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anonymous903302 Asked May 2019

How to decide if we want a DNR?

My mother has the full slate of estate and trust documents, including the health care proxy and living will. I am the POA, executor, trustee, health care proxy, etc.


The only document on which my only sister is listed is the living will. My mother's wishes are that my sister and I need to decide, mutually, whether to remove life support. It's a very detailed living will, so we will follow my mother's wishes.


There is no DNR. I have been asked many times, at the nursing home, at hospitals, in the emergency room, etc., whether she has a DNR, and when I say "no" they ask if she wants one. I always say "no." And, that she does not want one.


The reason I say "no" is because I know that it would be devastating for my sister if my mother had a cardiac event or other event and nobody tried to revive her because of a DNR and my sister did not get to say good-bye and touch my mother before my mother was declared legally dead. My father did not have a DNR, and he had sudden cardiac arrest, the paramedics revived him, but he ended up in a vegetative state in ICU. He had a living will, and we waited 7 days before removing the life support. But it gave time for people to go see him, while he was still breathing. He was not in any pain. Also, miracles sometimes do happen. That's what the living will is for.....removing life support, when 2 doctors have declared there is no hope.


Anyone else out there have this issue? DNR, or no DNR?

cwillie May 2019
I'm going to tell you a story. Back when I was working one of my coworker's mother (alzheimer's, but still living at home with his father) had no DNR. She had a massive stroke and "died" (coworker got a frantic call from his father telling him she was gone), but EMS arrived in time to bring her back. She lingered another week or two, her body and mind totally broken and hooked up to machines to keep her alive. In my opinion it was cruel, and never should have happened - I made sure my mom's DNR (signed by her years previously) was posted on the fridge when I cared for her at home. This isn't about you or your sister, you have your mother's living will to guide you so you both should have a pretty good idea what she would want.

BarbBrooklyn May 2019
My Rabbi told me a poignant story; his elderly dad was living with dementia in a Memory Care/Assisted Living facility. The Rabbi was visiting one day during lunch and his dad choked on a piece of food. He was gasping for breath, Heimlich maneuver wasn't helping, 911 was called.

The EMTs asked the Rabbi "does your dad have a DNR?". (He did). The Rabbi said to me "I lied; I told them no; I couldn't see losing my father over a piece of unchewed meat". They were able to suction and get the dad breathing again.

The Rabbi said he then told the EMTs, "I'm sorry, I lied to you. He DOES have a DNR". They patted him on the back and said "it's okay, we would have suctioned him even WITH a DNR. DNR only means specific forms of resuscitation, not general life saving stuff (or something like that).

So, as CW says, it doesn't mean they won't try to save her; it means that they won't prolong her life artificially with a full code.
jacobsonbob May 2019
Thanks, Barb, for sharing this, as it makes an excellent point!

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AlvaDeer May 2019
I spent my career as a nurse. I wish that every person insisting on the attempt to bring folks back after death had to be at the bedside while it is attempted. The feeling of pressing down on a chest and actually feeling frail bones snap under you is one that is beyond description. Very seldom is a person brought back without severe deprivations of oxygen to the brain. When someone has died at an certain age I believe it is terribly cruel to bring them back for the families own reasons. Death is the final separation, and often the elderly do physically "turn their faces to the wall", and take their leave. They are ready. It is so much better when we take these matters in our own hands, rather than leaving them to family. I personally have long had my DNR in place, and a POLST hanging in my house to say what may and what may not be done. This is personal opinion, of course, by someone who lived a life in medicine. Each family should talk about what they want, but they should also know what CPR honestly is, because it is NOT anything like a TV show. Unless the show is about a beating. Generally the person brought back in this manner lives out whatever remaining forment there is, helpless, with a tube down into the lungs, unable to do anything but look, with horror and helplessness, into the eyes of their loved ones, often with their hands down to prevent removal of equipment.
pamzimmrrt May 2019
I so agree with you!
pamzimmrrt May 2019
I work in a major hospital ICU, and I see death and "codes" all the time. You can indeed have a notation that says NO CPR, but everything else.. meds, fluids. etc. Just not compressions. And full tilt CPR is BRUTAL, I have often seen families change their minds when they see CPR being done ( yes we often have to do it with families in the room,, it is an emergency after all) You need to compress the heart to 2/3 of the body mass,, think about that for a minute. My mother is no CPr at all, and sad to say I agree with her,, she is 88 and frail,, she would be all broken up and in terrible pain for what was left of her life. And we often comply with the family desire to "keep them going for a few hours or days " so family can arrive. We are not all as heartless and cruel as some of the posters here seem to think we are.. after all we got into this field to save lives and prevent needless suffering. And I resent those who feel otherwise,, you do my job for a week!
worriedinCali May 2019
My grandmother had a DNR & at age 83 she collapsed in the dining room of her assisted living facility &
died. Her heart just gave out, after life long heart problems. She was always a small woman and she was probably 80lbs when she died & under 5 feet tall. Anyway she did not receive CPR, she passed peacefully just the way she wanted. I cannot imagine them performing CPR on her small frail body! Even if they had gotten her heart started again, she would have have painful broken bones and bruising and required rehab! People see CPR performed on TV all the time-where they make it look like nothing! But is actually physically grueling to perform CPR and it is violent to the human body!
Grandma1954 May 2019
There is a DNR than there is a POLST the POLST gets much more specific about treatment and for how long you want the treatment. Please look for a copy on line just to see the wording.
And now a few comments and this is just personal opinion here.
CPR works great on TV
CPR may work great on a young healthy person
but...
CPR will probably break several ribs
CPR will probably break the sternum
even then CPR itself may or may not work bringing the heart back to rhythm.
The amount of pain from broken ribs and sternum would be incredible and most likely pneumonia would follow since breathing would be compromised.
Please do your Mom a favor and get a DNR or better yet a POLST signed.

