Dnr

Specialties Geriatric

Published

Once again I found myself doing CPR on a 90 year old woman whose family wanted mother kept alive "no matter what". The poor lady had advanced Alzheimer's, didn't respond to verbal, basically just sat in her chair and slept. The MD had talked to the family several times about her code status,but there was no changing their minds. So, the little lady arrests, and we had no choice but to try to bring her back. How undignified that this little lady had to have this done! She was pronounced in the ambulance on the way to the hospital. Family is upset that maybe not enough was done for mother..... please tell me what more can be done???? Have been in LTC for 10 years and every time this happens it upsets me beyond words. Thanks for letting me vent...:(

Been there, done that..:o It is very sad.. If only the families can see what a code does to their loved one. I currently have about 6 pts with full code in end stage alzheimers... Its sad especially when as their nurse I've spent more time taking care of Mom and Dad than thieir kids have visited them in the last few years...

Perhaps somebody should produce a video of just what happens when we are coding the weak, frail elderly. Complete with breaking rib sounds and all the rest.

Might be a good bit of reality for those in denial.

-Russell

Specializes in Neuro Critical Care.

After having a terminal pt on the floor whose family wanted "everything done" I understand your feelings. The wife actually admitted that she hoped the RN would just find him "gone". We educated her on what would happen if we found him gone and luckily got the DNR 2 hours before we needed it. I think families just don't understand. A video would be a great idea but may cause trauma to the people watching!;)

In hospitals, in my country, the doctors are the one's who decide the DNR matters. The problems only starts if the doctors decide to give up on the patients too soon. That seldom happens, but it happens...

In our facility, we have a very specific DNR policy. It is discussed with residents ans families on admission and is included in our admission packet. To make a long story short, we only do CPR on resident if we witness the arrest. Which means, if we see them go down, we do something. We do not do CPR unless it is SUDDEN and UNEXPECTED.

We work closely with our families as soon as we notice the impending demise of a resident and explain carefully that their loved one may not make it through this one and invite them to notify relatives and close friends that my want to see their loved one prior to their passing. Our physicians are great at talking to families and recommending "Comfort Measures Only".

We talk a lot about Quality of Life with the residents, families, and staff members. We have frank, open discussions with families and our residents and find by the time it is necessary, everone is willing to let go.

I have worked for this facility for 14 years and remember only 2 times we actually performed CPR on one of our residents.

We do everything we can to keep them comfortable, address choking episodes as we would with anyone, and have actually had not negative issues.

Specializes in MS Home Health.

I can remember the sound and crunch of cracking ribs just hearing you say that.

renerian:o

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