Deciding if you want to be resuscitated

When someone is dying of a fatal or chronic illness, decisions have to be made about many things, especially about the death itself. One of the most important question is: “how hard to we try to prolong life?” The decision may be for your own life or it may be for someone you are caring for – neither is an easy decision to make.

For someone you love

If you are in the situation of caring for a spouse, perhaps a husband who has Alzheimer’s disease, and his heart stops, do you want the paramedics or doctors to do CPR (cardiopulmonary resuscitation)? If his heart restarts and he needs a ventilator to breathe, do you want that? Would he want that?

Now, let’s change the scenario to a young woman who has rapidly progressing multiple sclerosis. She may have young children and want to do anything to stay alive for a little bit longer – or she may not want to be a burden to anyone any more.

Or, perhaps it is for a teen-ager who has been in a coma for years following a car accident, with few signs of ever recovering. Would resuscitation improve his quality of life? Improve his chances of recovery?

These are the types of decisions that people have to face.

Doctor-requested DNR

In many cases, if someone is already in the hospital and considered to be medically unstable, with no foreseeable quality of life ahead, you may be approached by a doctor to sign a DNR, or do not resuscitate document. This means that if your loved one’s heart does stop, CPR will not be done and he or she will be allowed to pass away.

It may seem like an overwhelming decision to make.

Making the decision

Try not to make this decision alone. You can ask for help from a social worker, for example. Talking to family members may help too. Using the first example mentioned above, take into account how CPR would be for the husband with Alzheimer’s. CPR is a rough attempt at getting the heart restarted. The person doing CPR is putting his or her weight onto the chest in a regular rhythm to mimic the heart beat. In thin or fragile people, this can damage the ribs, causing some fractures, perhaps damaging internal organs; in others, it doesn’t do anything at all.

If the CPR does get your husband’s heart going again, how long he has been without a heart beat will determine how he will recover. Will he need a ventilator to breathe? Will he be able to be weaned from the ventilator eventually? Will he get better? Or is the CPR merely going to prolong what he is going through?

Ensuring legality of the order

If a DNR is what is ultimately decided, you need to ensure that the order is written properly according to the laws of your state or province. This is very important. If the person who is ill develops a problem while outside of the hospital, first responders and/or paramedics are obligated to perform life-saving procedures if there is any doubt as to the validity of the DNR order.