CPR on very old sick people.

Agree absolutely with MawBroon, none of us wants to see a loved one die but neither do we want them to suffer more than is necessary.

I agree Iam64 we should be allowed to make our own decisions and then carry a card to that effect, the same as being an organ doner. I volunteer for our local Hospisce and have been told that if you call an ambulance they are legally obliged to resuscitate unless there is written proof otherwise.

I work with elderly quite a bit, and it all varies. Some are ready to die, some are patently not. I think we all need to make our own plans about how we want to die! There are birth plans - why not death plans? I would not want to long, slow, debilitating decline, so if I were suddenly to die with a heart attack I would much rather be left to die than brought back... a long slow decline, loss of mobility, loss of choices in what you do with your life, loss of being able to care for myself are things I do NOT want...

My mum was 98 when she died in hospital after breaking her pelvis in two places. She had a DNR in place but they did it once anyway. I really don't know why they tried?

I wonder how many of you have been in the position of having to decide to turn off Life Support? I have and it is traumatic but my husband would have been a cabbage. I was asked by the consultant what I thought was my husband's situation,I told him that I thought they had a dead man breathing, to which he replied "You've hit the nail on the head what would you like us to do, we can keep him like this for as long as you wish" Myself and my three sons who were present said in unison "Let him go" It was the correct decision.

Last March, after an accident and operation from which he seemed to be recovering well, my husband caught an infection. One of my daughters and I went to visit, as family did every day, to be met by the surgeon who explained there was a problem with his heartbeat. He asked if my husband and I had ever discussed resuscitation. It was a shock as he seemed to be doing well. I said not in relation to ourselves but we both believed in quality of life. ( He was very disabled before his accident and they were hoping to send him for rehabilitation) He rallied and several family members including his twin sister visited him next day when he was quite cheerful and eating a meal. We had a call next morning to say he had passed away quite peacefully in his sleep. Though very sad we all felt it was a good outcome.

My husband had a DNR in place,it was the right thing to do

My relative is a paramedic and she really doesn't want to do CPR on a very poorly, often frail, elderly person, but she had to if there is not a DNR. Often, it is to resuscitate them only for to it happen again in a day or two or for them to die anyway. Her own grandma was in hospital with no propect of getting better when the doctor asked if the family wanted a DNR notice. She explained what would happen if they didn't and they all agreed to put the notice in place. On the other hand, she will fight tooth and nail for good care for, say, a 90 year old who had a good quality of life. DH & I will definitely have a DNR if we become that ill.

I have been told by nurses that they can become very traumatised when doing CPR on elderly patients and sad to say the state of the body when it is unsuccessful is terrible.

Thanks for clarifying that Chewbacca. I didn't know. I have to say it's one thing deciding what you want for the future whilst fit and healthy, but quite another when you are ill and fighting for your life, feelings can change! Who knows how you will feel, but the sensible thing I suppose is to decide in advance so that relatives are not left with the dilemma.

I hopefully have about 20 years left, and am relatively fit and healthy, but I wouldn't want CPR now, and have told all my family that. If I suddenly became sick enough for my heart to stop, the chances of CPR, even after my ribs had healed, returning me to full health are minimal. Brain damage, paralysis, locked in sydrome, it really does not bear thinking about. As the one thing I dread is a long drawn out painful death, I would have been delighted to escape this!

Anyone can opt not to be resuscitated - but people have a right to know and be reassured they will not be bumped off at a time of someone else's choosing

So then it comes down to playing god.
It is up to each and everyone of us to make a living will while we still have our faculties as I would not wish this responsibility/decision placed on my children let alone a well meaning ? well she is old so why let her suffer.

I don't see refusing to offer CPR as playing God.

If we consider that CPR and resuscitative care are treatments, they do not need to be offered to patients for whom they are unlikely to be effective.

Remember that when it comes to resuscitation, we actually save less than 30% of the people that we code. There is no guarantee that CPR would even be effective in many people.

