There's a POLST that was referred to earlier. Physicians orders life saving treatment. It specifies what can and cannot be done. If you call emts, they operate under a strict protocol and must save the person in the absence of a POLST.
freqflyer, I can answer in detail for one individual, my husband. He had a very strong family history of death from Arteriosclerosis. He gave up smoking after a brother died at age 38. (Not smoking is #1 thing to do for heart health.) He followed the Heart-Healthy diet. He certainly saw a cardiologist regularly. He was diagnosed with Congestive Heart Failure in his 50s and lived another 30+ years, defying the odds for that condition. He had a pacemaker and a defibrillator implanted in his chest. He did not want to die from heart disease. His life had quality and meaning.
Then he was diagnosed with dementia.
In a lucid moment early on he questioned, "Why me? Did I take such good care of myself only to suffer this horrid condition? Brother Fred came out of shower and dropped over dead putting his shoes on. Why couldn't that have been my fate?"
He would much rather die of a heart attack than suffer through the end stages of dementia.
So, he got a DNR order signed by his physician. He insisted that the defibrillator be removed from his chest. He was very, very serious about not wanting his life extended by preventing or treating a heart attack. Treating pneumonia? OK. Reviving him after his heart stopped? No, no way.
I don't know about people who have no other serious health issues, but people who do might welcome a heart attack. That would be their sure sign that it was their time to depart earth.
My husband did have a very scary episode one evening. I agonized over DNR thing. But I certainly didn't know if this episode was heart-related. I said, "I am going to let go of you and go call 911." He said, "Good." Wow! What a gift that he was conscious and could give me his permission. It turned out he had a bleeding ulcer.
Knowing what I know now, Mazy, I think the right thing for a spouse to do is call for emergency service and let the medical experts determine if this is cardiac arrest or a heart attack or something else. And if it is heart-related, then advocate for the DNR approach. I wish I had made this decision when I could have discussed this with my husband. Then even if he hadn't been conscious to be consulted I could have called 911 knowing I was honoring his wishes as we had agreed upon them.
Mazy, in today's world people have heart attacks and the vast majority survive without any major side effects from the heart attack. Curious why your hubby would just want to die. Does he have other medical conditions? Why does he think he might have a heart attack? If he has a family history of heart issues, he needs to see a cardiologist to help prevent a heart attack.
My Dad was in his late 80's when he had a heart attack. After being in the hospital for a few days, he was allowed to either come home and have physical therapy at home or to go to a rehab center. The physical therapy helps one's get one's strength. And Dad was back to being his old self in no time, climbing ladders [I know, yikes] and shoveling snow [another yikes]. Nothing stopped him and he lived to be 95.
thank you all for your quick answers on what to do .. I have a lot of thinking to do and I do need to talk to his doctor on this one.. I really want to honor his wishes but in the same sense I can't just watch him suffer and possibly die. I wear my heart on my sleeve and this would haunt me for the rest of my life... This is a awful choice to make with your spouse. I need to get a DNR and have it signed by his doctor... Thank you again for all your help
Yes, definitely get the proper paperwork in place for your jurisdiction, and keep it somewhere obvious. (I kept my mom's on the fridge door). The idea is that the wife (you) can still call 911 for support in an emergency but the paramedics on scene and doctors at hospital should honour the DNR, your job is to make certain every one sees and follows it's directions.
I will just add a little thing I didn't know until recently... Maybe you all already do ;-). My mom has a Medical POA and it states that when she gets to the final stage of Alzheimer's she wants to be considered DNR. She is now stage 7, final stage, and lives with me, POA. About 3 months ago she had a seizure. I had not read anything, anywhere about seizures with Alzheimer's and had no idea what to do so I called 911 (yes I was in a panic). When the paramedics arrived, I explained we wanted to stop the seizure but did not want breathing tubes, or to restart her heart if it stopped....limited intervention. They asked if I had DNR...I said it was stated in the paperwork.....here is where I received new knowledge. If you have all of those other papers in place it means nothing until you get a form signed that is actually considered the DNR...in Arizona it is orange but I have heard it is a different color in other states. I would suggest you discuss this with your husband's doctor...it requires a doctor's signature. I wish I had known this before! All went fine with my mom but they transported to the hospital, even though I didn't want to and I had to fight to get her back home... Took almost 12 hours. We now have the orange paper posted on her bedroom door and I know what to do in case of a seizure. There is so much to learn with each stage of this awful disease. Much peace to you and your husband.
Mazy, I think your husband should talk this over with his doctor and you, all together in the same room at the same time.
The thing is, YOU aren't going to know if he is having a heart attack. Even if you're a physician.
True story. A doctor friend was walking down the street and had a bout of really severe heartburn. He'd had this before, so he called up his doctor and said " I'd like to make an appointment so you can write me a script for that stuff you gave me last time". His doctor listened to his symptoms and said "go to an ER, you're having a heart attack. My friend (he's a doctor, remember, says, no it's just hearrburn". Well, he went to the er. It was a heart attack.
