I recently cared for Ernest,* an 87 year old gentleman who spent around two weeks on my ward. Prior to admission his health was poor. He was bed-bound due to the late stages of a degenerative neurological disease, and had associated cognitive impairment. He had several other health complaints, and had been in hospital multiple times in the previous year with infections. He had always responded to antibiotics but his condition and level of interaction with the world had declined with each admission. On arrival to our ward I noticed that he did not have a DNAR order and, since he was not able to discuss his wishes, I looked to the family for information and to broach this subject. I was surprised to find that several vocal family members were adamantly against a DNAR. I had lengthy discussions explaining my reasons for believing that attempts at resuscitation would be futile and that setting limits of care was important to ensure we pursued quality, not just quantity of life. They listened, seemed to understand, and themselves identified his frailty, deterioration over the last year, and decline in his quality of life. However they strongly objected to us making him “not for attempted resuscitation.” As the end of the week approached I felt uncomfortable about the lack of a DNAR order, and about the possibility of this frail gentleman suffering a brutal and undignified exit to the world should his heart stop.
Tweet about this post
Follow on twitter
My vital statistics
- 37,550 hits
- active ageing ageing well art Assisted dying Assisted suicide autonomy Blood test bucket list C. S. Lewis Cardiopulmonary resuscitation care chronic disease communication compassion costs CPR creativity death Debbie Purdy determinants of health Diagnosis Dignitas Discharge DNAR doctor Dying Matters empathy ethics euthanasia event Falconer family fear futility grief harm healing health health and social care bill Healthcare Health care honesty hope Hospital human inequality life Media medicine Mental health mortality National Health Service NHS old Organ donation patient Philosophy physician assisted dying politics Private healthcare privatisation public sector quality of life right to die Screening social determinants of health social interaction sympathy technology time touch training welfare state wellbeing wishes
seenbylj on InstagramPacking up ready to move. Time to throw away these pinnacles of my #protest #art!Irish stew and colcannon. Very hearty dinner after a day of packing and painting!Butternut squash and chorizo risotto made with @lafauxmagerie chorizo. So good!New friends in the new garden.We got a lovely cauliflower in the @oddboxldn so I made this roasted cauliflower with bulgar wheat & zoug! Adapted recipe from @olivemagazine. Trying to reduce #foodwaste so I roasted the cauliflower leaves too & they were v tasty with some seasoning & a squeeze of lemon.Lunch @mildredsrestaurants was delicious! Levant spiced kebabs - recommend. Also had a side of kimchi because #kimchi is heaven
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.