DNR

[Springsnake]

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

As above.

But it sounds as if the discussion is being dealt with very badly by the GP. Do you have her POA? Are you her closest living relative?

Have a look at the ReSPECT process www.resus.org.uk/respect/respect-patients-and-carers. It's much better.

Sadly if the GP is suggesting a DNACPR then this is likely to be because they know that, if your relative's heart stopped beating of its own accord, there is no chance of getting it going again. You might want to ask for an explanation of how the GP came to that conclusion.

Have you been able to see your relative recently OP? You state your relative has co morbidities, I think you need to find out what these are and how they affect them. Hopefully once you have a clearer understanding of their health, both mental and physical, along with an improved understanding of the CPR process you can make an informed decision. Ultimately doctors will make their own decisions however, based on your relatives best interests. Perhaps you would feel more comfortable not having to make this decision and instead leaving the doctor to do what he / she thinks is best?

What would they want?
My parents are very clear they dont want to live once they get dementia

Their neighbour has a DNR on every entry doorway- put their many years ago

I have medical LPA for mine- everyone should have one in place and. discuss what they want.

@Springsnake

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

Then you should have discussed her wishes when the LPA was put in place and written it all down.

Just to add to all the other very well written stuff
The cessation of a useful heartbeat, eg/ cardiac arrest, is the end point of a serious event (infection, heart attack etc). Unless you can reverse the cause of it, the person won't survive the resuscitation attempt. Reversal could be unblocking an artery in the heart or lungs, or surgery in the case of a traumatic injury. These procedures and medications are often quite invasive, even in a young previously well person.
In frail elderly, at the point of cardiac arrest, their organ(s) are often so irreparably affected that the likelihood of reversing the issue without causing many side effects is very low. That coupled with the likehilood of severe brain injury mean the person you recently knew is very very unlikely to come out the other end.

It's a bloody tough conversation to have and Situation to think about. Sorry you're going through this.

The sad reality is that by not having a DNACPR in place, you're not prolonging life, you're prolonging death. Sorry.

Two things that I think are unclear from your OP

1. The doctors say

"that co morbid conditions mean resuscitation may not be successful"

but you say

"with no co morbid conditions "

Are you sure about the no other conditions.

2. You say

"relative is in fine health,just a bit forgetful."

In which case why is she in a care home?

It is hard, my Mum had a DNR but it took a long time for my Dad to agree to it.
However I feel the doctors have a different view of her condition to you.

As a nurse who has cared for many patients with advanced dementia I promise you I would rather be left to die from cardiac arrest in the early stages of the disease than have a resus attempted that potentially prolonged my suffering.

I had to do this for my dad very poor relationship with him but still felt like I was saying yes to killing him.

But it's the best thing for him people think resucitation is like you see on tele the put pad on them press a button and 5 minutes later there sat having a cup of tea
The reality is it's brutal cracked ribs not to mention the possibility of brain damage depending how long it takes .

This is why we need to rephrase DNR as “allow natural death”.

If she suffers a cardiac arrest, there are a few
Circumstances where good, early CPR makes a difference, but the person then needs to have the reserve to then recover from it, which a care home patient with dementia probably (almost certainly), won’t.

If your relative has a cardiac arrest, then that is the end of her natural life. To put her through the brutal process of CPR/ICU etc would be cruel and only prolong the inevitable.

Like pp, it does not mean “do not treat”, and she could still have medication/pain relief other treatments, just that if she were to go, she could die in peace and with dignity.