When is it time for a DNR?

I think it is entirely up to the individual and his/her loved ones.

I believe it's what you want to do and family if you're close Also you know what kind of live you want to live and how.
I put DNR for myself. I don't want machines, life support, or lay. In a nursing home. I'm ready to go to heaven come my time. Not laying around here, unresponsive

Hugs

For me it was when my folks had died and I was the senior family member. I've always kept an updated will, powers of attorney, and more in good repair. You could really do a DNR when you write your first will. Frankly I think it is never too early. Conversations are much easier to have when it isn't an emergency. It is good to think about end of life when you feel centered, and not in the middle of chaos. A DNR, and the Five Wishes, and all end of life instructions are good to think about any time--they help me understand my life, and its meaning and values. Hope this is of use.

Thanks for the responses. I should probably restate my question. I don't have family, I'm 73 and live alone, however, I still have a good quality of life. My inclination is I'd want to be resusitated, although I too don't want to continue living with significant incapacitation. Are there specific medical issues or other information I should discuss with my internist to factor into my decision?

You might ask your internist what the survival rate from resuscitation actually is--both in and out of a hospital. I gather it is lower than I assumed from watching medical shows on television! It is a good question--hope you find good answers. Maybe share what you find out with readers here?

@sbcarcht You have posed a thoughtful question. No doubt there are many members here who may not have family, or nearby family if there was a medical need.

Here is a great website I found, from POLST.org, a non-profit. It discusses the differences between an advanced medical directive and a POLST.

Personally, I have both in place, and like @mir123 commented, I also have a 5 Wishes document. Although it is not technically legal here in Oregon, it was first created when I lived in another state, and subsequently it was made part of my planning materials.

Discussing with your internist what actions or non-actions you would want, documenting it all, and making sure proper friends/family/medical facilities have this information, can give you peace of mind if you are ever in a position to not be able to answer for yourself.
Ginger

For a solitary person who has led an active and involved life, a DNR might make sense if the alternative, maybe existing largely dependent or incapacitated for several long years, is unthinkable. Without strong ties to individuals with whom you'd like an extended and high-quality relationship (you have to think about what 'high quality means for you and for this exercise), or not wanting to be a burden to someone, the DNR makes a lot of sense.

Essentially....do you have a lot to live for? Will that still be sufficient if you are confined, bed-ridden, need to haul around machines or detectors, need others to take you places or to do manual chores and personal hygiene for you? Would you be okay with a year, six years, sixteen years, having to take six-ten drugs each day, some of them twice, to be conscious 12 hours each day, but little else?

For me, when I simply do not wish to keep struggling, when the intrusions of all kinds (as I define 'intrusions) are too much, when I become exhausted, or when living just ain't fun no more, then the DNR goes into effect when I say it does, witnessed, or when the designated trusted person who can legally put it into effect on my behalf, says so. In British Columbia, where I live, we have Powers of Attorney, Representation Agreements, and Advance Care Agreements. They're all legal, they all require sober forethought, and they all rely on the good will and savvy of a trusted adult to fairly and honestly represent the person invalided or incapacitated.

I don't mind heroics, especially if the care they intend is not going to leave me with a breathing tube for life, or on my back for life, unable to lift a TV remote on my own or to clean my own butt. Any of those taken away from me, hand me the cord and I'll pull it meself.

I’d consult with an attorney to confirm you have all the proper documents in place. In my state, an Advance Medical Directive sets out your wishes in case you are terminally ill…..such as if you want extraordinary measures like CPR or even artificial nutrition. A Healthcare Power of Attorney, is also good to appoint so they can assist in healthcare decisions when you can’t and ask for the DNR when you can’t. I’m not a medical expert, but I got my cousin’s (I was her appointed agent) DNR signed when she was diagnosed with a terminal illness (dementia) and entered into Memory Care. This was her instruction per her Advance Medical Directive, though by that point she didn’t understand what any of it meant. It’s important to get those documents done while you are healthy. Keeping in mind the reality of how different you could be if terminally ill. The DNR is actually an order a doctor signs to not resuscitate. It was kept on the wall near my cousin’s bed.

Tnx for thoughtful reply. Substantively, I’ve already thought this through, but it’s always good to re-study issues while still capable. Always a good question to ask what constitutes “joy in life.”

I am 74 years old, live alone, no family, no caregiver. I will soon have a DNR because CPR with elderly folks may cause more problems.

“ The main concern when choosing whether or not to perform CPR on elderly patients is the quality of life after resuscitation. CPR can have long-term side effects, and many patients who survive CPR wish they had not had it. Some of the risks of CPR include:

Broken chest bones. Smaller people or people with more fragile bones - such as the elderly - are at a high risk of broken ribs or a broken sternum as a result of CPR. Studies show 81% of people who receive CPR have broken ribs afterward.

Neurological damage. When the heart stops, blood stops flowing to the brain, causing the brain to be deprived of oxygen. Brain damage begins to occur four to six minutes after the brain stops receiving oxygen. In general, around one-third of the people that survive CPR end up with neurological problems due to lack of oxygen to the brain.

Vomiting. It is not uncommon for vomiting to occur during chest compressions. This can lead to stomach contents aspirating into the lungs, which can lead to infections like pneumonia.

Other complications can arise, like organ damage or internal bleeding.

The recovery process after CPR can be long and often requires a lengthy hospital stay in intensive care. The underlying conditions that led to the need for CPR play a huge role in the outcome.”

From the website, https://www.griswoldhomecare.com/blog/2023/july/cpr-on-elderly-long-term-side-effects-of-cpr/