DNR (Do not resusitate) abuse

applerose
applerose Member Posts: 3,621
edited 15. Sep 2015, 05:53 in Community Chit-chat archive
I'm sorry if this shocks anyone but I feel everyone should be aware of it. It shocked me to the core. It is a long post, the beginning setting the scene, so to speak, then what happened.

Some of you will know that my dad has been in hospital for 3 weeks. He is now happy to be back in the care home.

He went in to hospital with a water infection on the Thursday. In the early hours of the Saturday morning, my sister, who has Power of Attorney, received a call to say he had been moved to intensive care. There was nothing to be worried about. They couldn't stabilise his blood pressure and intensive care could better deal with it. On the Sunday morning, my 2 sisters and I met up and visited dad together. He seemed very tired and unwell but not too seriously. They had got him stable. He spent about 10 days there then was sent to a normal ward for a few more tests then, as I said, he was discharged yesterday.

As my sister was gathering dad's belongings, the matron told her dad's medicine was on the table. She then walked up to my sister and looking her straight in the eye, pushed an envelope at her saying it was dad's DNR and to hand it in to the care home. My sister was too shocked to say anything as she didn't know anything about it. None of us did. She felt the matron wanted to make sure we did know about it. My sister then asked my dad if that was what he wanted. He shrugged and said he didn't know what it was.

Instead of handing it in, my sister took it home to read. She then asked me and my other sister to meet up. That's when she told me what had happened. According to the date and time on the DNR, it was signed by a junior doctor 1 and a half hours after dad was taken to intensive care. No-one phoned to let my sister know about it. No-one mentioned it at all until the matron gave it to my sister.

After doing some research, we have found that whoever has POA, should be asked about DNRs. In our case, because dad has Alzheimers so wouldn't know what he was signing. Also because he was in no state to be making decisions on his own. If the POA isn't available, another member of the family should be contacted. The paper should also be signed by 2 doctors, not 1 junior doctor. We have found several cases where DNAs have been found in patients' notes where family members knew nothing about them. In some cases, the patient has died. In one case, a lady recovered then found it. She didn't know anything about it. Another case, an 80 year old woman went for a hospital appointment, was asked to hold her notes and found one. She wasn't even admitted. Apparently, AGE UK have said that they feel hospitals are using this as euthanasia for the elderly.

Disability Now suggested to one lady that she tell as many people as possible what had happened and to make sure it was in her notes that she DID want to be resuscitated.

We haven't decided exactly what we are going to do about it yet but we will be doing something.
Christine

Comments

  • mig
    mig Member Posts: 7,150
    edited 30. Nov -1, 00:00
    Thats really frightening. Mig
  • Sharon2960
    Sharon2960 Member Posts: 329
    edited 30. Nov -1, 00:00
    How shocking! Just too scary for words.
  • barbara12
    barbara12 Member Posts: 21,107
    edited 30. Nov -1, 00:00
    Christine, this is shocking..and so very scary..that it can be taken out of our hands if we are resusitated, its awful for you and your dad..I just hope you all have your say over this..on one hands they wont pass a bill for terminal ill people to take there lives, but the NHS can.. :shock:
    Love
    Barbara
  • Boomer13
    Boomer13 Member Posts: 1,931
    edited 30. Nov -1, 00:00
    I live in a different country but your story is pretty scary. My mum is deceased recently but I could see this happening to someone like her. She was so agreeable even with her Alzheimer's and unless you sat down and really talked with her you might not have known she had it. She would have signed what was put in front of her to be agreeable. She would not have been able to comprehend the document and then remember what she had signed.
  • frogmorton
    frogmorton Member Posts: 26,763
    edited 30. Nov -1, 00:00
    Oh Christine!!!!!!!!!!

    I am horrified about this.

    Disgusting. Legal advice I think ASAP.

    Please do let us know what happens won't you?

    Love and ((()))

    Toni xxx
    Love

    Toni xxx
  • dachshund
    dachshund Member Posts: 8,037
    edited 30. Nov -1, 00:00
    Christine
    you are doing the right thing looking in to it he's your dad you have the right.
    joan xx
    take care
    joan xx
  • applerose
    applerose Member Posts: 3,621
    edited 30. Nov -1, 00:00
    Yes Barbara, it's all wrong that people who are seriously ill with no chance of recovery are to be kept alive but people who are elderly and might recover could be left.

    Boomer, my dad is like that. He doesn't want to know what's wrong with him or what treatment he is to receive. He feels the doctors know best so let them do whatever they want. He would have signed the form if they'd asked but his signature wasn't on it. Only one junior doctor's. He told my sister he didn't know what it was but the doctors know best.

    Toni, my sister's partner is a lawyer (or some sort of legal eagle) so she has been talking to him.
    Christine
  • villier
    villier Member Posts: 4,426
    edited 30. Nov -1, 00:00
    Shocking Christine glad to hear you will be getting legal advice. xx
    Smile a while and while you smile
    smile another smile and soon there
    will be miles and miles of smiles
    just because you smiled I wish your
    day is full of Smiles
  • applerose
    applerose Member Posts: 3,621
    edited 30. Nov -1, 00:00
    My sister has asked the hospital to let her have their policies and guidelines on DNR. Once we have that, we can decide on the next step. A few people on the Alzheimers forums have said the care home should have discussed it when he first moved in there.
    Christine
  • barbara12
    barbara12 Member Posts: 21,107
    edited 30. Nov -1, 00:00
    Christine I still cant believe this..I have just been talking about it with my friend, her sister had a stroke and is in a care home so she is asking about there policy..for goodness sake its people lives there shouldn't be polices..only care,,unless the person says different..and they know what they are agreeing to....so glad you can get legal advice....scary stuff....xx
    Love
    Barbara
  • Cate
    Cate Member Posts: 280
    edited 30. Nov -1, 00:00
    I am horrified at this Christine. Some young man/woman barely out of university, holding your dad's life in their hands.

