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My mom, 65, has a ton of serious chronic issues. Her balance sucks, she's fallen a lot lately and knows she's nearing the end of her ability to live alone. Her memory is terrible, and she's a brittle diabetic with kidney disease, cardiac problems, among other things. She has spent the day sleeping today after calling my sister (in another state) and telling her that she felt it was time to end her life last night. I don't know if she actually enacted her plan, but she's been very deeply sleeping all day. I didn't try too hard to wake her until supper time, and got no response. She could have been playing opossum to make me go away. She has a DNR that was signed during a good time period. How do I tell if she's asleep or if she tried something and it got messed up? And at what point do I call an ambulance?

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You can call 911 even if someone has a DNR or POLST.
The difference is the DNR says do not use CPR. The POLST specifies CPR, Intubation, Tube Feeding, Comfort Care..
If she has a DNR and you call 911 they can do what they can within the scope of the DNR or POLST they just can not go beyond that.
My Husband or I should say I had a DNR for him and I called 911 10 times over the course of 3 years for a "Lift Assist" they would help him up after a fall and would help me get him into bed and they would leave. They would always ask if he needed medical attention and I would say no. That was it.  I would sign the papers stating refusal to be transported and they would be gone.
Having a DNR does not mean that you no longer desire medical attention. It just means that you do not want extraordinary means carried out.
When in doubt call.

I should say the exception for calling 911 for medical attention is when someone is on Hospice. Once you are on Hospice your Hospice becomes your 911 and for medical problems you call them. For help lifting someone up after a fall you can call 911 for a "Lift assist" just refuse transport. If the emergency responders think a bone is broken or there needs to be further medical evaluation you tell them the person is on Hospice and that you have called Hospice. (and if that is the case you call Hospice, as a matter of fact call them after you call for the lift assist)
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I think if it was me, I would call now.
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I'm an MD...I say-call. She could have either DKA or Hypoglycemia, or a Cardiac or Neurologic issue. Her kidneys could be failing. The longer you wait-the less likely they can correct the problem.
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Dontask4handout, do NOT ever move a person especially if you find him/her on the floor. They could have fallen down and broken a bone. Lifting them to put on the bed is the WRONG thing to do, shaking them violently is the WRONG thing to do. Jumping up and down on the bed? Bring in a dog to wake the person? Say what???

If a person doesn't wake up the normal route then 911 needs to be called. The person could have past out due to pain, and your suggestions would only do more damage.

Save a ton of money? If the person is 65 or older, Medicare usually pays for the ambulance, and pays 80% of hospital care, then secondary insurance pays the other 20%.

If the parent passes while the EMT's are trying to revive the person, then the county Coroner comes in, and it is up to the Coroner on what to do next. If Hospice care was involved, then the Coroner is not needed.

DNR is NOT a form of suicide. Without DNR we would have a lot of people living via tubes in a vegetative form for 10 years or 25 years, maybe 50 to 75 years. Yes, that many years because machines are keeping the heart pumping.
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Yes, agree call now.
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Dontaskforhandout's understanding of a Do Not Resusitate (DNR) Order is incorrect. Requesting to not have extraordinary measures used to prolong my life after my heart or breathing has stopped on its own is not suicide. It is, in fact, letting God's will be done rather than trying to over-rule God's decision. Or, letting nature take course, whichever you prefer.
That said, I hope emergency services were contacted by the original poster. Treatment options for conditions prior to the point of DNR are best determined with the help of professionals.
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It would be considered neglect if you didn't call 911, knowing what you know.
You called, right?
It's okay, you are calling now. You were right to ask.
Are you okay? Let us know.
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Sendhelp, you are wrong.
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Although I am very empathetic with you in your situation, I can't think of anything to suggest...I offermy kind thoughts. My God bless you and guide you in this difficult time..

Grace + Peace,

Bob
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Listen to Grandma1954.
When in doubt, call.
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