General Discussion

Warpy

(114,616 posts)

107. It's not just money

Wed Mar 6, 2013, 01:33 AM

Mar 2013

If you've ever been intubated and on a vent, you know it hurts. So do chest compressions and defibrillation. So do getting IVs and central lines put in and maintained so drips to control heart rhythm can be administered.

We're torturing some of these old people because the families just don't understands "do everything" does not increase their quality of life and most of the time, it doesn't buy them any more than a few days or weeks of constant pain.

Breaking the ribs and sternum are bad enough, but the broken bones then do additional damage, like lacerating lungs and liver and sometimes the heart you're trying to save.

CPR is incredibly violent to old folks with brittle bones. It also works very poorly on frail elderly patients. When it does work, it sets them up to finish their lives in horrible pain.

I would very much like to see "no CPR" standard for all elderly and debilitated patients. Electroshock, yes, drugs yes. Just don't do the compressions that do so much damage.

I sure as hell don't want it done to me.

Edit history

Please sign in to view edit histories.

Recommendations

0 members have recommended this reply (displayed in chronological order):

212 replies

= new reply since forum marked as read

Highlight:

CPR can crack ribs and only succeeds longterm in restarting a heart 20% of the time -- [View all] pnwmom Mar 2013 OP

How about the Shocker Pad Box? MADem Mar 2013 #1

One of the doctors addressed that, too. He's only 66, though -- much younger than the CA lady. pnwmom Mar 2013 #3

I don't think the defibrillators work if the heart is stopped. FarCenter Mar 2013 #5

But a heart could be beating irregularly and very slowly -- pnwmom Mar 2013 #8

No. An electronic shock device can detect bradycardia (slow heart beat) and respond appropriately. Aristus Mar 2013 #61

A defibrillator doesn't start the heart, it stops it. Warpy Mar 2013 #102

I have to say, I look askance at this "Let 'em die" guidance. MADem Mar 2013 #112

I don't have a single elderly relative who relished the idea of life so much pnwmom Mar 2013 #120

what your family wants is irrelevant. and the fact that *this* woman had a DNR is irrelevant to HiPointDem Mar 2013 #127

Well, I guess the point I'm trying to make is that it's fine and dandy MADem Mar 2013 #134

Perhaps it is true that pnwmom Mar 2013 #210

Yet this 66 year old doctor WANTS emergency aid. HiPointDem Mar 2013 #128

Just a few weeks ago I administered chest compressions marybourg Mar 2013 #2

I'm happy it worked out for you! pnwmom Mar 2013 #4

If my heart stops, I'll take the 20% of survival and broken ribs aikoaiko Mar 2013 #6

I would say that for me at my age now but I wouldn't at 87. pnwmom Mar 2013 #10

Especially if it includes more pain and suffering. n/t cui bono Mar 2013 #43

It depends entirely on health--I know people in their eighties and nineties who are still vigorous. MADem Mar 2013 #115

I'm with you. WHEN I change my mind I'll say so elehhhhna Mar 2013 #50

Could it be . . . Brigid Mar 2013 #7

I read that in CA an assisted living place has to have a special license to administer any kind pnwmom Mar 2013 #13

i doubt it; it was a facility with 3 levels of care & took public funding. ergo, it could give HiPointDem Mar 2013 #62

You're wrong. You can't take staff away from the licensed facility pnwmom Mar 2013 #81

It's the *same* facility, providing 3 levels of care on the same campus. we have similar facilities HiPointDem Mar 2013 #99

I think it is wrong for the facility to take that stance liberal_at_heart Mar 2013 #15

CA law requires a special license for a retirement facility to offer any kind of medical care. pnwmom Mar 2013 #17

why can't they get the required licence? liberal_at_heart Mar 2013 #23

Then it would be an assisted living facility, not a retirement home. pnwmom Mar 2013 #26

If you have residence in their 80's they are going to need medical assistance. liberal_at_heart Mar 2013 #27

Lots of people live independently in their own homes in their 80's without medical assistance. pnwmom Mar 2013 #32

