The doctor says your senior loved one is in the midst of a health crisis and asks if decisions have been made regarding life extending care. Are you the one who has to decide? What do you do now?
Many times our loved ones do not create a document that would help direct us regarding what they would want when tragedy strikes or their health quickly declines.
Even worse, we avoid discussing the topic together among family members so we usually don’t know what they would want to have done or not done.
The unfortunate reality is that we all have been or will at some point be in the position in which you may now find yourself.
As a caregiver, family member and healthcare professional, the dilemma over how to decide to initiate a DNR on a precious loved one is something I have had to face all too often, mostly through the eyes of those with whom I have discussed the matter as a healthcare worker.
I know this may well be the most difficult decision anyone will ask a person to make.
Do I let my mother, father, grandparent or spouse die? How can they ask me that question? What happens if I can’t decide?
What is DNR?
In order to understand fully what DNR means when a healthcare provider asks you if you want that for your loved one, let’s review the definition. DNR stands for Do Not Resuscitate. It means that if the heart should stop beating and breathing stops that CPR (cardio pulmonary resuscitation involving chest compressions, assisted breathing or cardioversion) will not be provided. It is not the same thing as a living will. It does not mean that treatments such as IV fluids, antibiotics, therapy or nutrition will be stopped or withheld to your loved one.
How Do You Decide?
Whatever ultimate decision you make, right now you probably feel like it is the wrong one. But that is not the case. Without an advance directive to guide you, you may find it helpful ask yourself several questions.
- What would my loved one want? Did they want everything done regardless of the outcome?
- Would my loved one want to live in this condition? Would they feel they were a burden to you or other caregivers if they were not able to return to their previous status?
- Did you ever discuss what they might want or think when others were in a similar situation that you can recall? What are their moral or religious beliefs?
- Will the provision of chest compressions to restart a heart that has stopped cause more pain? What is the likelihood that ribs will be fractured?
- Would your love one want to end up on a mechanical ventilator after CPR was performed in case this is the result?
- Would your loved one want a natural death free of pain when it was their time to die? Would they just want to be made comfortable without any heroic measures? Where would they choose to die?
- What is in the interest of my loved one? Taking my feelings out of it, what is best for her/him?
If you remember the life your loved one lived and can answer several of these questions after thinking it through, hopefully your decision will be easier and one that gives both you and your loved one comfort.
Sharing Can Help
If you have siblings, a spouse, a close friend, other family members or a spiritual leader that knows your loved one, they can help you come to a decision. They may have spoken to your loved one about this issue and can reassure you that your decision is what they would have wanted. Sharing the discussion, even if the decision remains yours, can give comfort that the decision is right.
By following your heart and putting yourself in their shoes instead of your own, you will find solace in your decision.
This is a very personal situation, one we realize you may consider to be among your most private. However, if you have a story you feel may help others and feel comfortable in sharing it, please know it is appreciated.