DNR or Full Code for Resuscitation?

Posted by grrranny @grrranny, Jun 26 7:31pm

How do you make the decision? Those of you who made the decision to have Full Code resuscitation (and have had it) instead of Do Not Resuscitate -- what factors did you consider, how old are you, and do you feel you made the right choice?
I have read that CPR is very hard on the body -- from breaking ribs to breaking bones. And there's also the possibility of being put on a ventilator -- which is sometimes deadly. What if an elderly person is already very frail, with multiple incurable chronic problems?

Interested in more discussions like this? Go to the Aging Well Support Group.

This is such a personal decision. Using your example, if I was very frail with multiple incurable chronic problems, I would choose DNR. It's all about quality of life for me. How old is the person you are thinking about?

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Thanks for posting on this topic. My husband and I have discussed this many times.i would like to think that I would have a dnr in place if I was a hospice patient or very frail and disabled by multiple problems. It's quality over quantity for me. Realistically I don't know what I will choose near the end. Great topic for discussion.

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Interesting. My mother had DNR in place. When her oxygen dropped and she was taken to hospital recently, we were asked if she had “DNI” as well. This was the first time I’d heard this term - for “do not intubate.” Fortunately, we knew her wishes and she was lucid enough. At 91, she died within 2 hours, holding my hand with an awareness that she was not alone - no drama, no struggle, apparently no pain. She was so very tired.

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It is imperative to have these vital decisions documented in our estate plans and our families need a copy in hand if we become incapacitated.
What happens once I have a pacemaker or if my family
doesn’t agree on end of life ethics.? Intubation is another issue that should be addressed as specifically as possible. At 70 we should know the differences between
palliative care and hospice for our loved ones. We are working on our end of life planning as part of successful aging. Take inventory of your health and resources.
If you’re having a good day enjoy the present. Great discussion points on Connection.

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This article gives clear information about the very significant downsides to CPR for elderly people.

Consider the advantages of dying from a heart attack. It's fast, pain is short and you're asleep. You've avoided long term medical care and life with neurological disability.

Suggestions to die in peace:
Get your financial, succession and burial papers together ("Get It Together" from Nolo Press or similar guides). Simplify your home and possessions: "The Art of Swedish Death Cleaning".
Get a DNR from your doctor and tell all your friends.
Get busy enjoying your life now.
Good luck!
https://www.npr.org/sections/health-shots/2023/05/29/1177914622/a-natural-death-may-be-preferable-for-many-than-enduring-cpr

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I'm 73 and if anything happens to me, I don't want to be rescusitated if it means I will not be able to take care of myself and interact with the people in my life, enjoy my morning cup of coffee or occasionally eat the unhealthy foods that taste so good. I don't want my wife to become a permanent caregiver with no life of her own. The decision becomes harder because medicine keeps advancing, and what was once considered incurable or irreversible has changed over the years. I'm not sure if I can make a blanket statement today to cover everything that will be an option tomorrow, yet I don't want to force my wife to make that decision either. My mom lived to celebrate her 101st birthday with us before suffering a bad fall and then a stroke. Within 5 weeks of her fall, she passed away peacefully in her sleep. Luckily we never had to make the decision for her.

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At 77, having a small build, & osteoporosis, I have a DNR in place.
The outcome would not be favorable with probable multiple broken bones & lacerated organs.
My grandmother lived to 84 and my mother to 90.
So I probably won’t be “going anywhere” for awhile yet.

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I have a POLST [Physician's Order for Life Sustaining Treatment] in place. It calls for DNR, my choice. My hospital of choice, along with all my different physicians/specialists have a copy. There is a copy in my car's glove box, and one in my wallet.

With my multiple health conditions, it is hard to say which one will be the tipping point. Quality of life over quantity.
Ginger

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A useful metric for EOLC - End of Life Care:

1. Has it been good, even great? If yes, then you've had the biscuit...or the bon-bon....whatever you call your 'goodie'. There's not much left to miss or to hope for.
2. Is it still good, even great? If yes, then why not continue to wring what you can out of Life? But, if it isn't great, are you likely to see improvement or any gains......again? Probably not, not if you have comorbidities, a lot of pain that needs meds, greatly reduced mobility, need help with hygiene, and are heavily dependent on other's efforts to get you through even a single day. If you're really not having much or any fun, it might be time to move on. So, what would be the point of resuscitation? Would you like to awaken after heroics, but in much greater pain, and with even fewer prospects and optimism?
3. Do you have fear over dying, maybe just general anxiety? Would it help to talk about this with a therapist to get you over some stumbling blocks? Is it one thing or several? What would you need in place in order to feel a lot better about nature taking its course when the time is right, and you having a DNR in place, in plain view, and known by all those who are likely to continue to provide you with some kind of care routinely?
4. Are your affairs in good order? You have a current will that you don't want to change? Do you have an executor to conclude your estate legally? Is there anything else that you keep bringing up mentally, something that might rob you of rest, of peace, or of sleep? Maybe you need to discuss this with a trusted friend who can be counted on to look after your best interests or to help you to parse out the problem(s) on your own terms. Once they are put to rest, you can be put to rest.
5. Don't overlook that long overdue apology. We all have things that eat at our conscience. We're all highly adept at suppressing them....until we near The End. Then they loom and occupy our thoughts. If there is still time, if you know you can reach the offended, now is a great time to unburden yourself....and them.
6. As a Christian, you know what I would raise here, but only with those whom I know are of the Faith. If you are secure in your own position on religiosity, faith, or any of the other philosophies, then at least that much can be tucked-in for the last time.
7. Lastly, if you deal with these forthrightly, maturely, with determination and resolve, you will live out your last days in peace and little else but the loved ones in your life will matter thereafter.

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Looks like it could a problem either way:

With DNR: it could be ignored, even after going to all the trouble of posting it everywhere.
(So why bother?)

With CPR, etc: a person could be a lot worse-off afterward, which could be horrible -- very painful. (And for who-knows how many years.)

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