There should be full information about what resuscitation actually entails.

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There have been a lot of press stories about older people being “forced” to sign DNR forms and understandably their families are getting upset.
However I think a lot of people believe that resuscitation is like it is on TV - pads being affixed to the chest, stand back everyone, patient miraculously recovers. It isn’t. It’s a brutal process that can result in smashed ribs, and for frail elderly people it can leave them in a much worse state, either dead or with prolonged suffering.
This should be made public knowledge, no dodging around the facts.
AIBU?

My mum was resuscitated, it was awful. If we'd have known then what we know now we'd have let her go peacefully.

It should still be the individual's decision though, not something imposed on them. My Dad had a DNR in place and received palliative care only until he died last Summer. But that was his own choice.

YANBU

Also it isn't distasteful, heartless or disrespectful to talk about and agree these things ahead of time. It's a really good idea and sensible.

I agree, I think the conversation needs to be opened up to everyone to allow informed choices, unfortunately people prefer to bury their heads in the sand. People are resuscitated but at what cost? I wouldn't want my Nan to be brutally resuscitated should her heart stop, at 83 id want her to pass peacefully and with dignity

YANBU
People should be given the facts clearly and appropriately with no scare-mongering or sanitising. That way they can make an informed decision.

I think there needs to be full and frank discussions with members of the public. There was a campaign a few years ago called talkings about it won't make it happen' where people discussed advance care plans with their GP. Unfortunately it needs to be a slow and steady type job which takes place with no underlying pressure which of course is impossible right now.

People also need to be aware that when it comes to it, it is a medical procedure and the decision lies with medics. You can refuse resus, but can not demand it, any more than you can demand chemo or an amputation. People also need reassurance that no CPR means just no CPR not 'no treatment' many people I have nursed think one = the other and once they are aware of the facts they are much more accepting.

YANBU.

I think a lot of people seem to assume that "DNR = do not treat at all".

In all honesty for once I feel we should be going back to a more medical model where it's down to a experienced consultant/doctor to make the decision based on medical facts whether resuscitation is possible/would be beneficial to the patient due to their current circumstances/illness.
I think it's awful that someone who may have survived could sign a DNR but someone who refused and had almost no chance of survival and as such would prolong suffering may have to experience resussitation.

I think the DNACPR = no treatment waters have probably been even more muddied recently with GPS sending out letters saying people should put a DNACPR in place and shouldn't go to hospital.

I think you are right, but having watched my daughter be resuscitated and not survive, I’m not sure this is something I wish I had known about beforehand. It is brutal, painful and a horrible way to die.

It IS a medical decision. As far as possible we talk to the patient about their wishes, abide by them if appropriate and if not explain why not. I have been present where family / the patient initially did not agree to DNACPR but the doctors have put one in place and explained the reasons why (futility). It's a horrible conversation which no one takes lightly but it is done if required.

YANBU. My Nana died very recently and we had a DNR in place. It was absolutely the right thing to do. Resuscitation would not have been in her best interests. She was 86 and very frail plus had multiple serious health conditions including cancer.

Much as we didn't want to lose her (obviously) it was far better to do what we did - organise palliative care in her own home because that's where she wanted to be. I cared for her in her last few days when she was at home, having worked with the hospital for the week she was in prior to that to get everything organised. She knew she was home, thanks to the fantastic community palliative care team she was comfortable throughout and died very peacefully surrounded by family.

If I could go back, I wouldn't do it any other way.

YANBU. A lot of people jump on the bandwagon without realising what resuscitation involves ☹️

Really? I watched ER and remember many, many poor resus results. Broken ribs, perforated abdomens, severe brain damage, etc.

It seemed to only be worth doing for people with hypothermia, heart attacks and children.

Absolutely Yanbu. It is very brutal and can have terrible physical and mental outcomes. We are obsessed with quantity over quality of life and need to try a lot harder as a society to allow peaceful deaths where possible.

I think being honest about the success rates would also be important.

It is ultimately the clinicians decision to put in place a dnacpr based on whether or not it is likely to be futile. Discussions take place with the patient or family, however they are just discussion. Family/ patient do not sign the form, I know my families wishes with regards to it, to me it is something that we should all discuss. We are all very good at thinking and discussing birth plans for having a baby, but not so great at discussing our plans for death. Dnacpr does not mean that you will not receive care and treatment up to the point your heart stops.

Absolutely agree. My father's whole ribcage was smashed. They did it for 45 minutes, when there was no chance of him coming back. And then had the nerve to say that because of all the adrenaline they were keeping him on to keep him alive, they might have to amputate his legs. But that he could still make a full recovery (apart from having no legs). Utter bullshit. Still so thankful he died before he woke up.

YANBU.

Kathryn Mannix is excellent on this:
www.facebook.com/DrKathrynMannix/posts/2949195348436749?tn=K-R

Yanbu.
We had to have to have this conversation with my mother at the 11th hour, end stage cancer. The Macmillan nurse didn't handle it very well unfortunately and my poor mother was terrified as to her, it meant lack of care and sudden death.

My late Mum had to renew hers pretty much with every medical encounter. I remember queuing up at her GPs to hand one in. It was her careful decision. I had a little cry but didn't let her see. She loved life and loved us and knew DNR was the best thing.

Does anyone have a link to reliable medical and legal information on what this all means? I'm wondering if I need to think about this for my own parents (I've got power of attorney if they become incapable) and also now thinking about myself and DH if we get the virus. I've never really thought about it before so want to be more prepared and consider it in advance of a crisis situation. Thanks

Completely agree ,but most people have very little understanding of this kind of thing ,it was like when there was a big uproar about the Liverpool care pathway ,people had little understanding that patients placed on it ime anyway were very close to death anyway ,and were given sedation and pain relief but no active treatment ,some people ,s perception was that it was Euthanasia which it was,nt

You are absolutely not unreasonable. Resusc is very traumatic and invasive process.

When we were asked about putting a DNR in place it was explained very clearly exactly what was involved, what the outcomes might be and given 24 hours to consider it.