In connection with my home hospice care, the issue of “do not resuscitate” has come up.

I am being told that unless I have the proper form, signed by me, the doctor, maybe some others, is in hand, when my wife calls to tell 911 that I woke up dead, the EMS crew dispatched will try to resuscitate me.

This seems so idiotic as to suggest it might actually happen.

What’s the real deal with these things? Can’t you die in peace without paperwork anymore?

Jim, my father also had to have one (in New Mexico)

May I just say that I hope to have a tiny bit of the grace, courage and humor you have when I inevitably face the reaper. More likely there will be little girl screaming and yelling with me but I respect the hell out of you.

Prayers, respect and hope for miracles for you and yours sir.

quote:

This seems so idiotic as to suggest it might actually happen.

What’s the real deal with these things? Can’t you die in peace without paperwork anymore?

I really wouldn't recommend ignoring the paperwork on this topic.

The fact that it seems absurd doesn't keep it from being a possibility.

quote:

Originally posted by JALLEN:
What’s the real deal with these things? Can’t you die in peace without paperwork anymore?

Just need to have that DNR paper in the Hospice binder. When you pass away, your wife does not call 911. This is emphasized from the start by the hospice folks. She will call the hospice folks, and the nurse will come and assess, then she/he will call the hospice doc on call to "announce", and will finish all necessary paperwork.

Jallen I’m sorry to say that I’m the state of Texas that is correct. As a paramedic I am required to provide life saving measures if certain parameters are not met.

A DNR negates that requirement. However the hospice provider should handle that paperwork for you. Make sure that a copy is readily available in case EMS does come.

ETA, read the above post that was typed as I typed mine. I feel it’s more clear.

Also be aware that if EMS is called and a family member asks that the DNR be negated then it will be.

One of my employees is a Paramedic for a good sized local agency. He says that 911 should not be called as the entire point of the medics arriving is to administer care. If you have a DNR with you, should they be called, they will indeed follow the stipulations within.

He suggest calling the Hospice people, letting them pronounce, and avoiding 911 and the ambulance all together.

You have touched my life, almost every day, for many years. I wish you peace and Love my Brother in Arms.

quote:

Originally posted by hbabler:
Jallen I’m sorry to say that I’m the state of Texas that is correct. As a paramedic I am required to provide life saving measures if certain parameters are not met.

A DNR negates that requirement. However the hospice provider should handle that paperwork for you. Make sure that a copy is readily available in case EMS does come.

ETA, read the above post that was typed as I typed mine. I feel it’s more clear.

Also be aware that if EMS is called and a family member asks that the DNR be negated then it will be.

How dead do you have to be?

I'm absolutely sure it varies by State. But in general where I am a responder if we get there and there is a DNR we can do somethings like provide pain meds or oxygen but if you have a DNR won't do others like CPR or defrib or active airway etc. So check with your Dr. to see what rescue activities (if any you are OK with) and document what is your game plan.

Jim:

First of all let me say that your wit and insight will be sorely missed on this forum.

I managed both of my parent's end of life decisions as they were well taken care of by their attending physicians and, subsequently, hospice.

Here in California I had to complete a DNR for my parents after having a conversation with them and their PCPs specifically discussing what resuscitation would involve and how that would likely affect their clinical outcome and remaining quality of life. Both of my parents did not want to be resuscitated.

If you have not done so already, I would recommend having a frank discussion with your wife and physician.

If you are all on the same page get the DNR in place while you can.

God bless you and your family Jim!

In LA County we use DNR/POLST forms, however we can honor family request to stop CPR if certain situations warrant it and we get approval from a base hospital doctor. Your hospice service should be able to help you out with the DNR form, its usually just signed off by a Doctor. My thought are with you Jallen.

I feel almost cruel for writing the above without wishing you the best possible outcome JALLEN. I've enjoyed every one of your posts here. But to add a small note, if you are dead it will not matter at all. Its only if you are near being dead that this issue comes up.

quote:

Originally posted by hbabler:
Jallen I’m sorry to say that I’m the state of Texas that is correct. As a paramedic I am required to provide life saving measures if certain parameters are not met.

A DNR negates that requirement. However the hospice provider should handle that paperwork for you. Make sure that a copy is readily available in case EMS does come.

