Dad said "full resuscitation" but nursing home asking about a DNR. Anyone else stuck in this dilemma?
I am my dad's health care proxy--he's 92, with Parkinson's, depression, incontinence, dementia, and Alzheimer's, and currently in a nursing home; my 88 year old stepmom lives nearby, while I am in Michigan, about 1000 miles away. A few years back--while he was still living at the house, although perhaps when the dementia had begun to manifest--my brother had asked him about a DNR. At the time, he indicated he didn't want that. A couple of days ago, there was an incident at the nursing home and they wound up doing chest compressions (since there was no DNR). He's recovered, but I was asked about whether I wanted to instate a DNR. I know the damage that can come from CPR, and have heard plenty of stories about unnecessarily prolonging life (my partner's a nurse). My stepmom, I believe, has a DNR. I understand my dad's wishes, but am also aware of the decline in his quality of life that resulted from the move to the nursing home, and I can't imagine he understands the reality of being hooked up to tubes, etc. My brother says he would support a DNR (but of course he's the one who spoke to Dad initially). Anyone else stuck in this dilemma?
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So here you are now, facing one of the most difficult responsibilities of the Good Healthcare Proxy. I'm sorry for it.
You could go ahead and implement the DNR, and no one would criticise you, and you already know you have your brother's support. Your father hasn't, in fact, given you any clear directions: there aren't any formal instructions from him for you to follow, and you didn't have the discussion with him yourself.
If you're still uncomfortable - which would be to your credit, and show a proper conscientiousness about a genuine ethical dilemma - then I suggest you talk the issue through with your father's primary physician and look on this as a clinical decision. I'd guess that the medical advice would be that to attempt resuscitation on a patient in your father's condition would be verging on unethical in itself; but it would be best to settle any doubts you have by relying on a professional opinion from your father's own practitioner.
Now if I was in a condition where the quality of my own life was way down on the scale, then forget about it, let me go. I wouldn't want any thing more than limited CPR... thus, don't keep trying. I will need to talk this over with my Elder Law Attorney.
When my Dad was in Assisted Living/Memory Care, the facility asked for signed legal documents that my Dad might have. Such as a Living Will and a DNR. When Dad was put on Hospice Care, then that DNR became important. Thank goodness the doctor/nurse never needed to use CPR as Dad passed peacefully in his sleep.
It does bring up an interesting question.
If he were in his right mind looking in, would he want to remain in this state forever, being another responsibility on the list for his family, or would he want his family to go and live to the fullest without worrying about him? Would he want to be trapped in fear, not knowing who anyone is or if they are friend or foe?
I have told my children to keep me alive if there is hope of recovering from an illness or accident. But if dementia has been diagnosed, I want them to feed me yummy fatty foods so I can have a heart attack and go before I get to the point where I am afraid of everything in life. What a horrible way to live.