CPR on very old sick people.

To clarify:

If there are 2 options, and doctors think not treating is the better of the 2, but family (especially with POA) say the person would want the treatment, doctors will usually take that into account and treat.

But if the doctors think the treatment is definitely NOT appropriate, someone with POA cannot make them.

POA will never override the person if they are still capable of making their own decisions.

When they are not, POA works mostlt like normal consent, but not quite. For example an individual may refuse to wash. So long as they have capacity thats up to them. But someone with POA couldnt for example refuse to allow carers to wash their relative. That would raise concerns of financial abuse (preserving the estate to the detriment of the persons quality of life)

Sometimes the court of protection gets POAs overridden when there are concerns that non consenting to treatment for the person are not being made in the persons best interest.

It is a BIG topic.

What the solicitor can do is prepare for scenarios where Dr's "best intetests" opinions differ from the family's understanding of what the person would want. That is all.

And again, only if the disagreement is Drs wanting to treat and family saying no. Not the other way around.

You can refuse to consent to treatment. (Or decline it on behalf of someone you have health power of attorney for). But you can't demand to BE treated (or have your relative resuscitated) if doctors don't deem it to be medically justified.

You can't demand palliative care if you are not in fact palliative. What you CAN order is "community care only" and have that put on the 999 system. Ambulances will treat injuries but not admit to hospital for complex treatment.

Again, to do this, he needs his physician not his solicitor.

Ps. he wears a diabetic bracelet

Notanan he has now got DNR in place.
His solicitor was for
A living will and lasting power of attorney etc.
His wishes are for palliative care only.

Giving his DC authority go make medical decisions based on his personal wishes.

Some poignant and interesting comments on this thread. I am not suggesting refusing appropriate medical treatment to those of a particular age. My dear MIL in her mid eighties had suffered many long years of v poor health and struggled on bravely with a lot of support but in increasing pain. She had all her marbles and repeatedly commented that she did not want to die in hospital. She had (another) leg haemorrhage when she was alone one afternoon. Pressed her emergency call thing. She'd have been worried about mess on carpet, I have no doubt. By the time her friends arrived (called by the emergency service thing) she was gone, so I think she must have lost consciousness quite quickly. I was a bit surprised to hear that her friend had attempted CPR under the circumstances. But relieved that she'd had a quick death with no more pain. I don't think it would have crossed my mind if I'd walked through the door to find her like that. I know someone else who is very sound of body but suffering advanced dementia. I'm sure he would not want to be kept going with antibiotics if he gets a chest infection. I really need to get on and do my Power of Attorney etc while I am still of sound mind. So that if I suffer a bad stroke or something, my husband would have the authority to insist on palliative care only.

He has now made arrangements via solicitor.
Solicitors can't do DNRs. He needs to see his physician.

I'm not sure what would happen if he was alone and again collapsed in the street or in a shop etc.
His physician can have his AAND/DNAR noted on the 999 system so so long as he was identifiable paramedics will know. He could wear a bracelet with his NHS number on it incase he was unidentifiable?

A close friends father collapsed in the street
A passer by called for the ambulance.
He was brought back twice by the paramedics.
Who did a fantastic job
He was cared by the wonderful doctors and nurses in intensive care.

But he would gave preferred to have been left to die.
He said he felt it was his time he is almost 90 with several medical problems.
He has already lost his wife.

He has now made arrangements via solicitor.

I'm not sure what would happen if he was alone and again collapsed in the street or in a shop etc.

Its worth considering that the CAUSE of death may have a higher impact on the survival stats (and by survival after resuscitation they usually look at whether someone is still alive 6 months later, not just whether or not they are brought back short term).

Survival after CPR where the arrest was caused by "fixable" events like catastrophic bleeds and drowning are very good.
Survival after arrests during certain risky medical procedures are even better.

Whereas survival rates 6 months later for people who had CPR because their bodies were no longer able to fight chest infections etc.... worse than bleak .

Lifestyle rather than age is probably a better determinater of chances of a GOOD recovery from a CPR.

An active sporty 70 yr old who might do themselves a trauma injury might do fine and get back on their feet.

An inactive 50yr old with an unhealthy lifestyle that's resulting in multiple complications and infections, probably wouldn't recover, at least not well.

