When is Do Not Resuscitate applied

I will quote one sentence from this article.
"Only 2% of those over 85 who suffer cardiac arrest survive without significant brain damage."

And here is the full article: < https://www.npr.org/sections/health-shots/2023/05/29/1177914622/a-natural-death-may-be-preferable-for-many-than-enduring-cpr&gt;

@vuk I have a DNR listed in my health paperwork. There is also a DNR engraved on my medical alert bracelet. There is also a POLST [Physician's Order for Life Sustaining Treatment] form in my paperwork, that is registered within my state of Oregon. My Advanced Care Directive includes the DNR.

Typically there are levels of the DNR, and you can choose that. Five Wishes is a great document to have, and allows you to indicates how you want things to be handled. And remember, what you choose today may change in 6 months, and you can make those changes.

It is admirable to be considering all the options now, before you need it. Last week when I had a syncopal episode at a hospital, I was glad to have my bracelet on, and see the response team refer to that.
Ginger

From what I read on the Red Cross site: about 10% of people who receive CPR outside of a hospital return to life; in a hospital it is 20%. This is not a high number, and I'm not sure how many folks function well afterward. As Ginger said, the Five Wishes is a very helpful document and it helped me get my priorities straight. Great that you can engage with these issues, and discuss.

Many people opt, to keep it simple and unambiguous, not to be resuscitated beyond perhaps 5 minutes of CPR and drug administration if their heart stops. IOW, no 'heroics', just standard CPR ...in case....but at the 5 minute mark, even with aggressive and expert CPR, you are losing ground upstairs. As stated in the article, after 80-ish, there's more damage done with the heroics such as sternum destruction, rib separations, potential for lung perforation, severe bruising, and of course the brain damage.

I had an ablation to treat my atrial fibrillation, but six days later was in the local ER. It was pretty serious with a heart rate of 180, and it seemed to be intractable. The internist came into the cubicle and gravely asked what my wishes were in case I 'coded'. At 70, I had never been asked such a question, and I wasn't prepared to deal with it at that instant. But, I did. I considered where I was in life, and felt that my disordered heart might never be the same again even if they could stabilize me. The ablation hadn't done it any good, and I was in bad shape in the three or four weeks prior to the ablation in terms of symptoms. It was awful. I asked them to take a solid crack at me, but no heroics...let me go if after a few minutes they simply couldn't restart my heart. I figured I wouldn't know the difference, and those who love me would understand that it was my wish to not live as a bed-ridden wreck of a man for a year or ten beyond that experience.

I went through this with a parent. I had the POA but the hospital was not very good and I waited too late to pull it.
If I could go back in time would have done it sooner and would have found a better hospital.
But I think it depends on the situation you are in...

thank you for sharing the article, I read it- I did not realize all the bad consequences which may come with a CPR - especially with a prolonged CPR, and especially for an older person with a chronic disease or cancer-

Thank you very much for sharing this illuminating article. I'll be having a talk with my daughter about the likely consequences of CPR and of how being allowed to "experience a natural dealth," may be a much kinder option.

I have not filed a DNR with any hospital but have one with my children to use if necessary. One important facet to me is to state “no feeding tube”. That way if I survived CPR but in a state where I couldn’t swallow, I do not want to linger in a vastly diminished or even vegetative state with only the tube keeping me alive. However, I recently went through this with my beloved ex-partner. I had moved to Texas to be near my children about a year before. At 84, he chose to stay on the west coast even after his daughter tried to get him to move into an apartment in her building in Texas. He just was not up to the move. After his stroke, it was extremely difficult for his family to choose no feeding tube, but they knew that had been his wish. Then when he was eventually asking for food the doctor and staff advised that if they gave him food he would shortly have a choking episode again and it would end that way and advised against it. His family tried, but eventually they could not deny him his requests for food. He had more time with his family and I think he appreciated that, b/c he had lived far from them and I believe he needed that time. He was discharged from the hospital and went to a small home that tended to the needs of people in his condition. This was very depressing for everyone including him. With no knowledge of how long he would linger, at 83 and in a lot of pain, I decided I had to leave him after he had been in the home several days. He did eventually pass soon, after a choking episode with only his daughter nearby. These are extremely difficult decisions to make. He is deeply missed and no longer talking with him daily has left a big hole in my heart and my life.
After this experience, I will tell my children that if after a similar stroke or other disabling event, they are not to feed me just to help me live longer and not to give me food even when I ask for it. But this would be an easier decision for me because I have moved close to my children and have a lot of contact and support from them. For that reason I can tell them ahead of time not to help me linger. But one daughter is strongly objecting, so I need to write this down explicitly and talk to her more, b/c my mother, grandmother and grandfather all died of strokes.

I have a sense that my comment above was too harsh b/c usually my comments receive responses but none here. Theses are extremely hard decisions. I just don’t want to suffer, even if in my daughter’s home in a long term dependant state where the best I can do is live in my bed or a chair. And nature may not provide an easy out.

It was not easy to think about, but I realized that if I was in cardiac arrest I would be unconscious and at peace. If I am allowed to die, my hope for a peaceful death will have been attained!
That is a far better option than days, weeks, months or years disabled and wondering how long I must suffer.
My wife and I have talked this over. We did end of life legal documents years ago, but felt it was really good to reassure each other, knowing that in an emergency one of us may need to call a halt to medical efforts. Reading the end-of-life document, I see that it does not specify "No CPR."
We will need to get more specific documents and keep them on the refrigerator.