DNR/Hospice/MC; Does the DNR only apply to CPR?
My mother is on hospice at her Memory Care.
1. If a patient is on hospice, is it standard to do sternum rubs and perform attempts to “revive” a patient at the time of loss of consciousness?
Mom has a DNR order at the MC. There is a copy in her chart. Hospice also has a copy.
My mother came out of her room. Collapsed.
MC RN stated that Mom had started to turn blue. RN did a sternum rub, “blew into” Mom’s face, and called her name.
Mom came to. Nurse called hospice, and got Mom back to bed.
I got there within 10 minutes, along with the hospice nurse. Mom was acting her usual self when I left.
2. For you medical types on the forum, would sternum rubs have brought my mother back from death ?
I do not want them bringing her back, if she is in her bed, and non-responsive. I do not want them bringing her back if she collapses in the dining room, or in the hallway, or her bathroom, either. Not the RN, not a caregiver, no one at all.
Hospice, of course, is not always right there, on scene.
3. Does the DNR only apply to CPR?
It’s the weekend, of course, and I did speak to the weekend Hospice Nurse regarding my wishes. I will speak to the regular Hospice Nurse on Monday.
Thought I would start with you all.
Thank you in advance.
12 Answers
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God bless you & bring you peace during this whole dreadful process.
Thank you. Thank you.
Prayers for you during this difficult time.
I got the phone call that my LO had been diagnosed with Covid at the end of March, 2020. I asked (begged) that IF POSSIBLE she NOT be hospitalized, and NOT be put on a breathing device except if she were actively suffering and pleading for oxygen. I don’t remember exactly how I stated my requests, but I considered them to be within the intent of her DNR.
My thoughts were honored, and she recovered with a decent quality of life, given her age and condition.
My point is that however a DNR is crafted, and I’m absolutely CERTAIN that hers was intended in a way that she thought would spare me ANY responsibility regarding making choices, I STILL was able to react with what I felt would be in her best interests.
She has now recovered from a second attack of Covid, and still at 93 and a Covid survivor, recognizes family, AND STILL has her sense of humor, so I think she and I are both content with how the situation was handled on her behalf.
My point is that the DNR seems to have functioned with a sense of reasonableness for your mom, and you can research it to find out if you can, or will want to, establish different terms if a similar situation occurs in the future.
You are certainly thinking in the right direction as I hope I am.
Sternum rubs are not so much a "revival" technique as a tool to assess brain function; it's a painful stimulus that a patient with intact brain function responds to, and that someone who is compromised does not.
Does your mother have a color-coded DNR wrist band? I seem to recall my mom did.
My rabbi told me a story years ago when my mom was starting down the road to dementia. He was visiting his father (who had a DNR) in memory care; they were eating lunch together and his father started to choke on something he'd eaten. Pounded on his dad's back, tried to Heimlich; EMTs were called and while one worked on the elderly father, the other asked the rabbi "does he have a DNR?"
The rabbi, thinking that they would stop trying to save his father if he said yes, lied and said no. The bit of food was dislodged, the father wss fine and the rabbi confessed to the EMTs that yes, his father DID have a dnr, but he didn't want his dsd to die from choking on a piece of meat. The EMTs said that they would have continued to dislodge the piece of food even with a dnr in place; dnrs apparently don't apply to these sorts of easily fixable situations, only to attempting to revive someone who's heart has stopped. But they needed to know IN CASE that happened while they were there.
I’m new to this, and my emotions seem to overwhelm logical thinking.
My mother wants sooo much to be done with this life. I want that for her as well.
Watching her suffering from dementia is torture.
A sternal rub is used when a person is unresponsive to touch or voice. It's uncomfortable and can rouse a person to respond to the pain in some way.
The DNR means that they will not use any methods to maintain her heartbeat or breathing if they start to fail -so no CPR, intubation, or medications.
Why might a person begin to turn blue in such an episode?
No oxygen = turning blue.
This is my first rodeo. Can ya tell? 🤪
I don't think you should expect every episode to be The One That Leads to Her Death. My mother has endless issues for which she's still being treated in spite of being on hospice, because they aren't life-threatening unless they got out of hand (infections and the like). I wouldn't expect them to stop offering food to her just because she doesn't want to eat on any given day, and if she fainted, I wouldn't expect them to just leave her on the floor and wait for her to expire.
It wasn't her time.
If she were not doing as well as she is right now, I would certainly have regretted my requests. Yet I do believe that they WERE made with her DNR in mind.
This was something that really didn’t occur to me until my current LO needed my decision.
When my dear mother was in hospice, she was much MUCH closer to death. In this case, my LO was able to understand, but not remember, that she was VERY SICK and had to do what she was told if she wanted to recover, and she did follow simple directions that ultimately led to her recovery.