Now I Have to Play God? So Daddy and I visited a lung specialist today who confirmed that there is a mass in his chest. With daddy's advanced age and other conditions, he feels it may be best to just let nature take its course.

The thing is...Daddy didn't make any advanced directives when he was of sound mind, and I'm left with the burden of deciding whether we should keep him alive when this mass rears its ugly head.

I have no support system as many of you know so I feel very alone right now. In a normal world I would discuss with the family but I can't take being railroaded by them right now or being called selfish for a DNR decision.

I'm angry. Why does this fall on me? Why should I suffer because he chose to smoke?

I'm afraid. I don't want this responsibility. I'm sad. I'm essentially left to decide his ultimate fate. I feel like a murderer.

This isn't fair. I don't know what to do.

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I've had to face just this situation with my mom a few weeks ago. She had a heart attack on top of an already weak heart. Long story short after two ER and hospital stays and rehab in between the docs couldn't find the right combo of meds that would strengthen her heart without compromising her blood pressure and kidneys. Though I had to push them to try in the first place and I believe they did, her body has too much damage. In the midst of all of that I had to deal with the DNR, AD stuff. She never dealt with it, neither has dad. So seeing her struggle I made the call to do the DNR.

It was very hard and not it's fair. Like you my brother is MIA and my dad has his own issues so it's on me like it or not. But I love her enough not to put her through any more turmoil than what she has already withstood. She started hospice yesterday and it's gut wrenching to go through this when she was walking the treadmill like a sport just three weeks ago.

You have to search your heart and you know your dad best. I struggled with all the same things too or many of them I'm sure. But after all I've seen with her, I prayed and said Lord I'm doing what I think is best. After all she's your child and now this is between you two. I am still there supporting her though and making sure to the best of my ability she has the best care possible.

You are no murderer. If you were you wouldn't be here in the first place telling us your struggle. Sounds like you are a loving, responsible daughter having to do some really hard grown up stuff and become the parent right now. You will make the right decision. Just know I'm right there with you facing it now, just like you.
Helpful Answer (27)

Good discussion. A couple of points:

When we are looking at this decision for an elder ask what you would want done if our situations were reversed. No one wants to play god but we drag life out far, far too long in most cases.

Nothing has had the impact on extending life like modern medicene. It's just nuts. Nursing homes are full of miserable old people who should have passed on long ago. Why do we do this. You can find 25 kids in any neighborhood with no insurance or medical care but we're keeping granny alive for another 6 months via heroic measures and at great expense. Oh yea, I know, death panels........Sign me up.
Helpful Answer (20)

Perhaps forcing treatment on him is playing God. Maybe this is Gods way of allowing his life to come to an end. Letting nature take its course is much more compassionate in my book.
Helpful Answer (19)

A large percentage of people choose to be a DNR. They make that choice when they're of sound mind. An elderly person being resuscitated is not a pretty picture and can be quite violent. Often ribs are broken, the chest is injured. The person can come back only to be put on a ventilator and the family has to decide at some point to turn off the vent.

In letting the disease process take over there are medications available to make the person more comfortable. The person may or may not be conscious. Hospice can be called in to make things easier on the family.

You are not a murderer. You are not killing your father. You have a choice to make. And once you make that choice there will come a time when you second guess your choice but stick to what you decide. Make a thoughtful, well-informed decision when you're not emotional and go with that decision. Your dad is going to pass away at some point whichever way you choose so you can't choose wrong.
Helpful Answer (16)

I had to make this decision for my father during his final week. It was not difficult for me, because I knew his body was too sick to go on and that he was ready to cross over. The nurse explained to me what could happen if CPR was done on an older frail body. I knew my father would not have wanted that. Fortunately, he had signed a DNR and I just had to affirm that it is what was wanted. If he had been brought back, it wouldn't have been for long. He was too sick. There would just be more suffering.
Helpful Answer (14)

Tacy022 is right. You are not playing god or murdering your father if you choose DNR. I faced this when my father died. I looked at the face of the man who raised me and with deep grief said no more suffering. At some point, medical intervention is just that... prolonging the agony with inflicted agony. Let nature take its course. You might second guess yourself. I did. But over the years as i have seen more, i know i did the right thing and what i would wish for myself.
Helpful Answer (9)