In most older adults, the reality is that their hearts stopping is usually the last in a sequence of events that we term as "active dying". CPR in those cases would be grossly inappropriate.

Current medical ethics state that CPR does not have to be offered to patients for whom it is not likely to be effective. If a patient is in poor physical health and is not likely to survive a resuscitation attempt, it would not be prudent to offer CPR even if the patient demands it. Instead, we would present an alternative plan of care.

It's not about bumping people off. Rather, it's about not providing treatment that's inappropriate.

I agree with you Jess. When my poor old MIL went into a home she said, "If anything happens I don't want them to do anything" meaning that she didn't want CPR though she didn't know the exact words to use.
She was confused and angry for much of the time and didn't want to live anymore - a sad state to be in. To add painful, broken ribs to her list of ailments would have been downright cruel.

NICE have guidelines on this subject
No two cases are the same.

I don't think anyone has yet mentioned this?
compassionindying.org.uk/making-decisions-and-planning-your-care/scotland/advance-directives/make-advance-directive/
Worth doing - I keep meaning to, and today's discussion has spurred me on. (DH and I each have LPAs but the Advanced Directive is important too, we feel.)

A DNR card would be a good solution,and one to be respected.There have been many types of CPR being performed on DNA patients,because of the resucitator not being aware of the DNR instructions, or ignoring them. Age shouldnt be a deterent, but the health of the person,if one is aware of the health situation.If CPR is performed on someone on the street, totally unknown, then it is the duty to perform CPR, its better to try to save a life than to wonder if one should do CPR, if there are broken ribs,the person has at least had the chance of survival. I am a CPR instructor.

It is true that CPR is very brutal and it surely should not be used on very elderly, frail people.

I can understand the comments on when is someone old and should not be resuscitated. The OP though did highlight the dramatic procedure of CPR. It is brutal and can cause damage. The older person may survive that but recovery from the effects may be very lengthy and painful. We allneed to ensure we communicate what we want to happen in such tragic circumstances.

Our fantastic, caring and very empathetic GP sat opposite my Mum holding her hands and said he thought she needed to consider a DNR note, he explained that if she was resuscitated, she would be in a worse physical and maybe mental condition than she was at present. She agreed, it was the correct decision, heartbreaking, but correct.

Five years ago, I was going to an exhibition with my husband, but when we walked through the door of the house where it was being held, he had a violent and horrible heart attack, dropping near-dead at my feet. CPR, when it came, was brutal - huge scissors to cut open a jacket he loved, and his jumper underneath, and then the onslaught of pumping, which only ended at the hospital where they told me he'd died.

Sorry, I clicked erroneously. I meant to add that I was in total shock at the time, but I've long since learnt that resuscitation would not have meant bringing him back as the sweet, erudite guy he was, but as something neither of us could have coped with, and I have to be grateful that that didn't happen.
I am a total supporter of assisted dying/euthanasia, and have set up a Living Will for myself which I hope will be honoured when the time comes.

Oh dear Stella1949 I'm nearly at your cut off point and feel fine. I don't think age can be used as a determining factor any more, one person at 90 can be relatively able whilst a 64 year old maybe not. I agree with the idea of cards similar to donor cards but family have to be aware of our wishes as well.

When I was a student nurse back in the 60's, anyone over 75 was automatically DNR unless their doctor had requested them to be resuscitated. Which I thought was a fair thing.
This is one case where I'd like to go back to the old days.

Not that long for you then either stella1949.
I wonder if you'll feel differently when you get to 75

Someone who is elderly and very sick, or even younger and very ill with a debilitating disease may hope for a merciful release from their suffering and would not wish to be resuscitated - certainly the scenario which JessM describes is wrong imo. However, I hope that a sprightly person in their late 80s or 90s would be given the appropriate treatment to enable them to recover and not just left to die untreated - although perhaps not the drastic CPR described.