I think some of you underestimate the bias against old people in hospitals. It is one thing to empower your family to refuse ventilation, etc. I’ve had two people in my family die of dehydration because IV fluids were considered too much intervention. One had dementia but still enjoyed many parts of his life and had occasional lucid moments. The other was simply weak and recovering from COVID (caught at the same hospital during an outpatient visit.)

Anonymous wrote:Just because you have one, doesn't mean people will follow it. My dad had a DNR and my sibling did not follow it.

We followed my MIL DNR.

Was the DNR with the patient?

It's not just about getting old or having a terminal illness. When my husband and I did our wills we did healthcare POAs with stipulations as to interventions--basically it has to do with when medical care is futile (I should reread mine sometime though!). It was also specific about different interventions.

People get in car accidents, pulled out of lakes and oceans, sometimes have unforeseen complications from common illnesses (I always think of Jim Henson, the muppets guy, he's hanging out at home with a nasty case of strep and then suddenly he's very sick and goes to the ER and then he's dead).

On the one hand you have the Terry Schiavos of the world, on the other hand they continue to learn unexpected things about the nature of consciousness.

Just because you have one, doesn't mean people will follow it. My dad had a DNR and my sibling did not follow it.

We followed my MIL DNR.

I appreciate the reflections you have shared here. It helps me understand / process the whole thing better.

As we've learned more, there were significant quality of life issues leading up to death that came on suddenly. I think I had justified those issues as - oh well they need to fix X and Y then those wouldn't be issues. What I didn't calculate was how bad surviving this episode would be.

He got to die before being dragged through it all. Which is a blessing in a country where we don't have a right to die. I think it was just so shocking. He seemed fine despite dealing with a lot of issues. We didn't really get to say goodbye because we didn't know it was the end.

Not using this as a political point, but choosing when to die allows you to say goodbye.

My mother is 84 and has a DNR. Some lung issues, needs a cane to walk, incontinence which can be controlled with medication but she doesn't like the side effects. Generally just all the small indignities of aging and misses my dad, who died five years ago ( she lives with family ask that helps). Her medical directive is no ventilators and a DNR. Given her lung issues I expect a likely end is a cold that becomes pneumonia. She was in the hospital for pneumonia a couple years ago and made it through without the ventilator.

As a nurse, for all the reasons you listed but add in Parkinsons (at a more advanced state) ALS, and similar degenerative diseases. I also plan to have a DNR at a certain age (will all depend on how my body and mind feel). Resus can be absolutely brutal and I would not want to put my body through it at a certain point.

I have VERY clear advanced directives. While I'm not a DNR, I have it detailed when and why I would want to be removed from any life sustaining interventions and allowed to die. I tell everyone to make sure they trust who they have placed as their DPOA to make those decisions. I trust DH with everything that I have, but I did not want to put that responsibility on him. A close friend who is an ICU nurse is mine as I know she will understand everything going on and be able to make the determination about what to do.

I was my dad's and chose to let him go vs having a procedure I knew he would not want. At the time, because it was so sudden, my mom would never have been able to make that decision.

Resuscitation is brutal. Especially for an elderly person. They break ribs. And if they have not been breathing for a while, brain damage. I have DNR but need to look to update it.

Anonymous wrote:I'm curious, when would you include a DNR in your wishes?

For me, before dementia gets to the point that I can no longer make decisions for myself. If I have incurable cancer. If my quality of life isn't good.

I recently lost someone to a DNR and, while I completely understood, I wonder if he knew that it would happen when it did if he would have regretted the DNR. They didn't attempt to revive him, per his wishes. We thought we had at least 1-2 years left. He was very lucid and totally there mentally.

He may have been very lucid before he went into cardiac arrest, but he almost certainly would not have been after resuscitation. People who are terminally ill don't just go back to being lucid after resuscitation.

I have one in place now.

I had a granddad die with dementia and I wouldn't hesitate with that diagnosis to sign a DNR. I saw what my granddad's dementia did to my Dad (granddad became angry and abusive to Dad particularly because Dad had to take steps like restricting his driving) and I'd never want that for my kids. I've long been concerned that my Dad would kill himself if he received such a diagnosis.

I also watched my mom's mom go through a very painful cancer, the surgery and chemo left her in terrible pain and my mom later revealed my grandmother was actually asking relatives with a medical background to help her die. For some people, the decline can be quite terrible.

So for some situations I wouldn't just be signing a DNR, I might move to a state with medical aid in dying.

BEFORE dementia takes hold for sure. And for that you have to be lucid much of the time otherwise then you're.... not. And it's too late.

I really admire a doctor I know who got the diagnosis, did the maths, took care of all his business and went to Switzerland.

Did he have 1-2 more lucid years left? Most definitely. But he didn't want to risk it or be remembered like that.

Right now, I'm remembering a loved one who was selfish, ungrateful, accusing due to dementia. Not how I want to remember.

I'm curious, when would you include a DNR in your wishes?

For me, before dementia gets to the point that I can no longer make decisions for myself. If I have incurable cancer. If my quality of life isn't good.

I recently lost someone to a DNR and, while I completely understood, I wonder if he knew that it would happen when it did if he would have regretted the DNR. They didn't attempt to revive him, per his wishes. We thought we had at least 1-2 years left. He was very lucid and totally there mentally.