Sunday, January 3, 2010

Do you have a DNR?

Do you have a Do Not Resuscitate Order (DNR)? That is one of the most emotionally devastating questions to be asked about you loved one. Family discussions about end of life preferences are important; however the triggering event is generally an abstract idea, something that may happen sometime down the road. Even signing a living will does not have the emotional impact of a medical professional asking if there is a DNR.

Our family has had many conversations regarding death, dying, our preferences and the like. My dad’s military background created an acceptance of dealing with this topic at an early age. My grandfather passed away when I was 10. My mom had to make the decisions as the end neared. She often told me the most important thing was that he was comfortable. After college I wasn’t allowed to go on a European holiday until I had a will. Burial vs cremation conversations began in earnest after my aunt passed away in the early 90s. For the record, we’re a cremation, no viewing family. When my mom had surgery a few years ago, the hospital requested a living will. She got one and so did the rest of us. Her living will like all other important documents is safely stored in our safety deposit box. (Side note- access to living wills is important. Bank hours may not be convenient for retrieval when necessary)

Fast forward to a month ago, my mom had gone to the doctor for pain in her back and by the end of the day she was admitted into the hospital. That was on a Friday and by the following Friday, she was dead.

My mom’s breathing had become labored. When I questioned what was happening the nurse asked if Mom had a DNR. Hearing that felt like a slap in the face thank you very much reality. In theory and in fact the question of DNR had already been answered by my mom herself. At that moment however, I just told the nurse I wasn’t prepared to answer that question and hurried away. Later that day when I was speaking with the doctor, he asked the same question. I told him my answer today will be opposite of my answer tomorrow once my brother saw my mom. Gratefully, that worked for him. That night was a sleepless one for me. Having spoken with friends about their experiences with DNR, I spent the night mentally preparing myself to sign the DNR. I don’t care what the medical professionals say; signing that paper is like signing my mom’s death warrant.

The next morning, after my brother had seen mom, we had a family meeting with the doctor. Things had gone from bad to worse overnight and the end was here. As we absorbed blow, I knew it was time for the DNR. Steeling myself, I turned to the nurse with the clipboard who attended the meeting and said I was ready to sign the form. Instead they tell me that, if there is a documented discussion with the doctor regarding DNR, it is not necessary to actually sign the form. Seriously, NOW you tell me this? It would really have been nice to have known the night before, I might have actually slept. (Note this applies for New Jersey, I don’t know about the rest of the country.)

After the anti-climax of the now non-signing of the DNR done, we turned our attention to making my mom’s last hours as peaceful and painless as possible. Mom’s last day was filled with family and friends. 

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