Question: I’m a 64-year-old female, very thin and frail, and trying to make an informed decision regarding end-of-life care in the future. I’m leaning toward deciding not to be resuscitated. I think this may cause a prolonged, painful death or greatly diminished quality of life, if survival is even possible. Some family members are resisting and do not want my code status changed to DNR; they think life-saving measures will not be applied to prevent death. Please help.
Answer: Sharing your aging plan is one of the best gifts you can give your family as you grow older. Planning ahead and having advanced directives in place – including a living will, power of attorney and health care surrogate – will help family members prepare and be aware of your wishes. It’s important to include both your health care provider and family members when discussing a living will and the choice to have CPR or do-not-resuscitate (DNR) orders.
DNR orders tell the health care professionals not to perform CPR on an adult if they go into cardiac arrest (their heart stops). Each state has a different form that’s signed by the patient/medical power of attorney and a health care provider. Without a DNR the health care team is required to initiate and continue CPR.
As we age and we experience multiple health issues, CPR is less effective. Survival rates with CPR out of the hospital have been reported to be between 10-20%. Even if a person is brought back to life after CPR, they’re not likely to return to their normal state of health, especially seniors. The following are common afterward: brain damage, heart damage, lung injury, broken ribs and lung injury.
Choosing CPR may not be recommended if you’re experiencing the following:
- Life-limiting disease that will not improve life span or quality of life with CPR
- Being diagnosed with a terminal disease and on hospice
- Increased age and dependence on others for care and support
It’s common for family members to be resistant to the conversation about end-of-life planning and DNR status. This is usually due to fears and misinformation. It’s helpful to involve family in your conversations with health care professionals regarding DNR status and end-of-life decision-making. Health care professionals can help guide these challenging conversations.