die from a heart attack, and it is quick, that would be a blessing. However, they are going to route of gradually losing their faculties and eating less and less. We have hospice started for them and there will be no feeding tubes.
Me? I will honour Mum’s wishes.
One of the things we must accept in life is that when families are far flung around the country or globe is that each visit could be the last.
You are 100% correct about having the opportunity for everything to be done and goodbyes to be said.
The medical profession is lying when they say you need a DNR on file for them, “just in case“ and it’ll be saved for when there’s nothing else that can be done. Bull. They will use that as their first choice.
I’d been caring for my clients for 6 years. He & his wife were in their early 90s. He lived for her, who had worse dementia than he did. his son had reluctantly made a DNR/POLST not a month before he passed away,
When my client was having trouble breathing, another staff called the paramedics. When they arrived they started to assist him. When they asked the other staff if he had a DNR, they said yes. They immediately removed The heart monitoring equipment they had put on him, packed up all their things and walked out. He died a few minutes later.
Another friend told me of a story of their dear friend who had a DNR but he wasn’t in a life-threatening situation and yet he had to beg for an IV of fluids because he had a DNR. Something to that effect.
I heard another story which I have no relation to whatsoever but the man was 55 when in with a heart attack and died because he had a DNR.
I do not know why, but my perception is that the medical profession is overwhelmed, there are too many people who don’t pay their bills, and maybe in the case of the elderly, maybe a lot of work is done on them and they pass away anyway. This way they can save money and time. I’m sorry I think that’s what it comes down to honestly. and that’s why they push DNR’s.
I know I’m saying this in a very cold way but I am still hurting over the fact that this man died when he didn’t want to die. He wanted to live for her, and she still here almost a year later.
I was always in medical professionals faces whenever they asked me if they had a DNR before they did because I felt this is why they want it. They don’t want to spend the time and money on people who are on their way out anyway. It doesn’t help the clients, it does not give them “peace of mind”. Wake up. It is for the medical profession . It’s not for the patient. Don’t be fooled.
Please everyone no DNR unless you know for sure they want to die no matter what. and very few people are like that I think.
I’m reading some of these other stories and I sympathize and understand. This is just my story
If the paramedics are called, they will do everything for them -- because they were called.
The intent of DNR is treatment but no CPR..but most doctors and nurses think just let them die. I've written to law makers to eliminate the word DNR and change it to No CPR.
Resuscitation can mean more than just CPR. If someone is dehydrated, and passed out as a result, IV hydration might be needed and not CPR. So if the person is dehydrated from the flu, and it can be a short term thing solved by hydration, then "resuscitation" is reasonable. If they are dehydrated because they have stopped eating and drinking, then no resuscitation would mean no hydration. But you might not call the paramedics for that.
This topic makes us come to grips with our own feelings as well as the desires of our loved ones. Might be a good time to revisit "Being Mortal" by Dr. Gawande to help think it through.
My dad was hospitalized a few months ago and to what I couldn't believe I heard he told them he wanted them to do whatever it took to keep him alive. I don't really think he understood. When he finally came home he is unable to live by himself now and we ended up putting him on hospice. The hospice nurse asked him and as she explained what they would do in order to keep him alive. He changed his mind.
My experience working in a hospital is that sometimes you end up with broken ribs, you may come out in a vegetative state. You never know the end results, sometimes a person might come out ok.
When you are around loved ones, you need to make each hour, each day count. You never know when your time is up. It can be a hard decision, knowing you don't want your loved ones to die. Call and talk to your sister and look at all the options.
Wish you the best, sending prayers.
So it hurts nothing to wait and see when the time comes.
First a DNR is a legal document. While the person who it pertains to can supersede it, I think the dr can be held libel if he goes against it.
But you are wrong about waiting, my stepfather hated the thought of being “put on a machine” but never put it in writing. My mother has also strongly opposed the same but when it came time to let him go she simply could not do it, even with all medical personnel telling her the reality of CPR, he had no chance of recovery etc. it was a horrendous 3 weeks until she finally accepted it . After his death she did make a DNR for herself along with POAs .
died. Her heart just gave out, after life long heart problems. She was always a small woman and she was probably 80lbs when she died & under 5 feet tall. Anyway she did not receive CPR, she passed peacefully just the way she wanted. I cannot imagine them performing CPR on her small frail body! Even if they had gotten her heart started again, she would have have painful broken bones and bruising and required rehab! People see CPR performed on TV all the time-where they make it look like nothing! But is actually physically grueling to perform CPR and it is violent to the human body!
When my father died he was on Hospice and at his own house. My mom was so upset that the hospice Nurses would not resuscitated him. His body was riddled with cancer and he was on high doses of pain meds that didn't completely work. He would beg us to let him die. She did not want to let him go. She didn't want to see that every inch of him was in pain. He had a DNR and she wanted to override it. It was so hard to make my mom see that she was thinking only of her own pain and not was best for dad. I didn't want daddy to go either, but watching him go through that much pain was more unbearable. I whispered into his ear that I would not let them do anything and he slipped into a comma and peacefully left this planet.
My mom is scare of death and wants to be resuscitated. I will honor her wishes for as long as it is medically possible. I am glad I was able to honor my fathers wishes and I will honor my moms wishes no matter how hard it will be for me.
I wish you luck with what ever you decide.
This is a personal decision, and it will be different for everyone.
My mother has said in the past that she thinks that I will pull the plug too quickly and my sister would wait to long. So my sister and I work together to make sure that when the time comes, the right decisions are made. In the meantime, the POLST form is on the refrigerator at my mother's facility, just in case.