By Elaine Marze
As marketing director of S.A.F.E. Planning I want to share some information so YOUR family won’t make the same mistakes some other people make – and regret. One of my friends recently lost her eighty year old mom when she had a heart attack. Diagnosed a few years ago with a heart condition, she had a DNR (Do not resuscitate), but when the fatal heart attack occurred and paramedics were called to the family home they had to “work her” because the woman’s DNR was in the safety deposit box at their bank. To do any good it must be readily available to First Responders.
When end of life documents are not available during emergencies, many times family members are forced into making difficult decisions later of whether to unplug their loved one from life support because even though there may be no signs of life when paramedics are called in, they are usually required to “work the patient” if the DNR is not available.
In my friend’s case if the DNR had been there the paramedics could have left her mom in peace, but because there was not a DNR then they were required to work on her which can be traumatic for the family. It can also be traumatic when an elderly, sickly person is hooked up to life support too against their previously stated wishes. But when the patient is unable to speak, it doesn’t matter what a family member says to the effect of what the deceased person wanted, the official document has to be in evidence for the medics to withhold treatment. Because the DNR wasn’t there, the wishes of the deceased were not honored.
“Just telling us that you have papers is like telling us there is an Easter Bunny!” explained one paramedic. “Your word doesn’t mean anything. Sometimes family members will be emotional and disagree with each other over the wishes of the patient. We have to have the document with the patient’s signature, and it has to be current for this year.” (Policies differ from state to state and even among Emergency Medical Services / Fire Departments so there is no one rule that covers every situation.)
One sad story a paramedic shared with me was an adult daughter driving fast and recklessly to their bank to get her mother’s DNR while screaming at the medics over the phone to stop working on her mother. The medic could hear brakes screeching and horns blowing so out of concern for the daughter’s life and innocent victims, he requested permission from the ER doctor to cease working on the patient and call a code (pronounce death). The moral of this article is to keep the necessary paperwork with you.
The paramedics I talked to said there are two places where they usually find DNR’s when they go into a home. It is common for people with life-threatening illnesses to keep their DNR in a can or tube in the refrigerator or hanging on the bedroom door. That’s where they look first, but these medics also pointed out that when they answer a 911 call, it is usually an emergency life and death situation, and they don’t have time to go paper / document hunting because they are concentrating on “bagging”, “working three rounds of CPR”, “giving drugs,” etc. They don’t have time to go searching for paperwork.
Steve Rainey said that during their S.A.F.E. Planning workshops in the Florida office he would ask attendees if they had Living Wills and DNR’s. A fair number of hands would go up. But when he asked how many had those papers with them, only a few hands were raised. Instead, the Florida “Snowbirds” had left their papers locked in safes and deposit boxes back in their home states of Minnesota, Ohio and Oregon where they couldn’t get to them if they needed them.
Also, without the correct paperwork some Emergency Rooms will not work on patients who are unable to speak for themselves which is not uncommon in emergency situations. They have actually laid there dying while medical staff is waiting for the correct documentation because the hospital is afraid of getting sued for working on a patient without permission.
Steve said he has advised people to download their paperwork on a flash drive attached to their key chains which would work well in a hospital where there is ready access to computers, but when I mentioned that to a paramedic he held up his cell phone to show there was no place to stick a flash drive, and they don’t carry computers. Since a lot of emergencies occur in vehicles while traveling, Steve suggested keeping copies of DNR’s and Living Wills in your glove compartment too.
Hopefully there is some good advice somewhere in this article that will help you be prepared for emergencies. We should all be knowledgeable about this subject.