Experience with ICU, DNRs, Living Wills and Hospice

Bobw235

Senior Member
Location
Massachusetts
On Tuesday this week we lost my 86 year old father-in-law. What started as a fall in his kitchen as he went to bring his wife a glass of water, ended with his dying a few days later. Along the way I got to see up close and personal what intensive care is like and the benefits of hospice care.

We got a call on Friday morning that my father-in-law had been admitted to the hospital with a fractured pelvis, having fallen the night before. Why it took his caretaker more than 12 hours to notify us is another matter. Somewhere after midnight, the phone rang and the hospital called to say he had coded, been revived and was in the ICU. Apparently the DNR that was so prominenty displayed on his fridge didn't accompany him to the hospital, and despite my having mentioned it to the nurse earlier on Friday made no difference as they didn't have an official copy.

We scrambled to track down my sister-in-law in Israel where she was vacationing. Got her agreement that we should consent to a phone DNR order for my father-in-law and arranged it with hospital. Saturday morning the hospital called to say that my father-in-law needed dialysis, which we declined, abiding by his wishes. By Saturday afternoon we were in the ICU with my father-in-law, witnessing the skill and dedication on display all around us. The team of nurses, the trauma physician, the manager of the unit could not have been more helpful and compassionate. Everyone was so kind and empathetic to our situation.

Hospice was suggested in view of dire condition of my wife's father and after meeting with a very gentle soul on Saturday who explained what was involved, we agreed that was the best course to take. By Monday evening he was moved to hospice, a quiet and peaceful environment devoid of the intrusions that advanced medical care requires. Twelve hours later, my father-in-law passed before we could get there.

I think my reason for writing this is to reflect on what an extraordinary few days it was. To remark on the care given to a loved one in their final hours. The experience, while painful, made his final hours better. We were able to play music for him, talk to him, hold him, all in a peaceful setting. Somehow it helped. It made me reflect on the fact that my wife and I have a living will, and now more than ever I'm glad I do. Still have to make my own "final arrangements" and this has brought it all home. The fact that my father-in-law had made arrangements so long ago made this event so much less stressful.

So, do other out there have living wills, healthcare proxies, DNRs and such? Have you made your "final arrangements" so that your loved ones don't have to scramble with those decisions? My wife brought it up again the other night. Guess it's time to do some hard thinking on this.
 

Three of my elderly relatives were fortunate enough to die at their nursing homes. We shared some of your experience, particularly being given privacy to play music and spend time with the women as they faded away. Hospital is the last place that I would want to be when I am dying. A good palliative care environment is what is required, whether you are in a hospice, a nursing home or at home.

My daughter who is a nurse experienced in this field holds our medical guardianship and we trust her to make appropriate decisions for us. We talk.
 
We both have living wills Bob, but we may need to update them, it's been many years. Neither of us has given the other Power of Attorney yet, because we're both still fairly healthy, but if we felt it necessary, we would do it asap. My father in law, when he was in the hospital after a major stroke which left him paralyzed and not able to function any longer, had a DNR which was never used. Don't intend to make any final arrangements, we both want to be cremated and have no specific wishes for the ashes, so it will be easy.
 

A living will is fine... as it gives people a general idea what your wishes are... however, it has no legal teeth.. and can be overturned when one person decides he/she does not agree with your decisions.. I have seen living wills fly out the window when a sibling decides that they want EVERYTHING done to save mamma and attempt to make her live forever..

The document you need is a Healthcare Power of Attorney. That is a binding legal document that give a designated agent of your choice complete authority to make your medical decisions should you be unable to do so. His/her word is final and Healthcare professionals are legally bound to comply. No one can step in and decide differently.

It is very important to make sure you have in depth conversations with your agent so they are aware of what you would want.. Not only about CPR.. Chemical CPR.. mechanical ventilation... but how do you feel about feeding tubes... or hemodialysis.. or even Tracheostomy. This person should be chosen for their ability to stand up to family members who may feel differently. They also do not have to be your spouse or child... or even a family member.. but can be a friend that you know will act on your behalf and according to your wishes.
 

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