[Cookie_Monster]

just read this beautiful article here about the daughter who didn't let her mother pass away, even tho she specifically asked for it. So my question is, if the patients doctor KNOWS she didn't want any interventions how can the daughter request keeping her alive?? From what I got from the article the mother had her wished written down. I makes me very mad and I certainly don't understand how can the daughter decide. It's her mother not her child, she is the child, she should follow her mother's directions and wishes. So is the advance directive worthless?
I'm a nursing students so I'm sorry if me question is silly, I just got very upset things like that are going on against patients wishes.

[Virgo_RN]

Unfortunately, advance directives can be overridden by family's wishes. I have seen DNRs overturned by the request of the family, even though that is what the patient stated they wanted when they were able to do so.

[jnrsmommy]

Things like that frustrate me to no end. A former state that I lived in was like that. You could have your DNR/AD written in stone, co-signed by the Supreme Court Justices (being silly, but you get the idea), and all it took was 1 person to say "Do something" and we were obligated to do it. Whenever I went in to talk to the pt about DNR papers, I let them know all the choices, all the interventions, and I told them to make sure that the family members were in agreement. Then I would ask the pt to notify me when family did show up, so that we could go over it all again w/ them, and let them hear from the pt why this is being done.

I started doing it that way when I had a new admit come in one night, he signed the papers, she was in the room and heard it all. A few hours later he coded (cancer w/ mets all over), she freaked, and demanded we intervene, and we had to

[scribblerpnp]

Advanced directives are often over turned. Sadly once the pt can no longer speak for themselves, the family can and often do make the decisions. It shouldn't be that way but it is. Probably one of the main reasons for this is that the docs/medical facilities are afraid of litigation from family members who can't let go, so go along with the family's wishes.

This is why people should have advanced directives AND a medical power of attorney who is CAPABLE and WILLING to do whatever it takes (even if this means twerking off the family) to make sure the pt's final wishes are followed. But I have seen MPOA who prior to the illness were gungho on following the pt's wishes, but once the pt made a turn for the worse, the MPOA got scared and caved. SO it isn't a 100% guaranteed.

I am my mom's MPOA, and (thankful it isn't necessary in my family) I am completely willing to do what I have to do to make sure she has the kind of death she wants. What has helped is that my mom has spoken individually to each of us and has been very frank and firm about what she wants and why. I wish people took the time to do this type of thing, no matter if they are healthy or not.

[sharrie]

This is such a difficult and emotive subject, yes the patients wishes should be respected but I do feel for the families who want so desperately not to lose thier loved ones.

We don't have advanced directives as such in the UK, resusitation decisions as I have said before are in the medics in charge of the care. Patients and family wishes are taken into account and if the patient has expressed not for resus then this is discussed at length with them.

I have been on both sides, the healthcare worker who tries to explain to the family that this is the end and even though they are suffering there is no more that can be done, and as a family member who would give anything to hold on for just one more day, hour, minute and second, no matter what state my loved one was in. Selfish - most definately but grief is so consuming it is difficult to think clearly.

I have read the story you describe, and it stirred many emotions in me, I felt for that poor lady who just wanted to die with some dignity and yet had to endure medical interventions which prolonged her suffering, and yet I could also feel the grief of her daughter, who loved her mother so much that the thought of being without her too unbearable and every last second, no matter what quality was another second to cling to. Obviously I am putting personal expereince to the second as I don't know the circumstances, but tragic and heartbreaking.

You are right, it was a beautiful article, and the daughter should have respected her mothers wishes but sometimes what we should do is not always the easiest option especially when we deal with overwhelming grief.

[BinkieRN]

Originally Posted by Cookie_Monster

just read this beautiful article here about the daughter who didn't let her mother pass away, even tho she specifically asked for it

May I have a link to the article? I haven't read all the replies and I don't have an answer for you but I can tell you that when the grown child won't let the parent go in peace that it is about them not about the patient and usually it's guilt that keeps them fueled It's not as simple as not wanting their loved one to go.

If they truly loved them they would let them go in peace.

[Ruthiegal]

Originally Posted by Cookie_Monster

just read this beautiful article here about the daughter who didn't let her mother pass away, even tho she specifically asked for it. So my question is, if the patients doctor KNOWS she didn't want any interventions how can the daughter request keeping her alive?? From what I got from the article the mother had her wished written down. I makes me very mad and I certainly don't understand how can the daughter decide. It's her mother not her child, she is the child, she should follow her mother's directions and wishes. So is the advance directive worthless?
I'm a nursing students so I'm sorry if me question is silly, I just got very upset things like that are going on against patients wishes.

When I was still working LTC, you would see this kind of selfishness all the time. A resident in an anoxic coma living for 20 years unaware and no quality of life because family believed the resident would waken even when there was no "normal" brain functions. Or the daughter whose mother stroked and now is unaware of herself, family and unable to care for herself at all, left as a full code because the daughter cannot bear to let her go peacefully. If families could only understand how their loved ones suffer maybe they would not be so selfish. It's hard, I know, I had a parent in the same condition, and as my Mom lay there with a vacant look in her eyes, my Dad had to make the decision, as hard as it was, he loved her enough to know when it was time to let her go peacefully.

Just my worth
Mydnightnurse

[morte]

Originally Posted by BinkieRN

May I have a link to the article? I haven't read all the replies and I don't have an answer for you but I can tell you that when the grown child won't let the parent go in peace that it is about them not about the patient and usually it's guilt that keeps them fueled It's not as simple as not wanting their loved one to go.

If they truly loved them they would let them go in peace.

bingo!!!!

[Xbox Live Addict]

Originally Posted by Ruthiegal

When I was still working LTC, you would see this kind of selfishness all the time. A resident in an anoxic coma living for 20 years unaware and no quality of life because family believed the resident would waken even when there was no "normal" brain functions. Or the daughter whose mother stroked and now is unaware of herself, family and unable to care for herself at all, left as a full code because the daughter cannot bear to let her go peacefully. If families could only understand how their loved ones suffer maybe they would not be so selfish. It's hard, I know, I had a parent in the same condition, and as my Mom lay there with a vacant look in her eyes, my Dad had to make the decision, as hard as it was, he loved her enough to know when it was time to let her go peacefully.

Just my worth
Mydnightnurse

In some cases, you would even see this where the patient's death was imminent, but they had not deteriorated until they verbalized, and the patient would verbalize that they wanted to go. But the family would grab on to the patient's ability to verbalize as a desperate hope, say "Oh, no, Mom, you've got to fight this". Other times, there would be disagreement in between family members. In most of these situations, fortunately, the person designated at the patient's attorney-in-fact was the one who wanted the loved one's advance directive/DNR honored to the letter.

Thankfully, most of the families I've dealt with did honor their loved ones' advance directives and did not demand heroic measures when death was imminent. My state has a standardized DNR form, issued by the Health Department, which is signed by the patient or their designated representative in the presence of a third-party witness. The patient or designee can check off several different forms of care (resuscitation, tube feedings/IV hydration, etc) that they can choose to withhold or not if death is imminent.

And with everyone on an emotional hairtrigger, there's also the occasional person who accuses the POA for wanting the loved one gone for personal gain.

[sharrie]

Originally Posted by BinkieRN

May I have a link to the article? I haven't read all the replies and I don't have an answer for you but I can tell you that when the grown child won't let the parent go in peace that it is about them not about the patient and usually it's guilt that keeps them fueled It's not as simple as not wanting their loved one to go.

If they truly loved them they would let them go in peace.

I think this is the article the OP is talking ablout