Thursday, March 18, 2010
Ona I'm so glad you went to see Mom and Dad and agreed with everyone that LNC is so nice. It makes me just that much more hopeful that I too will like it....well feel comfortable with it is probably more accurate. It seems as if they are getting super care and are really cared for which is so much more important than the place...for this I can exhale at night!! Here are my thoughts on the DNR order...I'm not ready to put that in their chart as things stand today. Right now, if something was to happen, I'd want them to try and save them...heart attack, I'd want the medical staff to shock them and/or do CPR. If it's a stroke, I'd want meds given and oxygen given. A DNR to me would be appropriate now only if Mom had terminal cancer or Dad's organs were failing and he was on life support...for all their ailments, I feel that they are too healthy for a DNR at this time. Don't get me wrong, I am in favor of a DNR if there's no brain activity and no chance for recovery, absolutely. Jeanie, you and I signed a Terminally Ill/Permanently Unconscious Act medical form from Mr Mooney that probably does need to be copied and put in their chart so that LNC is aware of who legally can make medical decisions for them in case an emergency arises. I talked with Jerry about this to see if I was off base or too emotionally connected. He said he too felt it was too early to issue a DNR because neither Mom nor Dad have a terminal/long term illness..alzheimer's is terminal as is old age, but you don't die from alzheimer's itself, but a complication of the disease..usually pneumonia. Diabetes can be fatal and I know there are complications that come with that as well, but he's being monitored much closer for that now and on a couple of meds for that. Jerry said something more like a living will with specific instructions on what we do and don't want done and the ability to deny heroic actions or undo heroic actions...ie ventilators, might be more appropriate for today. This might be something we need to sit down with Michael Smith and discuss in detail as a group...a good activity for April...I'd like to know more specifics before I'd feel comfortable with a DNR at this time. Love you all and Pat have fun in Texas with Molli!! Jamie
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Ok...I have given my comment a lot of thought and prayer because the last thing I want to do is upset or offend anyone...but I just can't keep my mouth shut because I see this everyday and I have to speak up. A DNR means "do not resuscitate" not "do not treat". They are 90 years old and I agree they are not terminal but they are 90 and we never know when God is going to call us home so why wait?....a chance of surviving a code blue in the hospital at that age is almost zero and in the nursing home it is even less but as of right now if one of them stops breathing or heart stops the staff is obligated to perform CPR, shock, medication, and mechanical ventilation...all I can say is what a blessing it would be if their heart was to stop or they were to quit breathing because there is no pain or suffering but I promise you if they administer CPR there will be....grandma is so frail they would break ribs and possibly her sternum with chest compressions and more than likely grandpa too. Do you (not you specifically but in general) have any idea how hard it is on families to take their loved ones off life support? I beg you not to let it get to that....being on a vent (breathing machine) is like breathing thru a straw and it is very uncomfortable and I promise they would likely never come off the vent then you will be asked if you want a trach and a feeding tube. The other question we ask families all the time is "who are you saving them for" because families feel guilty for not doing all they can for their moms and dads but most times they prolong the inevitable with a lot of pain and suffering for everyone. While I am being a downer here is something else everyone needs to think about....feeding tubes....specifically grandma because pts with Alzheimers dementia usually quit eating at some point...if you decide to go that route (which I don't recommend because there again who are you saving her for?) the life expectancy is about 30 days or less in my experience for these types of situations. Now if they have pneumonia...sure treat that with antibiotics, oxygen, etc but in the event of a heart attack, massive stroke, or in the event they quit breathing for what ever reason please let them go....they have lived a wonderful life and God is waiting on them...Leisa
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