DNR

[username8348]

My mum had her annual Dementia review with the GP recently and the Dr asked me if she would want CPR.

I said that she'd never discussed it or expressed a preference so yes resuscitate her if necessary.

The Dr said to discuss it with my siblings. I don't understand why. Can anyone enlighten me on why we need to discuss it please.

She doesn't have any medical conditions apart from the dementia.

hey! I'm a carer have been for 9 years and it all depends on her quality of life if you think she has a good quality of life still then I wouldn't sign it but there's a lot of risk with CPR like broken ribs etc

Can anyone enlighten me on why we need to discuss it please.

Because resuscitation is traumatic and for people with conditions such as dementia it's important to consider what benefit it would bring to them, essentially.

Yes I understand it can be quite traumatic and if she was very frail and had been ill for a long time, I could understand the question.

However her health is quite robust and she's not suffering.

Thank you.

I personally would not agree to be resuscitated. The whole process is hideous ,undignified and the outcome is statistically, for any age group is poor.

Maybe read up on success rates for out of hospital cardiac arrests.
Sadly,people are not just allowed to die these days .

Yes, that's certainly a consideration. Ty

I'll do some research and look into it. Ty

My mums researched and told us many times she never wants to be resucitated. All relating to how traumatic it is.

It is quite a brutal procedure and even if the person is young and healthy they have a high chance of suffering adverse effects and will need further medical treatment. In effect, they are asking whether you feel your DM has lived to the full and it might be her time to go or not. As she can’t give consent, they have to ask you.

As per all the posts above.

We discuss things like this very openly in my family, and my dc know I wouldn't want to be resuscitated if this question ever arose.

Sorry, I meant to say it is a shame you have not had those conversations when you could, but is there a possibility she might have done so with one of your siblings ?

Even if she hadn't, it is a big call for you to make, and it is good to talk about these things with other people who love her.

However her health is quite robust and she's not suffering.

Dementia is a horrific illness, she may not be suffering now but she almost certainly will be in the future. It might sound quite brutal but a heart attack would have been a better outcome for my nanna than the last few years have been.

For me it would be a no to CPR but I've signed a living will for no treatment if I'm diagnosed with certain conditions

Dementia doesn't improve. Say in 6 months she is in hospital for something and stops breathing, would you want to resuscitate for her then to go through the downhill slope of dementia? Or the lack of oxygen could affect her brain and mean she survives but the dementia is suddenly much much worse

I'll look into it. Thank you

Patient/family members do not actually have to sign a DNACPR form. It is a medical decision made by doctors but it is best practice to discuss with patients and their family before puting one in place.

I have done CPR many times on patients. It is brutal.

My mum is 78yrs and apart from arthritis is medically fit. I would not ask for resuscitation for her.

The actual act of CPR is just the beginning of the journey.. being ventilated in ITU, various invasive tests possibly being done, pain from broken ribs... maybe a chest drain if a rib punctured a lung... there is so much more to a person's recovery then just getting their heart restarted.

Far too much for an older person to recover from AND then have a decent quality of life afterwards.

If your mum is elderly and has dementia then she’s reaching the end of her life gradually. I’d want a DNACPR in this situation for myself or my mum.

OP I’ve had cpr and frankly I would not put an elderly dementia patient through it.

I had several fractured ribs and a bout of pneumonia to show for it, also, the brain can remain active for a part and I have actual memories of them starting the process.

If they’re asking about dnr they have reason to think resuscitation is not in her best interests.

Please don’t do this to your mum.

If she has a cardiac arrest there’s a low chance of successful resuscitation. If it is successful, the underlying terminal illness (dementia) still can’t be fixed, and she will have to deal with the complications of surviving cardiac arrest which can include rib fractures, pneumonia and further cognitive impairment.

I resuscitate people for a living. Where I work we do not offer CPR in these circumstances, as it would be unethical. We still offer lots of other treatment as appropriate. So antibiotics or IV fluids or things like that, but not something that cannot
improve someone’s life. If someone has a cardiac arrest in these circumstances we allow them to pass away peacefully.

I would not perform CPR or ask it to be performed on my mum in these circumstances, and indeed did not when this arose with my Dad. Accepting his peaceful passing was the last thing I did for him as his daughter.

If she is happy and enjoying life just now then trust your instincts and say no.

When the situation changes as dementia progresses, you can always agree to it then.

Edit to add we agreed to DNR for MIL as she is in now the later stages of dementia. She hardly eats, almost blind, deaf as a post, can't walk, totally incontinent, doesn't remember any of her family, forgotten she had a husband for 50 years and spends every day stuck in a loop wondering where her Mum is, and why her Mum abandoned her in the kids home. (She thinks the care home is a home for bad children).

From what the OP says she doesn’t have capacity. How do you explain the pain to someone like that? The pneumonia, the broken ribs?

And moreover what dignity is the person afforded when their death involves someone having shattered their body first?

There’s such a thing as the right time to die, and IMO a cardiac arrest in these circumstances is that time.

That was my Dads choice too

OP I know a hospital doctor who says one of the worst things is when families haven’t discussed this beforehand and are in the corridor arguing or having highly emotional discussions when a patient becomes v sick. Do talk to your siblings. Wishing you well.

The benefits may not out weight the risks if this was carried out.
Plus there's a chance of physical injury and other life limiting issues x

A man I went to school with (in his 60s) was resuscitated a few years ago (out of hospital) and is fine and back working.

I agree that it isn't for the elderly, but it could just save someone's life if they are younger.

OP my mum has dementia but is physically robust. I've worked with people with late stage dementia. I hope she has a heart attack and dies before she gets to that stage.