ETA, read the above post that was typed as I typed mine. I feel it’s more clear.



Also be aware that if EMS is called and a family member asks that the DNR be negated then it will be.

Exactly what I was going to say.

You have to look at the first responders side. If they were told and could not see it in writing a DNR and they just went with what was told to them, then to find out that there was no DNR order look at the liability those first responders would be opening themselves up to. It has to be in writing, original and I believe notarized.

Other posts seem to have covered it well. For both my dad and mom, the DNR was posted prominently on the wall next to their bed. Sad times.

May God bless you.

I'm no longer certified, but it used to be that we had no choice but to work on a patient without a DNR or verbal refusal of service. For those at home, a DNR over the bead or available to be presented was standard. The nuances of a DNR vary by jurisdiction.

In some cases, the DNR is necessary to allow the responder or medical personnel to not perform lifesaving measures, and in others it makes the performance of life saving measures illegal. Successful law suits have been prosecuted against those who performed life saving measures and did save the patient, when the patient did not wish to be saved.

quote:

Originally posted by EZ_B:
Jim:

First of all let me say that your wit and insight will be sorely missed on this forum.

I managed both of my parent's end of life decisions as they were well taken care of by their attending physicians and, subsequently, hospice.

Here in California I had to complete a DNR for my parents after having a conversation with them and their PCPs specifically discussing what resuscitation would involve and how that would likely affect their clinical outcome and remaining quality of life. Both of my parents did not want to be resuscitated.

If you have not done so already, I would recommend having a frank discussion with your wife and physician.

If you are all on the same page get the DNR in place while you can.

God bless you and your family Jim!

Thanks for that. My wife and I have frank discussions all the time. The “social worker” who is driving this strikes me as perhaps manipulative and maybe not someone to take important advice from. Maybe it’s that 40 years of lawyering left me cynical, suspicious, and mistrustful about certain relationships, like barbers telling you that you need a haircut.

Is it good for me, or good for Medicare, or good for the hospice, or maybe just a requirement equally bad for us all?

It is anyones responsibility or duty that has had CPR training and/or medical training to take every step available to restore a persons life. I don't know what qualifies for how dead you have to be. I would make sure to fill out the DNR form, if those are your wishes, even if it's just to cover your wife for not having called 911 and also it prevents ANY doubt with grandkids/kids etc. that those were your wishes.


I just revived my 69 year old mates life. He had a massive heart attack and was dead. No pulse, no breathing, eyes and mouth wide open and no movement. I started administering CPR within 30-60 seconds of him keeling over (in front of the dockmaster standing on the dock who he was talking to, who went and got me inside of the yacht.) I was performing CPR for 8-10 minutes straight before a AED/defibullator arrived from another yacht, most yacht crew and all Captains are CPR certified, someone else from a neighboring boat asked if I wanted them to switch out with me and give me a break, I replied "No, I've got it for another minute or two" thinking it had only been a minute or two that I had been administering chest compressions not 8-10 minutes straight. The AED arrived, was connected, it xapped Fred once, the other guy started doing chest compressions when the AED said to, then a minute or two later, Fred started breathing, eyes started moving and he had a strange look as he was looking at a bunch of guys staring down at him and he started talking, just as paramedics arrived. Bottom line is, I would have kept doing Chest compressions for who knows how much longer, maybe 20 minutes until I couldn't anymore,in my class I was told you do compressions as long as you can until you can't physically do them anymore, BUT, I had no idea how long it had already been that I was doing compressions until several people on the dock told me hours later.....adrenaline was flowing...... and I was wired...….So it's possible someone could try to recessitate for a long time or long enough after you're already dead.

Edited to add: First Mate on a yacht ,employee, not mate as in relationship or anything like that

I’ve always made it a point to review your posts JALLEN and have never been disappointed by your intellectual Perspective. Thank you, God bless you sir

We went through this with my Dad, also in Texas.
We had to have a specific DNR for the assisted living facility he was in. The physicians directive he had done previously was not good enough. This was reinforced by an earlier trip with Dad to the ER, we mentioned that Dad had a DNR, the ER showed us the records coming from the assisted living, no such info was relayed. Later on when Dad’s time did come, he was in Hospice care, they handled everything.....

Again JALLEN, God Bless and praying for His mercy, comfort and grace for you.