Re: DNR orders Originally Posted by nitenite 
What about a family in denial who refuses a DNR? I had a 104 year old end stage Alzheimer's pt who was sick with it for 30 years and the family wanted the works on him. He had no quality of life and they forced him to stay alive in that wasted body because they believed he'd snap out of it and get well.
I felt his sternum and ribs disintegrate when we coded him for the last time.
He died on Christmas day. This recent Christmas. The family showed up with presents because we called with the news after they'd already left the house. So they were screaming in the halls, devastated.
It was charted that they'd had DNR explained to them, and they wanted us to go after this guy with all guns blazing if his heart stopped.
Am I horrible if I say I feel no sympathy for this family, but my heart goes right out to that poor old man who was kept alive and miserable for so long? Who wants to spend the end of their lives like that?
It never ceases to amaze me when something like this happens. I work LTAC ICU,, where I see my more than my share of these dramatic outbursts. I've seen grown men and women throw themselves on the floor in an epileptic FIT when their 92 yr old grandparent died after being a nsg home pt for more than 10 years, contracted, drooling and out of it for YEARS... It is something that I can honestly say that the whole family has psychotic issues. Dellusions, falling just short of an active psychosis. I've studied these people for years and can't get my mind wrapped around where these false hopes come from. I certainly have made a point not to come close to giving any.
I know that typically, a family will accept that their loved one is aging and is ready to die when they're past 75-80 yrs old. BUT, that occassional family who is like what you described here... their loved one past 90, 95 and even 100..... Those poor old grandma's and grandpa's who have lived a wonderful life, it only takes one or two compressions to break their sternum and ribs. I think that (absent a REAL psychotic diagnosis) the family would understand better if they REALLY knew what happened to the patient's body when we started giving Levophed or did compressions.. or if they really knew how it felt to be intubated. The family only sees the patient once they've been cleaned up, looking their best possible. They don't stay in there to see the look on the pt's face when they're intubated, contracted, with bed sores, as you rip off the tape from their butt and wash their stage 4 sacral decubs and insist on repositioning them Q2 hours, while you're telling them you're sorry but you must do this, so they will "get better".. yeah right, okay... The family is full of delusions and false hopes.
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