I still think retirement homes should have CPR certified staff and should offer CPR to those who liberal_at_heart Mar 2013 #36

As I said, that's the case for WA retirement homes. pnwmom Mar 2013 #39

This message was self-deleted by its author HiPointDem Mar 2013 #114

Completely false, though you keep repeating it. HiPointDem Mar 2013 #116

as for your claim that it's different in wash, it looks like this corp has the same policy here: HiPointDem Mar 2013 #121

If you want the increased services you have to move to that section. dkf Mar 2013 #205

they don't need a license to give emergency aid. that is corporate policy, and this poster is HiPointDem Mar 2013 #126

CPR is not medical care Thor_MN Mar 2013 #52

CA law treats it as medical care and requires an license for it to be administered. pnwmom Mar 2013 #78

Care to prove that a random person adminstering CPR had knowledge of the DNR order? Thor_MN Mar 2013 #93

bullshit. you keep repeating that california law forbids independent living facilities to give HiPointDem Mar 2013 #117

that's rather misleading. every assisted living or skilled nursing facility is licensed to give HiPointDem Mar 2013 #63

What is misleading? The woman lived in independent living, not assisted living or skilled nursing pnwmom Mar 2013 #80

All the staff works for the same corporation. Anyone can give cpr in an emergency. No criminal HiPointDem Mar 2013 #100

No, employees of a non-licensed independent care facility in CA may not give CPR. pnwmom Mar 2013 #103

Employees can't because the facility forbids it. The family's wishes in this case make a great deal HiPointDem Mar 2013 #108

The law could easily be changed to require it and that's what should happen. n/t pnwmom Mar 2013 #110

The law does not forbid it. It's the facility's *interpretation* of the law. HiPointDem Mar 2013 #111

no. HiPointDem Mar 2013 #139

I think it is their choice. enlightenment Mar 2013 #9

I agree. n/t pnwmom Mar 2013 #14

I thought that another reason to administer CPR was to circulate oxygen oregonjen Mar 2013 #11

Yes, in the hopes that doctors could get the heart working again. pnwmom Mar 2013 #19

You are correct. My cpr instructor discussed a case where a group took turns performing cpr FSogol Mar 2013 #55

'let them die'. they're old and useless. i'd say that's the general sentiment. however, i guess HiPointDem Mar 2013 #65

I was a CPR instructor for EMS personnel nadinbrzezinski Mar 2013 #86

Upthread I posted a link to a situation where a bunch of people kept going for ninety six minutes. MADem Mar 2013 #195

rather vigorously promoting it. to the extent of pushing false information and straw men. HiPointDem Mar 2013 #201

Let them die. Why risk broken ribs? Buzz Clik Mar 2013 #12

How about "let them choose" before they're in that situation? pnwmom Mar 2013 #16

Sounds like a wise plan. Buzz Clik Mar 2013 #18

Same here. Mom posted her wishes on the wall by her phone; mother in law would never ever discuss... Hekate Mar 2013 #56

Sorry you had to go through that. pnwmom Mar 2013 #89

Had a terrible fight with a friend over the issue of the feeding tube Hekate Mar 2013 #94

"First, do no harm." bemildred Mar 2013 #20

What dogma? pnwmom Mar 2013 #22

The dogma that says you must give CPR to the elderly to "revive" them. bemildred Mar 2013 #25

I know of a woman who died at the age of 105 pnwmom Mar 2013 #29

Yes. bemildred Mar 2013 #31

It's not just money Warpy Mar 2013 #107

How horrible! No CPR--standard? The "default?" Do you really mean that? MADem Mar 2013 #138

Yeah, I'm 68 and I really mean that. bemildred Mar 2013 #150

Well, if "no CPR" is the default, someone else IS deciding when you die. MADem Mar 2013 #188

Have you ever cared for an 85 year old with a chest full of broken ribs Warpy Mar 2013 #177

I'm sorry. I just don't buy that logic. I think it's pretty awful, actually. MADem Mar 2013 #186

