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Original poster

DNR

60 replies

Springsnake · 05/05/2021 16:03

A relative has early onset dementia,is in a rest home ,when she first went in the gp tried very hard to get me to agree to a DNR ...relative is in fine health,just a bit forgetful.
This week I’ve had a phone call from rest home ,trying to get me to have DNR put on her notes ,explaining that co morbid conditions mean resuscitation may not be successful and relative left in a worse state than before ..relative is only 75 ..with no co morbid conditions
This can’t be right can it ,I’m the only next of kin ,why should I get to decide on a DNR ...surely the doctors do their best for everyone.
They also asked did I want her going to hospital to be treated ,or treated in the rest home ..I said well obviously whatever she needs to give her a successful outcome if Ill.
I felt pressured both times ...
I really hope I’m the exception and this isn’t standard practice in our country now

OP posts:
SoupDragon · 05/05/2021 17:34

Resuscitation itself is brutal.

This.

The doctor discussed this with me when my mum went into hospital. She was explaining that my mum had agreed to it (she's of sound mind!) and that it just meant they would not attempt to resuscitate in the event of a cardiac arrest, they would absolutely treat everything else. It is down to how brutal it is.

AfternoonToffee · 05/05/2021 17:37

Late last year, DH and I had to have this discussion about his Mum. She was 88 at the time. We have watched enough A&E style programs on TV to be aware of the brutality and risks of CPR, pumping up and down on an old woman's chest would be for our benefit and not hers. If I am honest it was a straight forward decision for us, in as much we knew it would be futile.

In the end she developed a blood clot which blocked flow to her lower leg, was put on an end of life pathway and slipped away a few days later. Yes it's shit, she knew she was going to die, but she went peacefully.

OP Have you any other family support? The GP would have suggested it as they felt it in the best interests of your relative and ultimately they have to be at the forefront. The hospital doctor actually thanked us for agreeing to the DNR, in a compassionate way.

Flowers it is a tough decision, but honestly it is not a way of trying to get rid of people, it is trying to maintain some dignity in death.

SoupDragon · 05/05/2021 17:40

We have watched enough A&E style programs on TV to be aware of the brutality and risks of CPR

Yes. I don't think I appreciated it until seeing it in this kind of programme.

Interested in this thread?

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Dementia & alzheimer's General health
UmamiMammy · 05/05/2021 17:45

There is a huge misconception around DNR that it means "do not treat". It doesn't mean this at all. It specifically relates to CPR being attempted in the unlikely event that the individual stops breathing / their heart stops.
I would not want an elderly relative of mine to go through that brutality..........

GrettaGreen · 05/05/2021 17:45

Reading the postmortem report of a family member who had CPR before death was sobering as it detailed the injuries sustained from it. I really wouldn't want to put anyone through that unless they were guaranteed to make a full recovery and be able to live a fulfilling life afterwards.

Original poster
Springsnake · 05/05/2021 17:45

I’m only half way through these messages
She’s 75 ,..she has years left of living ,she’s just forgetful ..
I thought you would all be horrified,

OP posts:
flashylamp · 05/05/2021 17:48

@Springsnake

I’m only half way through these messages She’s 75 ,..she has years left of living ,she’s just forgetful .. I thought you would all be horrified,
She has years of living? Come on OP

I'm sorry to sound harsh but she is in a home and has dementia. It's a progressive illness, quite a horrific one at that. She isn't just a little bit forgetful. DNR is absolutely right.

SoupDragon · 05/05/2021 17:48

I thought you would all be horrified,

I would have been before I found out the physical consequences of CPR.

Original poster
Springsnake · 05/05/2021 17:50

I have POA for everything
There is no one else .
I am so shocked at these replies

OP posts:
SinisterBumFacedCat · 05/05/2021 17:51

She’s is a care home with dementia. This is not just forgetfulness. Op how disassociated from her care are you? Because her carers probably know much more about her quality of life than you do.

SprayedWithDettol · 05/05/2021 17:51

Resuscitation is horrific. It isn’t like on the tv and the patient, if they survive it, will be in a much worse condition afterwards. Tbh the final decision is with the medical team anyway.
My DF had a DNAR when he had end stage dementia. He died peacefully rather than having his ribs broken in a vain attempt to give him a few extra hours or days of life.

