Hi. My father in law is in the end stages of Alzheimers and was given weeks to a few months left to live. He had a DNR in place but my mother in law withdrew it and now wants full life saving efforts performed on him. My question is, what options does my husband's family have? It puts myself, him and his brother in a terrible position as we are all EMT's and a nurse and we are required by law to call EMS and initiate life saving efforts on him. What do you recommend and is there anything that we can put in place to not have that happen? My mother in law will not change her mind. I hate the thought of him not being able to pass away peacefully.
That's the whole points of having these documents. POA doesn't give you the right to change what a person requests when they are of sound mind. You can only honor their wishes and act on their behalf in their best interests.
See an attorney.
I am sorry that your family is facing this. Not like the long goodbye isn't hard enough.
I think your best bet is to try to convince her to reconsider. Explain to her how painful resuscitation may be... broken ribs if cpr, electric shock to restart heart, possible intubation, etc. As EMTs you know the consequences. I assume he's under hospice care. If not, why not? They will provide him with a peaceful, painless, comfortable death. Would she want to harm him to extend a non viable life? I know you can't tell her this, but it's very selfish on her part.
Even as "healthy" as I am I can not imagine the pain that that would cause.
Is there hospice involved? I found them to be excellent listeners. Maybe they could help change her mind.
"Mom, what do you hope to accomplish by changing dad to full code?"
She needs to talk out what her thinking is on this to see if she understands that he is dying. I'm wondering if she's got some cognitive issues that have gone unnoticed.
The issue here is her heart.
This is a man she has been married to for many years. Her husband, her soulmate, her love. I'm sure one day she thinks yes to the DNR, so her love will not have to suffer any more. Another day, she thinks, no, I want him here with me, one more day.
I think this will just play out for the better. She may feel guilty signing the DNR, but when the time does come, the doctors etc, will do the right thing. So she won't have to live with the guilt about the DNR. She will at least know & feel that she did everything possible for her husband.
No invasive measures were on DNR, no morphine drips, no IV's. That was no fun. Thankfully no intubating the patient either.
They had strict instructions-DNR- not to call the doctor until you actually know he is gone. He went peacefully.
He was still in home when a family member inlaw was asking who wanted his computer... ??? He is still inside the house, and you are asking who wants the computer? seriously? And a few days later, someone was coming to pickup the washer n dryer because inlaw sold that, and his clothes were still in the wash. :(
While watching him decline over the course of 12 years my Head knew that a POLST was the right thing but my Heart broke a bit anyway.
But to want him to continue as he was was selfish on my part, I knew he would not want to continue to live the way he had been the past several years.
But in the end it does not matter..we will die. Cold hard fact.
But to die in pain due to life "saving" measures seems to compound the pain the rest of the family has to endure as well as the person who is lying there in bed now not just with a broken brain but broken ribs, sternum, and punctured lungs.
(and at this time with visiting restrictions due to COVID19 you will not be able to visit your loved one in the hospital so very good chance you will not be able to be with him when he dies)
DNR MEANS DO EVERYTHING EXCEPT SHOCKING, CHEST COMPRESSIONS AND INTUBATION. Make sure she understands that.
-->each new admission defaults as FULL CODE even with that yellow DNR directive on the chart. DNR has to be written as a new order with EACH ADMISSION. Also, a DNR CAN BE RESCINDED at any time and is never written in stone.
Mom died age 90 with her feeding tube, and it took care of all her needs so she died comfortably. However, it requires a considerable amount of care to keep it patent, clean and free of infection. I never had a problem with it. Ironically Alzheimer's did not kill her. She died of another health ailment so if she were a walkie talkie the same would have happened to her. Mamma had a lot of chronic diseases it surprised even the doctors she lasted that long...but trust me she was a LOT of hard work.
If your mom does not understand what DNR means, that represents poor nursing and medical care.
I would recommend that all of you have talks with her about your "code" experiences. She may not understand how traumatic a code can be. Remind her that a "full code" does not guarantee that he will survive longer.
Usually, big changes like this have to do with fear of loss. She may not be ready to let her husband go and is holding on with everything she has. Talk with her about her concerns about her husband's impending death. Ask her what she would want in her own "passing from life" experience. Ask her what would be her best way of "saying goodbye" to her husband and creating good memories while he is still alive.
As another poster wrote, if this is the hospital form, then it was only good for that single admission.
We need more information and you may need to consult with an attorney.
So if I were you I would place this all in God's Hands and watch Him take Dad home. I wish you all the best. Get a copy of Elizabeth Kuebler Ross's book. And do the Jesus thing, and forgive your Mom-in-law. ( with Alzheimer's and dementia, you really cannot stop the inevitable. When I last saw my Mom she had a surprised look on her face as she looked into Heaven).