You might have read my whole post, you know Warpy Mar 2013 #187

Well, I did read your post, and not every case--see the examples I provided, that you did not read-- MADem Mar 2013 #189

and i know a woman who died at 98 and spent the last years of her life taking a daily walk around HiPointDem Mar 2013 #66

So . . . pnwmom Mar 2013 #76

I agree, every case is individual. That's why the blanket policy that no emergency aid will be HiPointDem Mar 2013 #101

Why is it wrong if residents are fully informed and consenting, as this woman's family said she was? pnwmom Mar 2013 #109

It's fine if they are. It's fine in this woman's case. It's not fine to have a blanket policy HiPointDem Mar 2013 #122

I agree--the "default" should be to give care, not to refuse to give it. MADem Mar 2013 #143

Reminds me of my neighbor's mother. Just the same, minus the driving. MADem Mar 2013 #141

"Revive" them. Yeah, I'm sure they're pissed off about being "alive." GaYellowDawg Mar 2013 #136

So I hit a nerve, eh? nt bemildred Mar 2013 #149

A consequence of posting something so thoroughly unfeeling. GaYellowDawg Mar 2013 #153

Name calling isn't much of an argument either. nt bemildred Mar 2013 #154

the poster didn't call you any names. HiPointDem Mar 2013 #155

I didn't say he did. I said he made no argument, he just used insults. nt bemildred Mar 2013 #156

he made an argument. his argument was that your scare quotes around 'revive,' as though HiPointDem Mar 2013 #159

Those are "bullshit" quotes. When the "success" rate is 20% for an otherwise harmful treatment, bemildred Mar 2013 #161

the success rate is 20% for everyone. so i presume you are against cpr for anyone, since the HiPointDem Mar 2013 #163

Presume away, I don't give a shit what you presume. Go read post #157. nt bemildred Mar 2013 #164

Here, read this: bemildred Mar 2013 #162

i read it. what golden nuggets am i supposed to draw from it? it pushes a red herring, in HiPointDem Mar 2013 #166

The corporations policiies differed by facility. There were nearby facilites where CPR is done. bemildred Mar 2013 #167

bullshit. you don't even know the basic facts of the case. HiPointDem Mar 2013 #169

So the families statement means nothing to you? Got it. bemildred Mar 2013 #170

The family's statement has nothing to do with the issue in this case, which is not the fate of this HiPointDem Mar 2013 #172

I will talk about any issue I choose here. bemildred Mar 2013 #173

it's obviously is not your only issue, as you've posted that you'd like to see "no cpr" as HiPointDem Mar 2013 #174

Yeah, I like to kill puppies too: bemildred Mar 2013 #179

By the way, can you post a link to the statement you claim I made? bemildred Mar 2013 #180

In response to this post: HiPointDem Mar 2013 #181

Ah, I meant for me, no physicians should not make those decisions Edit: unilaterally. nt bemildred Mar 2013 #182

i accept that you may have meant only yourself. however, the question is about the standard HiPointDem Mar 2013 #183

Yes, that's what it says there. bemildred Mar 2013 #184

i see a great deal wrong with the largest corporate provider of 'senior living' requiring that you HiPointDem Mar 2013 #203

But that is not the case. There is no such requirement, nobody is compelled. nt bemildred Mar 2013 #207

The family's comments shouldn't be controlling anyway. This woman lived independently. MADem Mar 2013 #197

You can break every rib I've got if it might save my life. Codeine Mar 2013 #21

How many 80 or 90 somethings do you think would say that, pnwmom Mar 2013 #24

The two 80-90s I know. Hatchling Mar 2013 #59

Then they should be glad that it was this woman's decision to live in this place pnwmom Mar 2013 #77

"beats the shit outta dying" jberryhill Mar 2013 #28

You have to think about the underlying cause. I tell my hospice patients and their mucifer Mar 2013 #30

These issues are so complicated and that's why pnwmom Mar 2013 #34

yet this corporation has a BLANKET POLICY that decides for everyone. HiPointDem Mar 2013 #124

I also heard that your body fights any respiratory machine. cui bono Mar 2013 #45