& is AAND: allow a natural death.

You're quite correct. There is a school of thought that we should change the wording from DNR to DNAR, "do not attempt resuscitation", or AND, "allow natural death". The rationale is that these terms better reflect the fact that for many patients CPR is not likely to be successful.

Nope, they already ARE called that. Officially.
DNR is the lay term

My mum in her later years was often in hospital and treated for multiple problems. I often joked that I knew the inside of every local hospital as I visited her. She was always excellently treated regardless of how old she was and always until the very end when she was 94 assumed that she would get better and go home.

I suspect many of us are thinking about 'old' people and by that mean people older than ourselves. It has been suggested that 'elderly' is 10 years older than the person talking about it. It would be good to hear from more gns who are in their late 80s or 90s and see what they think. I hope there are some and that they will comment.

trisher and GreenGran I have heard of pneumonia described as 'the old peoples' friend' as it can bring a peaceful end to someone who may have been suffering from multiple other problems.
Indeed, both my own DM and DMIL, both in their 80s, died peacefully from pneumonia. They both had other problems and were not 'spritely' or 'fighting fit'.

Can I say that in spite of her age, the possibility that her mobility would be very restricted and her multiple medical problems I never doubted for a minute that all the medical staff dealing with my mum would do anything to keep her alive. She did in fact have a number of quite large medical treatments (including ops) while she was in hospital. As she died she was being treated for pneumonia. The only treatment she didn't get was CPR and knowing exactly what it entailed she had said very definitely that she didn't want that.

My friend's husband ended up in a nursing home, after a series of strokes. They said that he would only live for a few weeks after the final, severe one. He lived for 18 months. He was unconscious, being fed through his stomach, and his limbs were all contracting. He had several bouts of pneumonia, and even though he had a DNR they kept giving him antibiotics, saying that he had to be kept comfortable. His wife was stressed out, and also died soon after her husband, from a heart attack.
Personally, I think that they kept him 'alive', if you can call it that, because he was easy money for them. Just a quick wash each day, turn him now and then, and quickly pump some liquid food into his tube. They should have just let the pneumonia take him peacefully away.

My relative is a healthcare worker, and the trauma that she suffered after administering CPR to elderly patients was considerable. She still has nightmares where she hears their ribs breaking every time she pushes down... There's no way that I would want that..!

Please don't let oldbatty nurse me otherwise I'm ready for the the big GN in the sky
( almost) ?

Just for the record, there are huge differences between euthanasia, assisted dying and a person's choice for "do not resuscitate" and they really must not be confused. Many people do not understand this and do not understand the procedures. Many people are also terrified of death or dying. Those who have made their feelings clear should have their wishes respected. Those who have not are subject to whatever treatment the doctors involved feel is appropriate. That is quite a weighty responsibility for doctors who, I strongly suspect, do not take it lightly.

oodles

You're quite correct. There is a school of thought that we should change the wording from DNR to DNAR, "do not attempt resuscitation", or AND, "allow natural death". The rationale is that these terms better reflect the fact that for many patients CPR is not likely to be successful.

When learning about 'DNR'this with my parents what I found useful was referring to it as do not attempt Cardio pulmonary resuscitation, as this is what it refers to, nothing else, all other treatment is given. I learnt as much as I could about dying from heart failure, and it seemed to me that actually the heart actually keeps going while the other organs are shutting down. I do know of a much younger person who had CPR, which caused a lot of damage as he was dying

My mum died peacefully but suddenly in March after a long hospital stay. We had discussed the DNR and there was one in place. She was 94. She developed pneumonia, quickly deteriorated but died still trying to boss the staff about through her oxygen mask. The doctor attending her cried. We were so pleased she didn't have CPR or have to be attached to a life support machine. But it was a bit of a shock for everyone, including the people who had nursed her. They did say afterwards without the DNR they would have had to go into the emergency procedures.

When my mother collapsed with a pulmonary embolism the ambulance came quickly and started CPR. After a few minutes one of the paramedics said "You don't really want us to keep on with this do you?" She hadn't been breathing for 15 or 20 minutes and there seemed no point in manhandling her any more.

Obviously

not 75