Yes, good discussion. As I've stated in the past my mother has a very long, very detailed, very strict Advanced Directive - it barely allows for her to be picked up off the floor and made more comfortable in a bed. It's so strict that several months ago her doctors approached me for authorization to give her an antibiotic for a UTI - the hospital has her AD on file. I did say yes to the antibiotic as when it comes to a UTI I do view it as a comfort measure. I disagree with one part of moms AD - a feeding tube. I don't see a feeding tube as an extream measure if that is the primary issue as I don't think anyone should be starved to death. However, my mom feels differently and when I signed off on her AD I knew I was signing off to follow her wishes and beliefs, not my own. Just recently it became time to get hospice involved in my mothers care. The hospice doc and I went over every rx my mom was taking one by one and we agreed to stop everything but what I call "mood enhancers" - Ativan and antidepressants and also pain meds. While I did this with a heavy heart I did this without guilt or doubt. These are my mothers wishes and letting her life end naturally but without pain and anxiety is the most compassionate thing I will ever do for her.
Helpful Answer (9)

Although I can't claim any specific knowledge or research on this issue, I'm guessing that the proliferation of medical malpractice lawsuits, including those alleging wrongful death, had something to do with medical people covering and protecting themselves.

And let's be honest - look at some of the posts here inquiring whether a medmal claim exists because of events that might have been a normal part of dying but the family just wasn't ready or expected more from the medical community that was reasonable.

And now we have prolonged life, often well past the point of tolerance.
Helpful Answer (9)

First of all a DNR can be revoked, I have POA and advance directives in place. My husband makes first decision and if unavailable elder daughter.

I was about to undergo surgery for a burst appendix and the anesthesiologist invited me to sign a DNR immediately prior to putting me out. Knowing my survival rate was 20% I declined. he then asked how much I wanted him to do. I told him he could shock me a couple of times and if that failed my husband would make the final decision but I did not want to be revived to a vegetive state.

Having a DNR is not murdering someone or signing a death warrant it is just giving others permission to treat or not treat under certain circumstances.
Please everyone educate yourselves about end of life decisions and find out what your loved one would want.

Jude the use of a morphine pump or any other route of administration does not ensure that death will ensue. of course death may follow as the loved one is probably actively dying. It does relieve the pain and being pain free frequently allows the person to slip away at peace rather than staying alive to fight the pain.

I personally would have no problem administering a prescribed dose of a narcotic even though I knew it could accelerate the dying process. Do you want to watch your loved one screaming in agony, writhing round the bed and yelling for help, often pleading to be given more. I think not.

So put away the guilt all of you who made these decisions, loose the "what ifs" and grieve your loss. You owe it to your loved one to grieve completely so you can go forward with your life
Helpful Answer (7)

I googled "gentle CPR on the elderly", and came up with nothing. CPR's main function is to get blood flow to the brain of the patient during Cardiac Arrest , and if its not started within 3-6 minutes, then the patient Will suffer brain damage from lack of Oxygen. From everything that I read and have witnessed (I personally have never had to perform CPR, but have witnessed it being done several times), CPR is brutal and normally does break ribs, especially on the elderly, but the whole intent on starting CPR is to buy time until paramedics arrive with the defibrillator, as CPR itself, rarely Re-starts the heart or saves lives on its own. Broken ribs should be the Last thing you are thinking about, if your whole intention is to resuscitate, and start the heart to pumping on its own again. Ribs heal, brain damage is forever.

Personally, I think that a Cardiac Arrest at age 100+, is Gods way of saying that their frail body has had enough, and that we should let them go naturally. We can't keep them alive forever.

I have witnessed a situation with a 53 year old patient, who had a sudden Pulmonary Embolism, and even though aggressive CPR was done immediately, and paramedics arrived within 3 minutes, the EKG, and Defibrillator pads were attached, that the Defibrillators are so advanced and Safisticated, that the monitor "Speak out loud", to "Defibrilate", or "Do Not Defibrilate", as ther are instances where Shocking will not work, or is ill advised. DEFIBRILLATION does not always work either.

Its best to have a clear cut plan of action, Before you are faced with this situation. Decisions under stress and duress, are a bad idea.
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