Yes, they usually have to sedate people at least at first. mucifer Mar 2013 #47

Yeah, and sometimes even paralyze! cui bono Mar 2013 #53

To get the tube down we used paralytic s nadinbrzezinski Mar 2013 #105

Just listened to that a few days ago. It really gave me a lot to think about on this subject. DeschutesRiver Mar 2013 #168

I had to do the Heimlich at home this morning before work. postulater Mar 2013 #33

The weird thing is that I've done that myself. Codeine Mar 2013 #35

Wow. pnwmom Mar 2013 #37

Not sure if you're kidding or not, but I used to have to watch my dog eat as he had cui bono Mar 2013 #51

Not kidding. Just lucky I was there or she'd be dead now. postulater Mar 2013 #73

My heart stopped 9 times Kingofalldems Mar 2013 #38

Yay! pnwmom Mar 2013 #40

After reading th OP I am even more amazed that I am still around. Kingofalldems Mar 2013 #71

You were definitely a success story, and doctors and nurses never become immune pnwmom Mar 2013 #75

I'm glad CPR worked for you. liberal_at_heart Mar 2013 #48

I know from experience that when your heart stops Kingofalldems Mar 2013 #69

Yeah, but are you 87 years old? JustABozoOnThisBus Mar 2013 #148

That's why 80% of doctors DO NOT want CPR performed on them. cui bono Mar 2013 #41

How can you possibly know if the medical crisis you are going through is fatal? liberal_at_heart Mar 2013 #44

There are statistics as to the success of certain prodedures, and that's why the doctors answered cui bono Mar 2013 #46

If you are suffering from terminal cancer you HOPE it might be fatal. pnwmom Mar 2013 #83

link to that study, please? no, not to the radio show, to the study. HiPointDem Mar 2013 #68

Frontline had a program called Living Old a few years back Revanchist Mar 2013 #42

Thanks for the link. pnwmom Mar 2013 #84

When my FIL was in a nursing home they had to ask us about a DNR Hekate Mar 2013 #49

when my mother was frail, ill and 94 years old, I refused to have her transferred to another CTyankee Mar 2013 #54

people should make their own decisions about what they want, and review them yearly. the HiPointDem Mar 2013 #72

No, of course not. My mother was extremely old and frail at that point. She was essentially starving CTyankee Mar 2013 #74

I agree, you did the right thing by your mother. But my larger point is that not everyone living in HiPointDem Mar 2013 #98

I never said it should be everyone's decision. depends on circumstances... CTyankee Mar 2013 #131

i didn't mean to imply that you did. HiPointDem Mar 2013 #132

The family said they and the woman knew what the policy was, and she wanted to die a natural death. pnwmom Mar 2013 #90

I understand this family said the woman didn't want cpr. I did not see any statement that she HiPointDem Mar 2013 #97

Even making your own decision ahead of time isn't always adequate. A DNR doesn't guarantee... JVS Mar 2013 #175

another reason blanket policies made by corporations = wrong HiPointDem Mar 2013 #176

If you have a living will or a health care proxy you can direct a DNR order. n/t pnwmom Mar 2013 #82

Putting the discussion to the side, reflection Mar 2013 #165

I just turned 50, feel free to break my ribs. Thor_MN Mar 2013 #57

I've known about this for a long time ... but ... REP Mar 2013 #58

Right -- every decision depends on the person and circumstances. n/t pnwmom Mar 2013 #91

Absolutely. More information = more informed decisions REP Mar 2013 #160

An anti-CPR thread. WilliamPitt Mar 2013 #60

Simply stunning. Egalitarian Thug Mar 2013 #64

It's not an "anti-CPR thread. LisaL Mar 2013 #67

Thanks, Lisa, that's what it is. pnwmom Mar 2013 #87

There are a lot of posters on this site and on this thread who don't want anyone to make choices. AnotherMcIntosh Mar 2013 #104

And I think a lot of them might be younger people pnwmom Mar 2013 #106

I am not a younger person. I am an older person who has watched many people die and works HiPointDem Mar 2013 #123

