Are people not allowed to just die anymore?(62 Posts)
My gran passed away last night, she was 92, not mobile and had been in a nursing home for the past two years. She has had a urine infection and been confused these past few days and tbh I feel this is a release for her. However, I am less than happy that her final moments were spent being pummelled on the chest by nursing home staff and paramedics.
Please please don't think for one moment I am upset with the people involved, I am not, they do a selfless and wonderful job. However, it seems that protocol now deems you cannot "just die" but efforts must be made to revive you. I am certain that those present were just doing their job but I so wish my Nan had been allowed to slip off without the heroics.
It IS a sudden death because despite the urine infection she had no other issues beyond the normal ones for her since her stroke. The Coroner has had to be informed etc and she had not seen a doctor for some time. I assumed she was on antibiotics but apparently not.
My Nan has wanted to die for a long time, she would not have wanted all the heart pummelling and I am relieved for her that it wasn't successful but so so wish she had just been put back into bed and had her hand held while they contacted the family. As a nurse years ago I don't recall us doing much else (circumstances depending), even for a sudden death when the patient had such underlying health issues as my Nan did.
I am probably being unreasonable but just wanted a more peaceful death for her.
Sorry for your loss
My god she was old though, 92 years is an achievement!
Sad but true and more what the Liverpool Care Pathway is about than people want to know. They want to think it is a hastening of the end, but it is not it is a not slowing the inevitable.
What???? It's not a hastening of the end but it's a not slowing the inevitable??
Firstly bringing the Liverpool care pathway into the debate is completely irrelevant when we are talking about DNAR's. Secondly your statement makes no sense whatsoever.
It makes perfect sense to me. We have families going to the media talking about the fact their "92 year old cancer-riddled/etc family member was placed on the pathway" - what did they expect?
We seem to have lost the ability to come to terms with death - I've witnessed sheer panic and terror at the viewing of a cadaver. Death comes to us all and I think we need a change in mass psyche. It's not uncheatable and I think we also perhaps need to look at the sensibilities of keeping people alive for the sake of it. Medical advancements are wonderful, but they don't need to be applied in each and every situation.
I would be horrified and furious if an ill and frail member of my family was "kept alive" despite DNR's.
Again I want to thank everyone for their kind words and their comments about this.
My Nan was asked several times over the curse of her stay in the nursing home about resuscitation, each time she clearly said she did not want this. The home is a busy one though and I cant quite clearly see that a nurse who is new might not know everyone well enough to know who is and is not for DNR.
As a family we know she had fantastic care in this nursing home, she was as sharp as a pin and didn't miss anything. She repeatedly told us about being happy there and the Carers and Nurses, she knew all their names and about all their families. She knew all the other residents and all their troubles, I will laugh forever about "the new lady who can't drink from the cups because she has a nose like Punch and can't get it in the cups so has to drink from the side".....my Nan all over that was
Your nan sounds like a lovely lady with a real character.
I'm sure your Nan would have wanted the nurse to do her best for her in all the circumstances and it sounds like she was really lucky to be in a lovely place. Hopefully she didn't know or feel anything right at the end.
May she rest in peace, I hope you can enjoy sharing some memories about her with your family over the next few weeks.
I used to work as a clinican and one of the main reasons I left the profession was the undignified preservation of life. I specialised in neurosurgery and neuro- critical care. I had to deal with a lot of young people with AIDS induced vasculitis, massive head injuries and devastating intra-cerebral haemorrhages. These people were left in comas and some were given the prognosis of LESS than 1% chance of a meaningful recovery. Were we allowed to switch off machines? Were we hell! They had not met the criteria for brain death. I now have a living will that if I am unfortunate enough to ever find myself in this predicament I am not to receive active treatment and just to have basic pain relief and a dignified death. Treating these poor souls left me with severe clinical depression which disappeared a few days after I quit the job.
I think you should talk to the care home. It's good that you are able to accept it now but it shouldn't have happened if she had DNR on her notes.
I would calmly talk to them about reviewing their procedures so that it doesn't happen again. Someone mentioned a colour code system - perhaps over the door or somewhere discrete but obvious if you know where to look.
Even if she is DNR medical staff DO make mistakes. One of my colleagues successfully resuscitated a guy who was DNR once only for him to arrest again 2 days later. Thankfully the second time a decent doctor was on duty and he got to pass away.
Your nan sounds like she was a great lady. I love her observation on her fellow resident.
I found Jennifer Worth's book of call the midwife fame very enlightening on just what you are saying. She argues,as others have here, that death has become too abstract for most of us and dnr is often the most appropriate course in very old age, but this is not applied in current medical care. I do so agree with you being so upset that this wasn't applied despite your nan's wishes.
I am so sorry for your loss.
I'm really sorry. My Granny died last night too. She was in hospital for a couple of weeks and there was a tremendous fuss last week when she was given all these interventions and hooked up to all sorts, and it turned out they had lost her DNR and left it at the other hospital.
Once that was found, things got better...but my parents were in a state trying to get what she needed and wanted - she wanted to die at home but ended up on a noisy ward instead.
It is a minefield and very hard to get it 'right' I think, because it's not the sort of thing you can get good at, it doesn't happen that often to many of us and we're unaware of the protocols and so on.
I do think things should be made less bureaucratic though for the sake of the people who are dying and those close to them.
Rest in peace, both of our lovely old ladies x
I also found the book by the late Jennifer Worth very interesting reading. I didn't realise that life was preserved at almost any cost to the patient, even when the patient was highly likely to suffer a poor quality of life if resuscitation was successful, unless they had a DNR in place, which staff were aware of in an emergency where resuscitation was required.
The book had some truly heartbreaking stories in there of people whose quality of life was so poor after resuscitation, that even the family members who had originally begged for their loved one to be resuscitated, had realised it would have been kinder if the relative had slipped away.
Unfortunately this situation occurs too frequently; I'm a paramedic and we find ourselves carrying out resuscitation on people who common sense says it's inappropriate. For us not to start a resus depends on strict criteria eg how long since the person was last seen, what is shown on the ecg etc. We are not allowed to look at the person individually, or even to use common sense as everything is timed and ecg printouts required if resuscitation is not started.
Also I think most people think having a conversation with famillies/care staff, or writing their own letter of intent re resuscitation will be ok -unfortunately for us not to start a resus on someone who technically we should do, there has to be an official DNR hard copy in place, on the premises, for us to see. Even DNR's active in hospitals are usually not active once the person is discharged home/care home, and not many people realise they need to get a new one sorted by their own GP.
I hope you have lots of happy memories of your gran and as others have said she wouldnt have been aware of a thing xx
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