I understand that your husband doesn't want to suffer. But since there is no way for you to know what is happening, I think what you might both agree upon is to call 911 in an emergency and have the living will/dnr documents handy to explain to the EMTs what he will and will not agree to.
In my experience, EMTs will usually ask when called for an elderly patient "Is there a DNR?"
yes it is hypothetical question my husband is serious about this. He would like to know if anything would happen to me if I just did nothing he is very serious that he wouldn't want to live if he had a heart attack he said that maybe his brain would suffer or some other body part might have a reaction that he wouldn't want to live that way in the rest of his life. He wouldn't want to suffer ....
Is this a hypothetical question or has this already occured?
What is the wording of the living will? My mom's advance directive says that no extraordinary measures are to be taken and that she does not want to be intubated or resuscitated (dni and dnr) if there is no hope of returning to good health, or some wording like that.
How would a spouse know if their LO was having a heart attack, as opposed to a bowel obstruction ?
Tell us a bit more about this situation and you'll get better answers.
Then he was diagnosed with dementia.
In a lucid moment early on he questioned, "Why me? Did I take such good care of myself only to suffer this horrid condition? Brother Fred came out of shower and dropped over dead putting his shoes on. Why couldn't that have been my fate?"
He would much rather die of a heart attack than suffer through the end stages of dementia.
So, he got a DNR order signed by his physician. He insisted that the defibrillator be removed from his chest. He was very, very serious about not wanting his life extended by preventing or treating a heart attack. Treating pneumonia? OK. Reviving him after his heart stopped? No, no way.
I don't know about people who have no other serious health issues, but people who do might welcome a heart attack. That would be their sure sign that it was their time to depart earth.
My husband did have a very scary episode one evening. I agonized over DNR thing. But I certainly didn't know if this episode was heart-related. I said, "I am going to let go of you and go call 911." He said, "Good." Wow! What a gift that he was conscious and could give me his permission. It turned out he had a bleeding ulcer.
Knowing what I know now, Mazy, I think the right thing for a spouse to do is call for emergency service and let the medical experts determine if this is cardiac arrest or a heart attack or something else. And if it is heart-related, then advocate for the DNR approach. I wish I had made this decision when I could have discussed this with my husband. Then even if he hadn't been conscious to be consulted I could have called 911 knowing I was honoring his wishes as we had agreed upon them.
My Dad was in his late 80's when he had a heart attack. After being in the hospital for a few days, he was allowed to either come home and have physical therapy at home or to go to a rehab center. The physical therapy helps one's get one's strength. And Dad was back to being his old self in no time, climbing ladders [I know, yikes] and shoveling snow [another yikes]. Nothing stopped him and he lived to be 95.
About 3 months ago she had a seizure. I had not read anything, anywhere about seizures with Alzheimer's and had no idea what to do so I called 911 (yes I was in a panic). When the paramedics arrived, I explained we wanted to stop the seizure but did not want breathing tubes, or to restart her heart if it stopped....limited intervention. They asked if I had DNR...I said it was stated in the paperwork.....here is where I received new knowledge. If you have all of those other papers in place it means nothing until you get a form signed that is actually considered the DNR...in Arizona it is orange but I have heard it is a different color in other states. I would suggest you discuss this with your husband's doctor...it requires a doctor's signature. I wish I had known this before! All went fine with my mom but they transported to the hospital, even though I didn't want to and I had to fight to get her back home... Took almost 12 hours. We now have the orange paper posted on her bedroom door and I know what to do in case of a seizure. There is so much to learn with each stage of this awful disease. Much peace to you and your husband.
The thing is, YOU aren't going to know if he is having a heart attack. Even if you're a physician.
True story. A doctor friend was walking down the street and had a bout of really severe heartburn. He'd had this before, so he called up his doctor and said " I'd like to make an appointment so you can write me a script for that stuff you gave me last time". His doctor listened to his symptoms and said "go to an ER, you're having a heart attack. My friend (he's a doctor, remember, says, no it's just hearrburn". Well, he went to the er. It was a heart attack.
I understand that your husband doesn't want to suffer. But since there is no way for you to know what is happening, I think what you might both agree upon is to call 911 in an emergency and have the living will/dnr documents handy to explain to the EMTs what he will and will not agree to.
In my experience, EMTs will usually ask when called for an elderly patient "Is there a DNR?"
What is the wording of the living will? My mom's advance directive says that no extraordinary measures are to be taken and that she does not want to be intubated or resuscitated (dni and dnr) if there is no hope of returning to good health, or some wording like that.
How would a spouse know if their LO was having a heart attack, as opposed to a bowel obstruction ?
Tell us a bit more about this situation and you'll get better answers.