Dad told me he doesn't want to be taken to hospital if he's unconscious, under any circumstances

[falstaff1980]

He had done one of these RESPECT forms with his GP a while back, and he'd put hospital admission only for treatable conditions. Last week he got dehydrated (a treatable condition) and ended up semi-conscious so we called an ambulance and he was taken to hospital. He's very unhappy about still being there and saying he wished we hadn't called the ambulance.

If I were to respect his wishes and not call an ambulance to take him to hospital the next time this happens, how does this not make me an accomplice to suicide? Surely we're all responsible to do everything possible to keep someone alive, even if they don't want to be?

Just to provide some perspective - because there are various social media campaigns and unofficial directives trying to push a DNR agenda - less than 20% of elderly, sick patients have a DNR. And there has been research that shows patients with DNRs have worse outcomes. The Government really pushed to normalise DNRs especially during Covid and there have been numerous scandals of DNRs being placed in elderly patients and care home residents' files against their wishes.

CPR is NOT a treatment for a normal death, and patients who require CPR (even fit young people) rarely come out of it as well as they were in the run up to going in to the cardiac arrest (IE before this final deterioration into cardiac arrest) so if they were elderly and sick beforehand that will be moreso in the unlikely event that they are successfully resuscitated.

The ones you see in the newspapers are not representative of the reality in many cases.

Elderly and sick people should be encouraged and supported to consider their wishes in an informed way. We need to make conversations about death and dying less taboo in this country.

The problem is with the wording. We had this with my late dad, and had it worded such that he would be treated for an injury, but not an illness.

I would agree with those who say that we need to have conversations surrounding death. I was “fortunate” with my dad in that he was very open with his wishes, but people need to understand what DNR actually is-the person is already dead, and it’s an absolutely brutal treatment, often resulting in broken ribs at the very least. People also need to understand that because you CAN treat something, it doesn’t mean that you necessarily SHOULD

My experience isn't from newspapers. I've worked with patients, families, lawyers and medical professionals on this issue.

Your post is based on a misconception that those choosing not to have DNR orders have not had conversations with family and medical professionals. There is no research to support that view. In fact, the research supports the opposite. DNR notices were put into patients/residents files with no discussion. That is the taboo they no longer want discussed. The ECHR is clear on the human rights implications of this issue.

Thanks for all the answers everyone, seems to be quite a minefield and there are some diverse views on the subject.

I think what I'll do is just tell my dad that he can talk to his GP and update the respect form with any revised preferences he has.

Dioralyte sachets

he has no right to judge you for acting on an easily treatable condition. that is heartless of him to dismiss the stress caused to you. If he wants not to be hospitalised under any circumstances including treatable ones then he must very clearly say so in a legal document.

I am so sorry for you OP. That is absolutely grim. I have total respect for elderly people who don't want their lives prolonged unnecessarily. I share their views. But they must be really mindful and respectful of how this impacts loved ones who have a duty of care, both legal and emotional.

That sounds like a good plan.

You do also need to work through your own feelings about this. You say "Surely we're all responsible to do everything possible to keep someone alive, even if they don't want to be?", but like the care home worker pp, speak to medical professionals and you will hear that the vast majority would not want 'everything possible' to be done, it can often lead to intrusive and painful treatment and result in a short period of extra time with a pitiful quality of life. Even if they did, this is your dad and he needs to have appropriate control over his own body.

If your dad is still in hospital days later it sounds like he has a fair bit more going on than a one off dehydration. As well as a heart to heart with him, it could be helpful for you to speak to a counsellor, it's incredibly hard on you to be supporting him through this, especially if your wishes don't align with his, and you'll need support as well.

@KeepTheTempo thanks.

There's definitely a lot more going on than dehydration, and my dad might argue that the dehydration was caused by an untreatable condition. If you think about it, many untreatable illnesses are probably not the immediate cause of death, but did cause the "immediate cause" (if that makes sense?). Like a heart attack due to extreme weight loss.

As for how I'd cope doing nothing, there was a scene in Breaking Bad that haunted me, where the main character witnesses someone choking to death on their own vomit and he chooses to do nothing - made me shudder.

In the gentlest possible way, your dad is going to die, we all are, but in your dad's case it is going to be sooner rather than later. Talking about death and dying is still extremely taboo in the UK, and sadly this is were it gets us.

The first death I went to as a trainee ambulance technician, many years ago, came through as "101 year old female, unexpected death"... she died in her sleep in a care home?! But that really is typical of things in the UK, frequently patients, their relatives and even at time HCPs do not prepare themselves at all for death, even when it is long expected, and often have very unrealistic expectations of what is possible, and what is kind.

Your dad needs to take advice from someone who can get his thoughts down on paper in a clear, concise and legal way. You, OP need to talk openly with a professional or a wise friend.

Just been to see my dad at hospital and finally got an update from the doctor, they are going to refer him to palliative end-of-life care. Hopefully the local team that do this can help my dad with his respect form, and help myself and rest of family with coping.

That's good that he is now on a more clear pathway, even if it seems daunting at the moment.

Just for your information End of life care is now firmly part of a paramedics scope of practice (and every vehicle should be stocked with EoLC drugs), if your dad is ever sent a lesser qualified crew who pushes for him to go to hospital (or even a paramedic who is not confident in EoLC) insist on them seeking more senior advice (Ambulance clinical desk, GP out of hours, paramedic/advanced paramedic practitioner coming to scene, and even in some areas specialist EoLC paramedics exist).