Full code status in LTC - page 2

What do you all think of full code status in LTC. I am not talking about alert short term residents in for rehab, but like a 97 year old man with end stage alzheimers who absolutly has no quality of... Read More

  1. by   ChainedChaosRN
    Aimee...I'm sorry I did not see your post prior asking for a link. I have not figured out how to do links yet, but here are 2 sites interpreting Michigan law. I have that in hardcopy at work I received from a surveyor.

    The glitch in the law is that DNR, tube feeding refusal etc must be in writing or "stated" to at least two individuals before becoming incompetent...or they can not be withheld. If this is not in writing with specific instructions a Advocate or DPOA for health decisions can only make decisions about daily cares, treatments, etc....not the biggies.

    Here are two sites with interpretations:
    Http://users.netone.com.net/~lawone/advance.html

    Http://www.irmc.org/patient_care/you.../advance2.html

    Also if you would go to google and type in Michigan and Advance Directives there is alot of things on there. University of Michigan has a great site on this.

    Hope this helps...Dawn
  2. by   ChainedChaosRN
    Dang..they showed up as links....guess that's how you do it.
  3. by   Rnltc
    Hi All,

    I hear each and everyone of your cries.
    If you would like some help on understanding a little bit of understand type in Nancy Cruzan in a search screen and you will get several hits and they all cover the right to die.
    Nancy was a young girl from Webb City Missiouri where I grew up and lived till just three years ago and moved to the west.
    Nancy and I went to school and worked together and did some running around. We both had several common good friends. It was a large group of us girls and we all hung out together, but some were closer to each other.
    We all graduated high school in 1975. Nancy one night in Jan on her way home lost control of her car and went off a deep embakment and was not found for several hours (until after the sun came up) Jan in the midwest is extremly cold.
    When she was found the only thing she had was a beating heart. and working lungs. Her brain was dead.
    Her father mother and only sibling fought the United State and the State of Mo. for many many years. They even fought with the long term care facility she was out. They finally won and the supreme court finally said Nancy had the right to die. Her feeding tube was removed and Dec 26 1990 her heart stopped beating.
    So please go to these different web cites and see the living hell that her family went through.
    Nancy in the end was able to make a differnce in many states as after all this many states in the US took a look at their laws.
    Yes there are some still in the dark ages out there. The state I moved too is one of them Washington.
    I have worked in long term care since 1984. Started out in housekeeping and I have been a Director of Nursing or a consultant since 1989. As a consultant I was all over the United States and yes there are states that are still in the dark ages, but the only thing that will help to bring them into these times is our letters to your local legislation.
    Start writting them letters.


    We all will keep shedding the tears for these dear little residents who we care for and become their families and they become a part of our extended families. And yes WE are the ones there watching them suffer when there is no need. But just remember with each touch and smile and words you give to them YOU make the difference in there last days....NOT the family who is off spending their money...........they are not the one that is there hearing the ribs crack. But we are the last ones to touch the resident when that heart is stopping. AND it is OUR touch that they take to heaven.........
  4. by   Rnltc
    We all will keep shedding the tears for these dear little residents who we care for and become their families and they become a part of our extended families. And yes WE are the ones there watching them suffer when there is no need. But just remember with each touch and smile and words you give to them YOU make the difference in there last days....NOT the family who is off spending their money...........they are not the one that is there hearing the ribs crack. But we are the last ones to touch the resident when that heart is stopping. AND it is OUR touch that they take to heaven.........
  5. by   tigger2sassy
    no one could say it any better-- god bless you for saying something that needed to be said-- i lost my father a year ago today-- it took a lot to talk my family into letting him go-- i knew what he wanted all along and the family could not accept it-- at last, my father is at peace
  6. by   sassynurse78
    All of this is so sad! The worst experience I have ever had was doing cpr on a 92 year old woman, People always told me that the ribs crack, but I could not ever imagine how horrible it felt being the one cracking the ribs. It was the worse feeling in the world. I always try my best to explain everything to the families who are trying to make this decision. I have found that it is always not fully explained to them and they do not really understand what a full code is.
  7. by   gwenith
    Step back in time ----- A cardiac arrest was defined as a "sudden and unexpected cessation of heart beat" (American Heart Association 1986)

    Social issues apart - one of the reasons why we have this controversy is that there no longer is a definition that distinguishes death from cardiac arrest. If we worked on this in legistaltion and medical/family perception then we may get some "wins".

    As for the social issues where family are collecting the disability allowance for another and spending it - i would write to my local media outlet and local member of parliment. Here if you are in an LTC most of your pension goes toward maintenance of care in that facility. I would speak out to get this "rip off" stopped as it would also neatly stop the "continue" orders on those who have a right to death with dignity.

    OH! and to put your minds at rest - most of the time when you hear a "crack" during CPR it is actually the costal cartilidge not ribs. Ribs sound LOTS louder.

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