Help with abbreviations on medical notes please

[GreenBudgie]

Can some kindly MN medical types help my father decipher his medical notes please? He has a copy of the write up from his 1st visit from palliative care team. Dad knows he has terminal cancer but has taken issue with the statement in his notes that he was "not willing to discuss PPD or DNAR. I assume one is Do Not Artificially Resuss. Can anyone help with the other please?

PPD generally stands for preferred place of death (i.e. would they prefer to pass away in a hospice/at home etc) and you are correct about DNAR - it specifically relates to cardiac arrest rather than general treatments - for example "fluid resuscitation" if he was dehydrated.

Often people find this stuff really difficult to discuss, I imagine the team will try to gently broach it again with him.

Hope that helps you - I imagine this is a really difficult time for you all. Do speak to the palliative care team, they can be a great support to relatives as well as the person and are often really kind, approachable people

Palliative care is not really my area but I would guess preferred place of death and do not attempt resuscitation.

Do not attempt resuscitation and not sure about PPR.

Thank you Caoraich, your help is much appreciated :-). Dad is 86 and remains stubborn, opinionated and resistant to sensible instruction. He will die fighting women telling him what to do to the last. He is receiving superb care from the NHS, I can't thank them enough for keeping him here so long after the initial diagnosis.

Sorry to hear about your dad. Are there any staff he would feel comfortable discussing his notes with?

Rascally, he is at peace with his diagnosis, and his pain is much reduced since his meds were reviewed. He is indignant at being accused of not wanting to discuss these 2 points which would have been mentioned as end of life care, not the abbreviations used in the report. I will talk him through it tomorrow, thanks to the help of everyone who has replied.

It might be easier to ask him about whether he wants to,die a natural death. DNACPR ( the correct abbreviation) is about withholding full resuscitation in a sudden deterioration ie Do Not Attempt Cardiopulmonary Resuscitation. The idea is to prevent the indignity and distress of resuscitation attempts that would be futile. There is no need for your father to discuss this as it is a clinical decision made by the medical staff. There is a requirement to offer the opportunity for discussion about it. It sounds like they were following policy and tried to hold the conversation. He is likely to have a DNACPR form signed and in place.
This doesn’t mean they withhold all treatment.
The preferred place of death (PPD) or Preferred Place of Care (PPC) is about determining where the patient would want to spend their last days or hours. It’s about allowing and supporting the dying to,be discharged quickly to their homes, to a relatives or sometimes to a hospice. The majority of people die in acute hospitals whilst the vast majority of asked want to,die at home. It’s about trying to meet peoples wishes.

Hope you are ok too OP. This hard on everyone. X