Advice and info re dnr

[thesandwich]

Hello all. Any advice info/ pointers to info regarding the implications of dnr?
Dfil is currently in hospital for the second time in 2 months with dehydration/ Uti etc. He is mid 80's, had a severe stroke 8 years ago and has been in a nursing home for several years. Until recently quite with it but declined massively and refuses food/ drink. Doc is asking about dnr- what impact would that have? It is as if h e is only being kept going by drips/ antibiotics and will go back only to decline again? Any thoughts welcome.

[Rozbos]

I've not been in this position personally but am a nurse so can talk you through it a bit. A do not resuscitate order means that if your fil dies, (heart stops beating or stops breathing) they would not resuscitate. They would however continue to admit him to hospital and treat him as appropriate with medication, iv fluids and antibiotics. If they feel that it's not appropriate to continue to give him antibiotics, fluids etc this should be discussed separately. Resuscitation on an elderly gentleman with multiple health problems in reality is very unlikely to be successful, it's not like on tv unfortunately, the vast majority of people who have a cardiac arrest will not be successfully resuscitated and if they are again the vast majority will rearrest within 7 days. Resuscitation is also pretty brutal and, by necessity, undignified. I think you also need to consider his quality of life which would only decline following even a successful resuscitation. As a nurse I personally would not want my relative to be resuscitated in this situation however I understand it's an impossibly hard decision. I hope this helps.

[Sosidges]

The DNR only applies to invasive procedures. I have lost 3 elderly relatives recently all with aDNR. They were given nourishment, until they could not eat, kept hydrated and also had an anti-biotic drip.

I found the hospital dealt very well with me and all of my relatives had an easy passage into death.I told the doctor that after my mum passed away a few months earlier, My step-father had expressed a wish to die. He had made me promise I would not let the hospital try to keep him alive. Because of this he was not transferred to ICU but died on the ward 5 days after admittance. The kindness of his doctor was wonderful.

[Sosidges]

One more thing, is to prepare yoursel for the process to take longer than you might think. No-one will tell you how long, as each patient is different. My mum survived for very many weeks after her stroke, even though she ate nothing during all that time.

[ImAMoving]

The DNR or DNAR just applies like others have said to resuscitation, I.e. the patient has already stopped breathing or their heart has stopped. It is very traumatic and not very successful for elderly people who are already really ill and their quality of life afterwards is poor.
They will still be washed/given fluids/antibiotics/pain relief everything else. Although unlikely to receive treatment in ITU as that goes hand in hand with resuscitation

[thesandwich]

Thank you all really useful info.