Ginmakesitallok · 05/05/2021 17:52

CPR is not usually successful. Its NOT like on the TV. The chances of an elderly person being resuscitated and having any quality of life after it are very very slim. Yes, she probably has years of life ahead of her - but if her heart stops then she will be allowed to die peacefully. Xx

Original poster
Springsnake · 05/05/2021 17:53

Ok ,well thankyou everyone for taking the time to answer .
I’ve obviously made the wrong decision,I will speek to her doctor ASAP

OP posts:
Aquamarine1029 · 05/05/2021 17:54

I am so shocked at these replies

Why? If she needs a care home, she is far beyond just "forgetful", and she will only be getting worse as her disease progresses.

tigerbread20 · 05/05/2021 17:54

Having a DNAR on your records means it won't be attempted, that isn't to say if they don't have it that the person will.
This happens very commonly in hospitals, families will have disagreemebts between themselves about whether they agree with a DNAR but at the end of the day the doctors decide what is in that person's best interests, ie not commencing anymore active treatment, further tests or attempts of resusitation.
You being asked is a gentle nudge that if anything were to happen to your relative it may not be in their bests interests, it gives you time to come to terms with it before it is an imminent issue.

swimlittlefishy · 05/05/2021 17:54

..surely the doctors do their best for everyone

yes, such as seeking DNR's where appropriate.

user113424742258631134 · 05/05/2021 17:55

@Springsnake

I have POA for everything There is no one else . I am so shocked at these replies
I'm shocked that your relative has an attorney who has not informed herself about what CPR means and its effects, and is not engaging with discussions about her best interests at the end of her life.
SinisterBumFacedCat · 05/05/2021 17:55

You also need to speak to her doctor about what dementia actually is and does to someone.

Ginmakesitallok · 05/05/2021 17:57

Oh - re being take to hospital if she needs care. To be honest I would choose for her to remain in the home. Bringing someone with dementia into hospital can be a terrifying experience for them. Most illnesses can be cared for in the home, admission would only be needed for something v acute. The risks of hospital admission are high. Is there a version of hospital @ home in your area?

FlibbertyGiblets · 05/05/2021 17:57

Ok.
In my area the level of care needed to be considered for a residential place is 5 visits a day to their home.
So she must be very dependent already.

I know it seems harsh. We are not advocating no treatment, we are advocating no invasive treatment, there is a difference.

Her life has value, beyond pearls.

tigerbread20 · 05/05/2021 17:57

FWIW I'm a nurse and I've decided at the age of 60 I will ask for my notes to be updated with DNAR. If it wasn't for my children I'd do today. I have no underlying conditions and not at all expecting to need it but if I've had a cardiac arrest it will have been a quick and painless death, the same can't be said for quality of life having been brought back from that.

maxineputyourredshoeson · 05/05/2021 17:59

I echo other posters OP, it’s a horrible conversation to be having regarding a loved one, but in my opinion an incredibly important one.

My dad has a DNR in place, he’s now 64 but has Parkinson’s. Unfortunately he has early onset Parkinson’s and 7yrs ago had deep brain stimulation surgery (DBS) and, in discussion with me it was decided that he wanted to go ahead with a DNR. I won’t lie it is one of the hardest conversations I have ever had, not helped by the fact he lives 4,500 miles away from me in Canada. After speaking with him I realised it would be my selfish reasons to want him to be resuscitated. With his illness he will only get worse and eventually die. If I can help him in any way, shape or form not to suffer I would in a heartbeat so talking him out of the DNR would just prolong the inevitable but with how many more years of potential pain and confusion etc.

I also agree you need to speak to the doctor again, maybe write down some questions?

Felty · 05/05/2021 18:10

OP, the DNAR and Advance Care Plans are two quite separate conversations and decisions to be made. Indeed within an ACP you can and should discuss several different scenarios should your relative become unwell.
Many of the posters on this thread, myself included, who have either experience of performing CPR and/or caring for older people in care homes with dementia understand the kindness and wisdom in making a decision not to attempt to resuscitate someone whose heart has stopped. However, as you have POA it is absolutely the right thing to question this decision with your relatives’ GP. I’m surprised that the care home have initiated the conversation and not the GP, as ultimately this is a medical decision and document that lies within their remit and not the home’s.
Having these conversations is hard and shocking and upsetting but it is far far better to have them now, while your relative is well, rather than having to make them in a rush during an emergency.

AfternoonToffee · 05/05/2021 18:28

@Springsnake

I have POA for everything There is no one else . I am so shocked at these replies
It sounds like you have a lot to deal with especially if you are having to do it all alone. Posters who have had to make that decision understand how difficult and gut wrenching it is, but ultimately it is often the best course of action. See it as an act borne out of love, sometimes the right decisions are the hardest to make and saddest to come to terms with.
Tempusfudgeit · 05/05/2021 18:31

CPR has a 4% success rate. That's on a young, otherwise healthy person. There's an almost 0.0% chance it would be successful on a 75 year old. It is however, traumatic for the staff, expensive for the NHS and likely to cause potentially unsurvivable injuries to the patient.

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