    I agree that you need legal advice, but I would also contact the national press. If this sort of thing is happening, it needs to be made public.

    I feel really hurt that someone - anyone - could have their life treated so casually.....Cate.x
  • kathleenT
    kathleenT Member Posts: 3,388
    edited 30. Nov -1, 00:00
    I agree, so scary. I've heard of some elderly patients having a DNR tattoo somewhere prominent. Perhaps a tattoo saying Please DO resuscitate should be used, just to make sure we are safe if ever in this position.

    "Women and cats will do as they please, and men and dogs should relax and get used to the idea." Robert A Heinlein

  • stickywicket
    stickywicket Member Posts: 26,278
    edited 30. Nov -1, 00:00
    I, too, would have been horrified if this had happened to a family member and it must have been deeply shocking for all of you.

    However, a little research shows that it isn't new and it isn't 'unreported'. The Daily Telegraph was reporting it 4 years ago (http://tinyurl.com/ng8wdvm ) I wonder why there was no outcry then?

    To be fair, there has been debate in the medical profession about how ethical it is to perform CPR on elderly patients. It's not like Casualty or ER. 80% of young, fit patients don't recover let alone the frail elderly or those, like us, on multiple meds for multiple problems. Patients in their 70s have only a 7% chance of achieving hospital discharge and, in their 80s, 3%. Here's an article on it from the New York Times http://tinyurl.com/qffgwy8

    CPR was introduced to enable wounded, but otherwise very healthy, soldiers in the Korean war to be revived long enough to get them to a field hospital. It's quite a brutal procedure (again forget those gentle pushes in TV dramas) which often results in broken ribs and punctured lungs.

    I'm not arguing either for it or against it. I do believe, as Christine says, the choice should lie with the patient or their relatives. But I can see why it might not. If Grandad had a fall neither he nor his family might appreciate being asked. “If it all goes pear shaped would you wish to be resuscitated?” And, I guess, that would be the reality because, in old people, or those with multiple medical conditions, things can suddenly take a swift turn for the worse.

    We don't like talking about death but we need a proper debate about it with the true facts and figures. Surely, it has to be the patient's / family's own choice but an informed choice not one based on the fiction of hospital soaps. 'Successful' CPR might well mean death by punctured lung several painful days later or heart beat restored but other faculties lost in the process. The right to choose pre-supposes the responsibility not to complain about 'frightening' questions and too much information at either a horribly traumatic or apparently irrelevant time. We need to talk about how and when we deal with that.
    "The deeper sorrow carves into your being the more joy you can contain." Kahlil Gibran
  • applerose
    applerose Member Posts: 3,621
    edited 30. Nov -1, 00:00
    Sticky, the first link is the one we first found. Some interesting points in the second link. I too can't understand why nothing was done about it back then. Surely we should all have been made aware. At the very least, the family should be told as the patient goes in to hospital. Or maybe they don't say anything so they don't distress the patient and their families. A couple of people in the Alzhiemers forum said the family should be told of the possibility of this happening by the care home. My sister has sent an email about what happened to an Elderly Abuse charity to see what they say.
    Christine
  • frogmorton
    frogmorton Member Posts: 26,763
    edited 30. Nov -1, 00:00
    Sounds like a plan Christine and the more people are aware of it the better.

    We only take note of things like this when it's relevant to ourselves so I believe we should be consulted as next of kin whenever a patient goes into hospital/residential

    Best of luck

    Toni xxx
    Love

    Toni xxx
  • stickywicket
    stickywicket Member Posts: 26,278
    edited 30. Nov -1, 00:00
    I'd be interested in hearing the reply, please, Christine.
    "The deeper sorrow carves into your being the more joy you can contain." Kahlil Gibran
  • applerose
    applerose Member Posts: 3,621
    edited 30. Nov -1, 00:00
    The reply from the hospital said their policies are developed from national guidelines and they work with the patient and their family. If we have any concerns to contact them.

    The Charity for Elderly Abuse has said they have concerns for what my sister has told them and the email has been sent to their chief executive for further attention. Hopefully we'll get a reply from him soon.
    Christine
  • stickywicket
    stickywicket Member Posts: 26,278
    edited 30. Nov -1, 00:00
    I think, in a sense, the hospital did 'work with the patient and their family' given that the matron was clearly wanting your sister to understand what the envelope contained. Where they fell short was in issuing the DNR notice while telling the family that there was no cause for alarm when your father was moved.

    After all I've read (Thanks for raising the subject) I certainly wouldn't want CPR for myself or any elderly relative. I was once in re-suss when a bad cold resulted in my throat virtually closing up completely and I think I was down to my last few breaths. They gave me a cocktail of antibiotics, anti-inflammatories, anti-histamines and pain relief explaining they'd no idea if it'd work or not. It worked instantly. I wouldn't wish to have missed out on that :lol: but my understanding (I could be wrong) is that that sort of treatment will only work if the heart is still functioning so would still be available to anyone with a DNR notice as long as the heart was OK.

    Here are two more sites that might be of interest.

    http://www.bbc.co.uk/ethics/euthanasia/overview/dnr.shtml
    Although DNRs can be regarded as a form of passive euthenasia, they are not controversial unless they are abused, since they are intended to prevent patients suffering pointlessly from the bad effects that resuscitation can cause: broken ribs, other fractures, ruptured spleen, brain damage.


    http://www.facingbereavement.co.uk/do-not-resuscitate-orders.html
    "The deeper sorrow carves into your being the more joy you can contain." Kahlil Gibran