DNAR & DNAR 2

Share information, support and advice on all aspects of caring.
About a year ago my Wife who I care for went into hospital because of an infection which became Sepsis. On her return home, the ambulance crew handed me a Do Not Attempt Resusitation form, which Ros had signed. It was the first I knew. I asked Ros why she had signed it. She as a former nurse she did not want CPR. There has been no discussion with me as the primary Carer. I accept and respect Ros' decision. But you would have thought there would have been some sort of advice and explanation to the carer. ;)
I took Ros to Newcastle for 2 weeks to see her family. Ros stays in a local Nursing Home. Anyway on arrival I handed over Ros'.DNAR. I was told that they could not accept the DNAR for 2 reasons. 1. It was out of date, they said it had to be renewed annually, which was news to me. 2. They said the form was the wrong version, I had version 3 and they were on version 17. The missing bit on the DNAR we had was the GPs registration number. So they had to sort out a local GP to get Ros another up to DNAR.
On the Monday I contacted our Stevenage GP about this. They said as far as they knew, the DNAR was the one our CCG authorise for use and that they had never heard of annual renewal.
It appears that the DNAR process can vary CCG or Trust. Makes it a bit challenging as a carer.
Hi Norman ... thanks for bringing this thorny issue to the attention of forum readers.

( A previous thread also covers DNR : https://www.carersuk.org/forum/support- ... /dnr-33983)

An Internet search ... UK DO NOT RESUSCITATE ... will reveal numerous links ... almost like a library without
a clear index unless one expands the search by adding key words.

One interesting one directly relevant ... from the Compassion In Dying web site :

https://compassionindying.org.uk/making ... ar-forms/

When will a DNAR form be issued ?

Your healthcare team will assess whether or not CPR is likely to be successful, for example, whether CPR is likely to restart your heart and breathing.

Normally a DNAR form will be issued if :

Your healthcare team feel that CPR is unlikely to be successful

If your healthcare team think that CPR won’t work then they won’t attempt it. A DNAR form will then be added to your medical records to reflect this. You must be told if this is the case. If you lack capacity to make a decision, for example if you’re unconscious, and it’s decided that CPR won’t be attempted if your heart and breathing stop, then your healthcare team should discuss this decision with your family.

If your healthcare team say that CPR won’t work but you still feel that you would like them to attempt it, you should talk to them about your feelings. Although no one has the legal right to demand a treatment, in reality no healthcare professional would refuse your wish for CPR if there was any possibility of it being successful and you making a healthy recovery from it.

Your healthcare team should also give you the opportunity to ask for a second opinion if you disagree with their decision. You don’t have the legal right to a second opinion but a doctor will rarely refuse to refer you for one.

Your healthcare team feel that it’s unclear whether or not CPR would be successful and, following a discussion with them, you decide that you don’t want CPR

If your healthcare team are unsure if CPR will work then they’ll need to decide if it would be in your best interests.

Attempting resuscitation would be in your best interests if, for example, it might mean that you could enjoy your life for a longer amount of time. However, sometimes when CPR is given people need to spend a long time in intensive care, or are left severely disabled by brain damage due to poor blood supply during the cardiopulmonary arrest. In these circumstances attempting CPR might not be in your best interests.

Your opinion is very important in making this decision and someone from your healthcare team will talk to you about what your preferences are. If a decision is made not to attempt CPR, then a DNAR form will be added to your medical records to reflect this.

You don’t have to talk about CPR if you don’t want to, and you shouldn’t be put under pressure to make a decision. If your heart and breathing stop and you haven’t told your healthcare team what you want, then they’ll decide whether to attempt CPR. They’ll base their decision on the likelihood of CPR being successful and on the likelihood of you making a healthy recovery afterwards.
DNAR forms and your rights

In 2014, there was an important court case involving a woman who had a DNAR form placed on her medical records without being consulted. The court ruled that the doctors were wrong not to include the patient or her family in the discussion, and that doctors should speak to patients before a DNAR form is put on a person’s medical records.

The judges also said that a patient getting distressed and upset can’t be used by a doctor as a reason to avoid discussing the DNAR form with them. The only time a doctor has a good reason for not consulting a patient is if the conversation would risk causing them physical or psychological harm.

The Resuscitation Council has issued guidance in response to the case. The guidance stresses the need for doctors to have clear and honest discussions with patients about CPR and the likelihood of its success. Records should be kept of these conversations.



Templates for the standard DNR forms are available through the following link ... click on the format required ... a sample
in .pdf format will open in a serarate window.

https://www.resus.org.uk/dnacpr/do-not- ... del-forms/

Interestingly , the bottom section ... REVIEW DATE ( IF APPLICABLE ) ... ties in with Norman's experience.

As for the carer ... I have always maintained that a caree / carer relationship is a partnership ... difficult if the partners
do not share vital information ... in this instant , the individual concerns take back stage to the partnership ones.

Not a nice subject but ... relevant to many.
Duplicate posting after Mods tied up this thread.
Norman,

News to me... I am thinking maybe the care home is simply referring to an internal system they use to track service users who have DNACPR in place as the actual medical document is binding/indefinite, they can have a suggested date for review depending on the likely hood of recovery but that doesn't insinuate an expiry date

Just keep a hold of the original and enquire when you get home.

Best wishes to both of you, its nice that you are able to take a trip to visit family and I hope it gives you time to have a rest.

Take care of yourself

p.s. friendly suggestion to contact a moderator and shortern your username this forum is a safe space but it is still encouraged to protect your personal information (email on display) as there are lots of naughty boys and girls out there
Hi Norman,
in case you don't pick up my PM sent over the weekend: as Honey Badger says, it's advisable to change your user name as this is a public forum and you do not want to email to be inundated with spam. It's also worth protecting your and your wife's identity.

https://www.carersuk.org/forum/support- ... name-36367

Melly1 Moderator