Tag Archives: dnr

Doctors dropping the ball on nursing home transfers

Anyone who has spent any time in a hospital, whether as a patient or a caregiver knows that seeing the doctor is like finding the holy grail. I remember endless hours just waiting for the elusive doctor to appear, just so he could take a cursory glance at my mom or dad, flip through the chart, and then provide the signature we’d been waiting all day for. This is especially frustrating during hospital transfers.

hospital hallway

A recent University of Missouri survey of that state’s nursing home staff members found that there is poor communication between the doctors at transferring hospitals and physicians on staff at the admitting nursing homes. The survey also found that orders are often incomplete and difficult to read. The transfer process can take hours, creating a frustrating experience for both staff and families.

I wrote recently about the guilt I felt about Dad’s last minutes in this world. His DNR order had not transferred from the hospital to the skilled nursing facility, so the nursing home staff were legally required to take all measures to save his life when he collapsed in the shower. The result of that failure: my dad suffered broken ribs as he died.

The blame for this failure is not just on the doctors, hospitals and nursing homes. As family members for loved ones who are ill, we become patient advocates. I remember wondering if the DNR order for my dad had transferred, but I never inquired with the staff at the skilled nursing facility. It had been so difficult to get Mom to agree to the DNR at the hospital, I frankly did not want to deal with that drama again. I hoped Dad would pass quietly on his own, but as many of you know, that often doesn’t happen.

So yes, as patient advocates we need to demand better communication between the hospital staff and nursing home staff. But we also need to check behind them, and then double-check, to make sure medical care orders are recorded properly. Dealing with these issues may be frustrating, but it is much better to know that you tried than to have to live with a lifetime of regrets.

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Filed under Awareness & Activism

Dad’s fear of death

I believe I’ve mentioned before on this blog that my dad was afraid of dying. I never really explored the specific reasons why with him, but I do know he was afraid of suffocating and would have terrible nightmares around that theme.

Well, I hope Dad is okay as ashes in a container. I haven’t sealed the lid on my container, just in case he needs some more space!

But on a more serious note, his deep-seated fear of death led to a stony silence about any end-of-life discussions. My mom, ever the optimist, was more than willing to go along with him and pretend that the “d-word” was never going to happen. Sadly, this happens in a lot of families, and it’s usually the children or other relatives that are serving as caregivers that have to deal with the consequences.

I’m not a fan of legislation that tells people what to do, but I almost wish there was a legal requirement for people to indicate their basic end-of-life wishes in writing. Of course, these decisions would no doubt change over time, and the document would have to be updated, which would no doubt be a mess in some situations. Bureaucracy can be a big ugly beast, but the flip side is this void of knowledge, and a desperate family member forced to make life or death decisions for their loved one.

It was excruciating to watch my mom, who was in charge of making my dad’s health decisions, keep avoiding the DNR request, despite pleas from me and the medical staff. I know in her heart she felt she was doing the right thing, by giving Dad every chance possible to “recover.” But as those who have dealt with Alzheimer’s in their families know, that recovery is limited at best.

I say the above even though I’m not entirely sure what Dad would have wanted at the end of his life, if he had been in his right mind. Would he have been as afraid of the DNR order as death itself? Perhaps. Would he have wanted the broken ribs that came with the CPR that was given to him on the day he died? No, of course not, no one would.

I think Dad was most fearful of the unknown that comes with death, despite his religious beliefs. Did Alzheimer’s erase that fear or add to it? I wish I knew.


Filed under Memories