Take their advice on the DNR/DNI paperwork seriously. Yes, if not present an EMS crew may try and resuscitate.

Keep in mind hospice does not mean end of medical care. Not to wish ill will, but if you have a fall or other event not related to your current illness, you may be transported by EMS to the hospital for care. The DNR/DNI paperwork needs to in place for EMS to communicate to the hospital they transport you to.

We had a living will and organ donor rolled into the package when we did our Will. Didn't cost much. Good thing to have to express your wishes and possibly minimize stress on those left behind. Our Lawyer had us sign them, witnessed and notarized.

Hospice care may make a difference. Ask Hospice if you haven't, they should know.

My Aunt had Hospice. Cancer. They were a real blessing for my Uncle. She did have the paperwork done.

When she passed My Uncle called Hospice, as he had been instructed. They advised him to do nothing until they got there. They came in and dressed her in a clean gown, gathered and took all her remaining meds and remade the bed with clean sheets. They called the funeral home. The funeral home came and got her and every thing was handled quietly and very nicely. No ambulance, no hospital trip. She had pre made her funeral arrangements.

Prayers for the best possible in your remaining days.

Some people get DNR tattooed on their chest. Not sure if it's legally valid.

My dad had a DNR.
I was with him on a visit where they set (re-set) his pace maker and I noticed during the procedure that the unit contained a auto-act defibulator.

That contradicted his DNR and I had to 'fight the system' to get it turned off.
I do not know if you have this implant, but it is a heads up on how technology may work around our intentions.

Best of wishes for you and those close to you.

Make sure your Doc is on board with your wishes. We had one Doc who ignored pt wishes and wouldn’t sign off on them. This was in a hospital setting, but he had final call.

I have multiple health issues and have filled out the same DNR forms which are at both local hospitals and my primary care physicians office. I have DNR on my Medic Alert bracelet and the doctors phone number. Not 100% sure the bracelet by itself will do the trick but the physician being aware should close the circle.

Here’s what we were told when our loved ones were in hospice:

1. Have a copy of the official DNR form on the fridge or somewhere else it can’t be missed (we had a bright yellow form).

2. 911 does not have to be called. Discuss this with your hospice nurse and primary physician.
3. Make sure your wife and any other caregivers know what is expected.

4. This may not apply to you, but any ICD should have its defibrillation mode turned off.

I hope hospice is as much a blessing for you and your family as it was for ours, for my mother, stepfather, and an older sister.

Stan

quote:

Originally posted by LS1 GTO:
Jim, my father also had to have one (in New Mexico)

When I was a EMT in New Mexico in the 1980's we were required to start BLS except in very few cases.

When I had cataract surgery recently at a large eye clinic, I had to sign a form acknowledging that they had informed me that the clinic ignored amy DNR forms.

I am an EMT here in Virginia.

I have to begin life saving measures UNLESS there are definitive signs of death. IE pooling of blood, rigor, etc. OR a DNR. I have to physically see the DNR.

We had a patient that we transported from a nursing home the week before for falling, we knew he had a DNR, saw it. The following week the DNR paperwork had been misplaced. He woke up dead, and we had to work him until the medic showed up and spoke with a DR on the phone. We were all majorly pissed, and that was one of the last calls I ran, so ridiculous.

Have a copy on your refrigerator. A copy at the hospital, a copy in your wife's purse...

I am so sorry you are in this phase, I have enjoyed your posts very much, and will miss you!

I will keep you and your family in my prayers.

My mom passed last year. The hospital required a copy of the health care proxy with the DNR order.

quote:

Originally posted by 12131:

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.

Around here, in addition to this, there is no rush for the spouse to call anyone. A spouse should take the time she needs with the person.

quote:

Originally posted by Oz_Shadow:

quote:

Originally posted by 12131:

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.

Around here, in addition to this, there is no rush for the spouse to call anyone. A spouse should take the time she needs with the person.

Yes, no rush here, either. The hospice folks tell us to take time with our mother.

Jallen,
I wanted to clarify a couple things, one I was at church and didn’t remember to add that I am sincerely sorry that you are going through this and you and your family are in my prayers.

In Texas there is no requirement that EMS be called initially, hospice can and should handle the immediate time period after a death. At some point PD may show up for paperwork and sometimes they call us to verify.