Oh, and I found this out when my Husband broke his hip..they will "suspend" a DNR during an operation, the idea is if a person is able to have surgery they don't need the DNR and according to the dr.."no one dies on the table" they may die in recovery but not on the table.
And if you call the Paramedics even with a DNR they will do what they can it is their job and you called them.
One last thing if you do not have the DNR with you or if your Mom dies not have it with her when something happens ...it does not exist so everything will be done until that document is produced. (Example.. if you have a DNR at the facility and you take Mom for lunch and you are in an accident they will do what they can until the DNR makes it's way to the emergency room.)
So again do Mom a favor and get a DNR or POLST signed but make sure you carry a copy with you and make sure Mom has a copy on her at all times.
dogparkmomma Oct 2019
Very bad for hospital statistics as well as the stats for the surgeon and the anesthesiologist for a patient to die on the table. :-)
You are very right about the POLST. In the POA that my inlaws completed 20 years ago, they designated my husband as POA. That form also included the DNR instructions that indicated they did not want intubation or CPR etc. However, now that they are in memory care, we had to complete an updated POLST form, which spells out that we want to do comfort care only. If they die from a heart attack, and it is quick, that would be a blessing. However, they are going to route of gradually losing their faculties and eating less and less. We have hospice started for them and there will be no feeding tubes.
anonymous683453 May 2019
Have DNR for my 94 year old dad. Once quality of life becomes poor and possibility of recovery is practically nil, what possible good can come from prolonging a person's suffering? I would never ask a physician to keep my dad alive just so my brothers can come and look at him laying there in a coma. To me, that is cruel and inhumane and I see no point in it for either dad or my brothers. That's my opinion, having gone through this heart break twice already.

Tothill May 2019
My mother decided she would not have a DNR after she and Dad witnessed the violence of the crash cart team doing cpr on my grandmother after she had a peaceful death. No they did not bring her back to life.

Me? I will honour Mum’s wishes.

One of the things we must accept in life is that when families are far flung around the country or globe is that each visit could be the last.
jacobsonbob May 2019
Are you sure you meant "she would not have a DNR" after seeing CPR? I suspect you meant that your mother WOULD want one so she wouldn't have to endure CPR.
katiekat2009 May 2019
My mom instituted a DNR herself while in the hospital. My sister still blamed me because, as POA, I didn't override it. I followed my mom's wishes. I would suggest you both sit down with mom and discuss. If they shock you, are you ok with that? A ventilator? Extreme meds. I think we all fear being on a ventilator with no brain function and that's why we sign a DNR.

mjmm16 May 2019
So here is my experience.. My mom had always told me growing up that she wanted to be a DNR. She had worked at a hospital and did not want people pushing on her trying to bring her back as you never know what can happen if she would ever be the same.. I told my dad and my brother both I honored her wishes and would not let them put her in a nursing home either as that was where her father was. In the beginning both fought with me and I said I would take her to my home and take care of her til the end. Eventually they both agreed and I moved in with her and my dad. I was there until the last hours.

My dad was hospitalized a few months ago and to what I couldn't believe I heard he told them he wanted them to do whatever it took to keep him alive. I don't really think he understood. When he finally came home he is unable to live by himself now and we ended up putting him on hospice. The hospice nurse asked him and as she explained what they would do in order to keep him alive. He changed his mind.

My experience working in a hospital is that sometimes you end up with broken ribs, you may come out in a vegetative state. You never know the end results, sometimes a person might come out ok.

When you are around loved ones, you need to make each hour, each day count. You never know when your time is up. It can be a hard decision, knowing you don't want your loved ones to die. Call and talk to your sister and look at all the options.

Wish you the best, sending prayers.

llmusick May 2019
It is so hard to let the ones we love go. A DNR should be the decision of the individual of whom it concerns. It would help to educate yourself with the dying process. Understand that a DNR is sometimes a kinder thing to do. And sometimes it is not. To resuscitate a dying elder person who is in a natural process of dying can be excruciatingly painful for them.
When my father died he was on Hospice and at his own house. My mom was so upset that the hospice Nurses would not resuscitated him. His body was riddled with cancer and he was on high doses of pain meds that didn't completely work. He would beg us to let him die. She did not want to let him go. She didn't want to see that every inch of him was in pain. He had a DNR and she wanted to override it. It was so hard to make my mom see that she was thinking only of her own pain and not was best for dad. I didn't want daddy to go either, but watching him go through that much pain was more unbearable. I whispered into his ear that I would not let them do anything and he slipped into a comma and peacefully left this planet.
My mom is scare of death and wants to be resuscitated. I will honor her wishes for as long as it is medically possible. I am glad I was able to honor my fathers wishes and I will honor my moms wishes no matter how hard it will be for me.
I wish you luck with what ever you decide.
anonymous683453 May 2019
Amen
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