Do not resusitate order - family informed?

I am not sure if you or your family understands what the DNAR means - it doesn't mean that they will not treat his illness or continue to make him comfortable- just that if he he has actually gone into cardiac arrest they will not attempt to resuscitate, as in if he needs CPR as there can be more damage to the body from this and for someone with little quality of life who is very ill it can be the case that their body will be further damaged and they will live on in more pain.

There is also no guarantee that CPR would be successful.

But yes your dad can overturn this, if that is his wishes. If your dad has 'capacity' they must go by his wishes - they would only ask family members if he would be thought to not have capacity e.g. If he had dementia and then they have to do paperwork around 'best interests'.

that reminds me - have they given him any antideps?

also confused by what you are saying

your dad can overturn the DNR.

as for the illness, I didn't realise your dad was so young. My auntie has been living with COPD for years, she's late 60s. She is in a care home, when she goes outside it's in a wheelchair. She's on oxygen most hours of the day.

but she also wanted to live. She was adamant about it. She is pleased to have more time and has recovered enough to read etc.

sorry, as it's Elderly Parents I just assumed your dad was 80+ but at 65, there's more they can do to help him recover....maybe?

it sounds like possibly everyone is in that horrible place of panic and sadness combined, and a step back from those thoughts and a good visit with your DF will help?

Please speak to PALS. When you say ‘your dad is not able to overturn this’ I am not sure what you mean. If you are referring to the progress of his illness then that is true. If you are talking about the DNR this is not an absolute.

I do feel for you as it seems your Dad hearing this news feels it is a death sentence and an inevitability about his situation. 40 years ago, my dad had one of his lungs removed and 3 years later was admitted to hospital for an operation on the other lung. He overheard the doctors discussing him and saying the other lung was inoperable and he would be discharged. Like your Dad, he was very upset and gave up.

I know it is hard when you are so far away and not the NoK. I send you good wishes .

Perhaps they didn't use the actual words DNR, but maybe something more round about. Like if your heart was to stop, do you want us to treat it. Or something like that. I know of someone who was asked like that. But from his reply I don't really think he understood what they were asking.
What they are really asking is if you want. Nice peaceful natural death or a barbaric resuscitation that a frail person is unlikely to survive. Which you really don't want to put anyone through

Could PALS at the hospital and/or his GP be of help?
I want to echo what app said about doctors using indirect language. Some doctors are no good at the” bad news” bit and really use fuzzy language that can be misinterpreted easily. So the conversation may never have hit home in the first place.
So sorry for your situation op

are you all familiar with the DNR process?

also, if you ask your dad, is he likely to need an explanation of it?

if he is asked and says he would prefer not to have a DNR, I would respect that. There are certainly people who want to live no matter what, he may be one of them.

I don't think it's cruel at all to accept that a DNR is appropriate for your DF. Tbh, I think it's often crueller, in practice, for families to insist on resus when it can essentially only do harm - it's a rough and nasty process with a low 'success' rate at best. But it's not my DF so it's easier for me to say that. for you.

Resuscitation, as I am sure you are aware is extremely traumatic. I had a DNR for both my mother and stepfather as they were both very weak in the final stages of their life. My mother had made a living will bit my step-father had not. In both cases the Doctors treating them were extremely kind. They explained that admittance to ICU was very invasive and that the body had a way of knowing when enough is enough.

Though they may not have used the words ICU or DNR, do you think they spoke to him in terms of ‘when the body has had enough’. I truth this maybe should be discussed with the family, but the first duty, is with the patient.

Having a DNR doesn’t mean he won’t get well again, or that he will necessarily die soon, it just means that when he does die, they won’t try to resuscitate him. When someone with advanced COPD dies-from infection, or heart failure, or something else on top of their COPD, it is extremely unlikely that they would be able to be resuscitated and even if they were, their quality of life and life expectancy would be minimal.

It may well be that the doctors phrased it differently to him and the actual words DNR or resuscitation might not have been used.

DNR does not mean no treatment so maybe reassure your dad that they will still be doing everything that they can for him like treating infections etc.

