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Hi. My father in law is in the end stages of Alzheimers and was given weeks to a few months left to live. He had a DNR in place but my mother in law withdrew it and now wants full life saving efforts performed on him. My question is, what options does my husband's family have? It puts myself, him and his brother in a terrible position as we are all EMT's and a nurse and we are required by law to call EMS and initiate life saving efforts on him. What do you recommend and is there anything that we can put in place to not have that happen? My mother in law will not change her mind. I hate the thought of him not being able to pass away peacefully.

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I don't mean to sound cold, but if he needs to have CPR done, have her watch it. This has worked for us in the hospital when pts have needed to be coded and the family was in the room. Most families have this TV happy notion that it will save a life with no harm done,, instead of the broken ribs, crushed sternums, punctured lungs , etc that are the reality. May families seeing the reality are then able to go along with the pts DNr wishes.
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Grandma1954 May 2020
I have said in previous posts..CPR works great on TV and or someone young enough to recover from the broken ribs, broken sternum and most likely the pneumonia that will come due to decreased lung function during healing.
Even as "healthy" as I am I can not imagine the pain that that would cause.
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I wonder if some one person can have a quiet conversation with mom....

"Mom, what do you hope to accomplish by changing dad to full code?"

She needs to talk out what her thinking is on this to see if she understands that he is dying. I'm wondering if she's got some cognitive issues that have gone unnoticed.
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Pepsi46 May 2020
I don't think cognitive issues come into play here.
The issue here is her heart.
This is a man she has been married to for many years. Her husband, her soulmate, her love. I'm sure one day she thinks yes to the DNR, so her love will not have to suffer any more. Another day, she thinks, no, I want him here with me, one more day.
I think this will just play out for the better. She may feel guilty signing the DNR, but when the time does come, the doctors etc, will do the right thing. So she won't have to live with the guilt about the DNR. She will at least know & feel that she did everything possible for her husband.
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I would contact a certified elder law attorney, I don't believe that anyone can change your end of life wishes.

That's the whole points of having these documents. POA doesn't give you the right to change what a person requests when they are of sound mind. You can only honor their wishes and act on their behalf in their best interests.

See an attorney.

I am sorry that your family is facing this. Not like the long goodbye isn't hard enough.
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I don't think there's anything the family can do unless someone other than your MIL is the healthcare POA for your FIL. I would get an elder care atty involved.

I think your best bet is to try to convince her to reconsider. Explain to her how painful resuscitation may be... broken ribs if cpr, electric shock to restart heart, possible intubation, etc. As EMTs you know the consequences. I assume he's under hospice care. If not, why not? They will provide him with a peaceful, painless, comfortable death. Would she want to harm him to extend a non viable life? I know you can't tell her this, but it's very selfish on her part.
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How about looking up the videos on line of Dr. Atul Gawande entitled, "Being Mortal." His book of the same name is fantasic, though it does cover more than the very end of life. It's something to really consider when making end of life choices. The video is very good as well. Nothing graphic, but confronts the reality of our end.
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Your father put the DNR in place and his wishes should be expected. I was shocked when my mother chose DNR but when the physical effects of resuscitation were explained to me then I supported her in her choice. Perhaps the family could explain to your mom why it is not in the best interest of elderly people to go through resuscitation, she might change her mind. I assume your father is no longer competent and as next of kin she can legally choose for him. Perhaps if she knows the specific injuries he could incur, she would not want him to suffer.
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Theres not much they can do other than talk to their mother and try to change her mind. Surely with their job experience, they can adequately explain to her what the downside to life saving measures is since they’ve seen it firsthand. Other than that, she’s his wife and his first next of kin. There’s nothing you can put in place that changes that.
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Barb, this has happened before with my Mother. She sits down with the primary care physician, and the doctor talks her into signing the DNR, so my Mother signs it understanding fully what she has signed, and then when she gets into the hospital, she panics and says no I don't want to die!! Take the DNR off!! We've been through this a couple of times.
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What!? Didn’t your father have to sign the DNR? I know my dad did. If he signed it then it’s his wishes. I didn’t know someone else could withdraw it. Can a chaplain from hospice or her pastor, priest, rabbi etc. talk to her about death etc? She is obviously not facing reality of her husband’s condition
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When I was going through all this with my Husband I said I was being ruled by 2 major organs in my body, my HEAD and my HEART.
While watching him decline over the course of 12 years my Head knew that a POLST was the right thing but my Heart broke a bit anyway.
But to want him to continue as he was was selfish on my part, I knew he would not want to continue to live the way he had been the past several years.
But in the end it does not matter..we will die. Cold hard fact.
But to die in pain due to life "saving" measures seems to compound the pain the rest of the family has to endure as well as the person who is lying there in bed now not just with a broken brain but broken ribs, sternum, and punctured lungs.
(and at this time with visiting restrictions due to COVID19 you will not be able to visit your loved one in the hospital so very good chance you will not be able to be with him when he dies)
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