Question about a DNR...

Follow
Share

I hope this isn't a stupid question, but it just isn't clear what or how to do this. My mother is in a very loving and small assisted living facility. She was diagnosed with Alzheimer's 6 years ago, although my sister and I knew for some time (a couple of years) that there was something wrong. She also has heart disease and stage 3 chronic kidney disease. Should also mention the severe arthritis in her knees that make her a fall risk. She and my father were placed in this facility a month before he died. He was verbal about his wishes. Wanted to be cremated and didn't want to be resuscitated should he stop breathing, etc. During this time my mother stated that she didn't want to be cremated...(understood, no problem).. But never said anything about not being resuscitated... We we're focusing on him at the time, in fact she was very upset about it. Since his death there has been a sharp decline in her dementia as can be expected. In her living will she states that she does not want to be kept alive artificially in the event that it is determined that nothing more can be done... (No breathing help, no feeding tube, etc.) Recently when having a conversation with the nurse at the facility, she was asking about a DNR. This came up when I went out of town for a couple of days. When I leave, there is nobody here in this town to be their for her in case there is an accident or severe health crisis that puts her in an ambulance to the hospital. (My daughter lives nearby, but is not reliable in this case, can't take it. Won't visit her unless I'm there with them.) I explained to them what her LW says, but they need a signed form. The nurse said that I really should discuss it with her. My question is how do I do it... She hates these kinds of discussions, is not reasonable anymore, and already thinks we're out to put her away until she dies. I'm finding it a very difficult thing to do. My sister expects me to do it because she lives in another state, I've (my husband and I) had to care for both of them for the past 6 years with no real help from my siblings. My sister wants her to have a signed DNR in place so that we don't have to face "pulling the plug" after something happens to her. But, obviously, she's not willing to discuss it with her. How do I approach the subject with my mother? I know that she didn't like it for my Dad, but it could have just been about not wanting him to die, not necessarily about herself. And, of course, the dementia causes her to not be able to reason clearly on anything. Just was hoping to get some suggestions about. Thanks in advance.

This question has been closed for answers. Ask a New Question.
6

Answers

Show:
Sorry about that. The Hospice nurse discussed it with him in front of my mother and all the kids. His wishes were clearly known to all. Came from his own mouth.

Aside from my sister, none of my siblings will be visiting her, I'm sure.

Thanks again for your help!! Hugs to you all!
Helpful Answer (0)
Report

Thank you do much for all of v your kind suggestions! I hadn't reviewed her living will in a while so I got it out to look more closely at it.

It seems to address everything except CPR. She wants life support to be removed... removed (repeated for emphasis)...if she enters a vegetative state, is in an irreversible coma, or is diagnosed with an irreversible terminal condition that will result in death within a short period of time. She does state that she wants palliative care, even if it results in prolonging her life... So no food or water once it's clear that death approaches, but she does want pain management and comfort care . (Sounds like Hospice to me). But nothing about CPR. It seems logical to me that if she doesn't want food, water or breathing assistance she wouldn't want to be resuscitated.

I don't have medical POA.

I do appreciate the suggestion to call an elder law attorney. Perhaps I should do that! Need to get all of this sorted out. Will make things easier in the long run.

I also appreciate the suggestion to have her doctor talk to her about it. That's what happened with my father. The Hodpuce
Helpful Answer (0)
Report

If she already has a Living Will, I'd consult with an attorney about how you should honor that document. If now she is not competent, I'd try to avoid confusing her.
Helpful Answer (3)
Report

I found this a confusing issue with my mom too. I didn't even know there was a separate paper I had to have signed. I had her wishes both in her living will and on her medical POA paperwork. She was stage 7 and had a seizure...I had to fight with the paramedics and the ER doctor. Finally they brought hospice in and the hospice doctor signed the paperwork. My mom is still with us and had had another seizure, but I now know how to deal with it on my own. We now have the orange paper, DNR, on her bedroom door. Our first responders are wonderful, but it is tough for them when the patient it past a certain point. I will try not to put them in that position again.

I suggest you take the paperwork and chat with the doctor. Do you have POA?
Helpful Answer (2)
Report

I feel it is easier if a nurse or social worker, or even the doctor if you have one that takes time with their patients, has this discussion so there is no emotional baggage involved or paranoia that the family is trying to get rid of them. If it is up to you then maybe start with a general discussion about getting older, perhaps bringing up examples of those who are amazing for their age (Queen Elizabeth or Betty White spring to mind) and those who are not, then segueing to how she feels about those in the latter category and their quality of life. The way it was presented to my mother was "if you should die of a heart attack would you want them to bring you back?"
This all assumes she is still able to participate in such a discussion, if not then you will just have to rely on your knowledge of her thought before dementia and her living will.
Helpful Answer (2)
Report

Hasn't she already said what she wanted in her Living Will? Does it address CPR, artificial nutrition, etc? I would go by what she said when she was thinking clearly. I'd take that document and talk to her doctor. My LO's doctor signed a DNR order. It is orange in color and stays with the patient. My LO's hospital also has it on file there. And, there is a DNR designation on her room at her MC. If you have questions, I'd read about what happens when CPR is done.

I think that if she's not thinking clearly, she may not be able to sign legal documents now. Of course, you can check with an Elder Law attorney. You can show them what she has already signed, too.
Helpful Answer (2)
Report

This question has been closed for answers. Ask a New Question.