If EMS is called a valid DNR is a necessity, in Texas a DNR bracelet will also work.

If your hospice social worker makes you feel uncomfortable please ask for someone else. They should put you at ease.

Please make sure that your family understands your wishes and is on board with your decisions so that there are no issues when the time comes.

Please email me if you have any questions or need clarification, in addition to my line of work my father was a hospice social worker for a while so if I don’t know the answer we can figure it out.

JALLEN,
I am truly sorry to read your post. I have always enjoyed your contributions to this forum, even tho sometimes I have disageed.

I understand your wishes about DNR, and will consider it when my time comes.

I have no advice other than what has already been given by others. Make sure all the government requirements are taken care of.

God bless, peace to you and all those who love you.

For everyone: In addition to keeping a copy of the DNR in the binder, post it over the bed in large, high-contrast letters. Post it wherever your loved one spends a lot of time (near the living room chair, for example). Brief every in-home health care worker there is a DNR in place AND NOT TO CALL 911 BEFORE THE FAMILY. If they have a hard time with that, politely let them go, call their company and remind them of the DNR that was previously briefed to them before they were hired. It really screws with your Hospice care and Medicare payments to medical facilities if the DNR gets ignored because it was hiding in a binder or the home healthcare worker didn't agree with it. Been there, done that w/ Mrs. 'Hook's father.

Assisted Living locations, Nursing Homes and hospitals may have a requirement to fill out their own copy of the DNR if you check into their facility. Check before you agree to stay there, and ask about their DNR policies and whether they will honor the existing DNR. Failure to do so can get financially expensive and prolong the painful life of a loved one who is looking forward to escaping their situation.

I've been through the Hospice experience with my dad and both in-laws, and each experience was unique. Hospice workers are by-and-large earthbound angels who do a tremendous service to both patient and families.



JALLEN: Best wishes and prayers for you, sir. This Aggie has always enjoyed both your wisdom and terrible Aggie jokes! Fair winds and following seas, shipmate.

Jallen, has hospice told your family to call 911?

When my dad passed (this was in PA) we called hospice and the nurse handling his care responded. She called the official time and we called the funeral home who came and picked him up.

We sat with my dad until they funeral home people showed up and the entire process was calm and dignified.

My MIL passed away many years ago in Iowa. She was in an assisted living home, had a DNR, which had been prepared by a lawyer, properly legalized,
everyone in the assisted living home was aware, and she had given up on living. The early morning she passed away we received a phone call from the home nurse who we had been working with for several years, and was told that she was close to passing, but the doctor on call ( her regular doctor was out of state), was a young woman who did not believe in DNR's, and was getting EMR notified etc.
The nurse in charge asked me to drive slow on the way, so that she had time to get the doctor squared away (her terminology) without agitating my wife at a difficult time. By the time we arrived she had passed, a supervisor doctor from UIHC ( they were contracted by the home) had arrived, pronounced my MIL, and was in a private room with the young doctor having a very heated discussion. I saw through window!
The people of hospice care, facilities where elderly or others in need are can be very helpful, knowledgeable, and just knowing about these things.
It was amazing to me to find that doctors unfamiliar to a situation can attempt to impose their personal feelings into a situation that is already resolved to everyone's desires.
Short version the hospice people know!

I have not commented previously on your announcement, but wish you the best. I have enjoyed your insight and references in your posts. It has been enjoyable knowing you if only through your thoughts and actions on this forum.

My mom was moved from a hospital to nursing care when she was placed on hospice. The staff at the nursing care took all their instruction from the hospice folks. We were provided with direct contact to the hospice nurse in charge of my mother’s case. When she passed, the nursing care folks, contacted hospice to do everything. I believe 12131 is correct. Your wife should contact hospice not 911.

Jallen...this may have been addressed prior to my post, but as a former Texas Paramedic my experience was as follows:

If there is dependent lividity (obvious blood pooling from being deceased awhile) *or* injuries incompatible with life then I had standing orders that allowed me to pronounce the patient “deceased”.

If that is not present and there is any question about a DNR (paperwork not present, etc.) then I was obligated to start resuscitation measures.

Sorry if that’s ghoulish, I hope that helps a little.