I would not be seeking to overturn the DNR. It is a brutal process with little chance of success.

it doesn't sound cruel at all

are you worried that he might not be okay with DNR now?

If you and your family think it's best, and if he won't answer the question, I would leave it in place.

I know how hard this is, I really feel for you. My dad had an unpredictable condition and didn't sign a DNR until just before he lost the capacity to do it, I'd say. I loved him, but I was relieved. It doesn't make you bad that you think it's best

petite is it a possibility the dr's have spoken to your dad in the past and discussed what resuscitation will actually mean, CPR especially on the elderly (you don't say how old your dad is) is violent. It can result in broken ribs, damage to internal organs and internal bleeding, meaning more time in pain and weeks in hospital just to go through it again weeks later.

Maybe it made complete sense to your dad at the time when he signed it and he felt in control of the decision for his future, but now the reality is closer and he isn't as strong mentally it is understandably scary to think about how it will end?

Regardless of whether there was consultation on the DNR with family, do your family agree with the DNR? It is worth talking about together, if your dad suffers a cardiac arrest at home you need to be in agreement so the paramedics know what to do when they arrive and if any heroic measures should be taken.

Dad didn't want carers and he insisted on washing/dressing himself even though it took hours, mum helped with the rest and we supported them both, but he did have the district nurse (Scotland) who would pop in at least weekly to see if that situation had changed.

My mum is in the end stages of cancer. Coincidentally, I witnessed her DNR being put in place yesterday in hospital. She had to sign it but the fact I was there was irrelevant.

Sorry, I just re read that he's discharged. I hope your mum manages to get the meeting arranged. Could the GP help? I'd also ask them about care help, or research local care firms who they may have to pay for, but could be useful.

I feel for you. I've had my mother in hospital twice (COPD and heart issues) and my husband in several times over the past 18 months, and it's been increasingly frustrating getting information from consultants. They seem to always be in a rush and often speak to patients (who often aren't in a fit state to understand) when there are no relatives around. I'd speak to the ward sister, outline your worries, and ask to see a dr with your dad. It may only be a ward dr, not the consultant, but they should be able to explain things to you. This happened with my husband and I, we told them how frustrating it was and how we weren't feeling informed, and from that point we did get more effort and explanations. If that doesn't work I'd speak to PALs perhaps.

I also wonder if your dad doesn't remember signing the DNR

perhaps ask for the date of it - they should be able to provide that information.

to you and yours.

sorry to hear about your dad, if mum is struggling then has she spoken to the ward sister about getting some help at home if that's where your dad wants to be, he can have a care needs assessment to see what help he would need, I think asbestosis has it's own special need. He may well be involved with a lung care nurse who could talk to him. The family don't need to be informed of a DNR, it is a medical or patient decision. Your dad could ask to see the form and discuss it with the doctors. Try and speak to the ward sister and ask if you can meet with the doctors, with your dads permission, and ask about his prognosis, future care and where would be the safest place for him to live. If he will need carers or decides he would like to go to a carehome then your mum should ask for a full assesment for him, a carers assessment for herself and funding decisions, he may be entitled to full care funding.

My dad had COPD and a DNR. Towards the end he was on oxygen 24/7 (machine at home with long tubes so he could move around the house) and had a nebuliser at home too to help clear his lungs. To be honest it was no life, the only time he left the house in 3 years was when blue lighted to HDU 3-4 times a year when he had chest infections and he readily agreed with the DNR and mentioned it to us. It was not our place to discuss or disagree.

We always knew COPD wouldn't be the primary cause of death, it would most likely be a chest infection and/or cardiac arrest from over exertion and could happen at any time, but it was still unexpected when it did, especially when it was in summertime instead of another winter chest infection. It was just too damn hot that sumner. Always thought we'd have longer.

It really is a horrible condition watching someone struggle to breathe knowing nothing can stop it. That was 5 years ago and there really was no treatment other than oxygen and the nebuliser to make him comfortable and into hospital when he had chest infections. Accept the DNR and make the most of the time you have left.