End of life care is a delicate subject. And as such, oftentimes health care professionals as well as family members are uncomfortable discussing some of the options available to people as they approach that stage of life.
At CalaCare we believe strongly in the dignity of the person and we believe that a very important part of maintaining that dignity is to educate those we interact with about some of the options open to them and their family members as they approach the end of life.
One such subject is a DNR.
DNR stands for ‘do not resuscitate’ and is short for a ‘do not resuscitate confirmation form’.
First, and most simply, it’s a piece of paper. In fact, here is a link to one if you want to take a look.
That form is an official ministry of health document that you can have a health care professional sign on your behalf (you cannot sign it yourself) which indicates two things:
- The health care professional signing the form has explained the contents of the form to you clearly
- You have confirmed that it is your wish to not be resuscitated by emergency personnel should those personnel be called to your aid
Put another way, it confirms your wishes to have emergency personnel not perform CPR on you should those personnel be called to your assistance.
Why (you might ask) would someone want to get one of those?
Well, let’s say that someone believes themselves to be very near end of life and as such, if their time were to come they would prefer to allow their body’s natural actions to take precedence over medical intervention. For some people this is a choice they would very much prefer because many medical interventions can be very invasive and have a dramatic effect on the environment of an end of life situation.
By example: interventions such as chest compressions, defibrillation, and endotracheal intubation can be very invasive and it may not be what people want at this point in their lives.
Still not sure what I mean? Perhaps the easiest way to say this is as follows…
Sometimes (not always…but sometimes) this:
Is preferable to this:
Now although a DNR removes the legal responsibility emergency medical personnel have to use all means available to them to keep your heart going, they will still use all available means to keep you comfortable and alleviate pain. This allows them to use palliative care measures while still respecting your wishes to avoid intervention.
This is a very big decision for people and so it’s also very important to know that a DNR is revocable, so you can change your mind at any time.
One last practical note: should you choose to have a health care professional sign one of these on your behalf, your work is not yet done. In order for emergency personnel to act on a DNR they must first find it. And that means actually finding the paper. Unfortunately there is no electronic system that tracks DNRs so when medical personnel arrive they will always do a quick inspection to see if a DNR is visible to them.
If you’re wondering, a great place to put it would be your fridge. All emergency medical personnel who come to your home will always check your fridge door for these types of directives (as well as any other notes such as medication lists) that you would like them to find.
Or, should you prefer not to post the whole paper to your fridge there are smaller stickers that emergency medical personnel are familiar with that will point them to where to find your DNR without you having to post it publicly.
There you have the basic facts about DNRs, how they work and why someone may (or may not) want one.
As always, your comments and questions are welcome! Palliative care is deep passion of mine and I love to share with those experiencing these situations (and to help!) in any way possible. If there’s any way I can help please give me a call!