I am no spring chicken myself, and I have a lot of "geezer" friends/acquaintances. MADem Mar 2013 #144

I agree that this meme is being shopped, and that's why this thread pisses me off so much. HiPointDem Mar 2013 #146

I'm thinking my older friends will prefer to just stay in their homes and rely on the "I've fallen MADem Mar 2013 #147

actually, i think everyone is fine with people making choices, but against corporations making HiPointDem Mar 2013 #113

"everyone is fine with people making choices"? How could you think that if you've read the posts? AnotherMcIntosh Mar 2013 #118

show me the post where someone says "they should give cpr even if the person has a dnr order". HiPointDem Mar 2013 #119

In this case the daughter confirmed that her mother did not have a DNR order pinboy3niner Mar 2013 #129

IN THIS CASE. The facility is lying when it says the nurse did not understand their policies HiPointDem Mar 2013 #130

If that's what they want, why should CPR be forced on them? LisaL Mar 2013 #198

where do you see me saying anything like that? HiPointDem Mar 2013 #199

Um, no. GaYellowDawg Mar 2013 #137

What???? It's an everybody-needs-to-make-their-own-decision thread. pnwmom Mar 2013 #85

If CPR does not succeed broken ribs do not matter. MineralMan Mar 2013 #70

Her family says she didn't want intervention. LisaL Mar 2013 #79

If they'd done that to MY mother after she'd said not to, she'd have sued them blind afterward Hekate Mar 2013 #95

I was not there, nor do I know that woman's wishes. MineralMan Mar 2013 #152

The person in cardiac arrest was in a position to say what she wanted pnwmom Mar 2013 #88

But did she do that? I don't know. MineralMan Mar 2013 #151

Her family said on Tuesday she was fully aware of the policies of the independent living facility pnwmom Mar 2013 #185

I remember reading a very touching essay about CPR in a nursing journal many years ago. Silver Swan Mar 2013 #92

no, it's not done to 'comfort' the survivors. HiPointDem Mar 2013 #142

The system makes it impossible for anyone to know the truth kickysnana Mar 2013 #96

20% is better than 0%. Apophis Mar 2013 #125

Thanks, but for serious advice like this, I'll trust my own doctor... Violet_Crumble Mar 2013 #133

Well, what the fuck? GaYellowDawg Mar 2013 #135

+100. HiPointDem Mar 2013 #140

+1 nt MADem Mar 2013 #145

turn off the lights datasuspect Mar 2013 #158

This woman wanted to die naturally. LisaL Mar 2013 #196

But she *had it* done on her, by the EMTs. So apparently this facility didn't bother to tell them HiPointDem Mar 2013 #204

Coincidentally, I just listened to a podcast covering the same thing DeschutesRiver Mar 2013 #157

Thanks for your link and post, DR. pnwmom Mar 2013 #194

Thanks for that link as well re family statement. Although these threads have Terry Schiavo aspects DeschutesRiver Mar 2013 #208

In WA state we copied that law of yours and so that's an option here, too. pnwmom Mar 2013 #209

I did not know that WA had done the same DeschutesRiver Mar 2013 #211

If I'm dead, I won't care about cracked ribs. Go for it! JVS Mar 2013 #171

If you're 87 and it only gives you a couple more weeks of life, you might regret it. pnwmom Mar 2013 #192

and you might not. HiPointDem Mar 2013 #202

Hell yes. I'll take a 1 in 5 chance over no chance, anytime and anywhere. (nt) w4rma Mar 2013 #178

Me, too. But I won't want it when I'm 87. n/t pnwmom Mar 2013 #191

After years of TV watching (where it almost always seems to work), hughee99 Mar 2013 #190

They're only an issue if you would rather have a relatively peaceful death than a violent one. n/t pnwmom Mar 2013 #193

hogwash. there is no guarantee of a peaceful death. HiPointDem Mar 2013 #200

People need to realize that if you are frail, CPR is very painful. dkf Mar 2013 #206

Even less than that... Javaman Mar 2013 #212