How do you put a DNR in place? Living will?

[CameleonAreFightingBack]

So I want to put a DNR in place.
Im not dying but I’m chronically ill and my quality of life isn’t great.

Seeing few people survive CPR and those who do often have problems following that, I simply dont want to add to the already long list of stuff I’m suffering from.

But how do you get on doing that?
Do I start with my GP? Someone else and then have it put in my records?
I found lots if bits simply by googling but nothing that looked like a step by step instruction - for want of a better word

Parents were given DNR form from Docs completed and given to Docs, copy held in their home.

Uncle younger but wanted to put something in place, I found a document online, they completed it and dropped it in at Docs

Speak to your GP, they will discuss it with you.

I started by telling my adult DC and my DP, and more than once.

It's really important that they understand your wishes around this, and tissue donation etc.

This is step by step and legally valid if properly signed and witnessed:

https://compassionindying.org.uk/how-we-can-help/living-will-advance-decision/#make-a-living-will

Your gp will be able to organise a DNAR and will put this information on your records. The DNAR form itself will be given to you and needs reviewed every 12 months.

My mother's GP set hers up. I was staying with her when they phoned to discuss it (as they were signing it off) and also a few days later when her copy arrived in the post.

Ask your GP. They should know this.

If you make a living will you can set out any other interventions you wish to refuse. It can be much more detailed than a simple DNAR if you wish.

Thank you all.

It sounds like a visit to my GP is on the cards.

@user1846385927482658 thanks for that link. Lots of infirmation on there I hadn’t considered (like how will paramedics know)

You put signs on each entry to your house and the fridge

Tbh I haven’t actually thought about it much further than the DNR.

Something else to discuss with my GP probably.

And you have to make sure a 'next of kin' i.e. relative doesn't come in and start over-ruling your wishes. Doctors (understandably) get nervous around gobby relatives shouting about hospitals trying to murder their mum.

I'm doing:

Conversations with nearest kin
Followed up with emails
Letter from me attached to will
Advanced directive
Discussions with GP surgery and Consultants

Most living wills are not at all helpful - they often don’t have enough useful information to cover different sets of circumstances.

a good starting point might be to ask your GP about a ReSPECT discussion/form. It can include decision making re CPR, but also priorities re treatments in some different scenarios. HTH.

My mum had one put in place when.she had capacity. There was a large notice on an internal door instructing the doctor/ emergency services not to attempt CPR.
It wasn't required as she passed peacefully in her sleep x

Paramedics look on the entry door/s and the fridge apparently
That may just be in my parents ambulance area but that is what they were told.

Paramedics need to see the orginal documentation, my grandad kept his in the entry way on the wall as they would have came into the house but now he lives with family they all know where the paperwork is and it would be presented to the crew as they walk through the door.

A delay in this paperwork being shown would most likely if deemed a workable cardiac arrest result in the crew beginning CPR then ceasing efforts when paperwork is shown. Obviously if you has passed hours prior in your sleep that would be a different situation, I'm talking about a witnessed cardiac arrest.

You need it set up properly via your GP with all the necessary documentation because Paramedics will resuscitate anyway if they're not satisfied with the documentation.

@Greybeardy whats the difference between a DNR, a living will and the ReSPECT form?

It's actually very difficult for both the medics and the family, even if there's a DNAR notice. On the patient board in an acute ortho trauma ward, about 75% of the names had DNAR in red. DMIL had fractured a femur, at 94, which is not something that many people recover from. But as she never needed an active intervention, the team eventually discharged her back to the care home, where she died six hours later. They did everything possible to help, but her time ran out. I think she would have said that her body kept going long after she wanted.

My Granny has one, including much more detailed instructions/wishes including a wish not to be fed/hydrated and withdrawal of medicines upon any loss of capacity- an "advanced decision". All in a lot of detail, legally witnessed and which cost her a fair bit of money to have put in place.

Unfortunately now that she's lost capacity/in the process of losing capacity there are some medications that doctors have said that they can't/couldn't withdraw. So when she had a stroke, whilst she wasn't resuscitated she was given medicines that stopped her from dying because the doctors working in the emergency situation said they had to. Once we got to the hospital- where she had been sent by the home she lives in, the home which rightly informed them of the DNR and other wishes, but which in the heat of the moment didn't supply the whole document- the doctors informed us that even if they'd had the details, there are some things that they just have to do for all patients.

So just a warning that you can make all the advance decisions you want, but they may not work out.

Dh and I have added paragraphs to our Health and Welfare Powers of Attorney, to state clearly what we do or don’t want in the event of being unable to state such things for ourselves. We have also made dds (who will have P of A) fully aware that in certain circs. we certainly do not want any ‘striving to keep alive’.

Talk to your GP, and then notes on the inside of your front and back doors, on the fridge, above your bed, in your wallet.

The fact is that paremedics are always going to try unless they see a big honking sign not to, so big honking signs it is.

I thought the GPs DNAR forms were now supposed to be shared centrally with paramedics too, so could be accessed by them too, so not reliant on the fridge magnets…maybe this is regional though

Go to the alzheimers uk website for plain explanations. A living will/advance decision covers more than Do Not Resuscitate, such as use of antibiotics if you get pneumonia.

the doctors informed us that even if they'd had the details, there are some things that they just have to do for all patients.

That's not true. If a patient has legally refused consent, anybody administering treatment is committing a criminal offence.

You cannot insist that you receive treatment that medics don't believe is in your best interests, but medics cannot overrule you if you refuse treatment.

Thank you all. Very helpful

The fact is that paramedics are always going to try unless they see a big honking sign not to, so big honking signs it is.

That has been my understanding so far. which is raising another issue: what is a big honking sign? At home, you can make clear. But what if you are involved in a car accident, you’re out shopping etc…
I actually doubt, they’ll first start with checking my wallet etc…. Let alone a passer-by who will try to do their best.