autumn-832334_640The other day we were evaluated for our HMO's Palliative Care program.

Part of the process was to explain to me about the Advance Directive. I felt that I was being pushed to check Do Not Resuscitate. My husband had a stroke three years ago and has since been diagnosed with vascular dementia and depression. I know it will be necessary for me to do this eventually but I feel that it is too early.

I'd like to know what others have experienced concerning this issue.

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Hi Michelle-What would your husband want?\n\nAnd, here's an article that Teresa reference in regard to how doctors die:\nhttp://www.npr.org/sections/health-shots/2015/07/06/413691959/knowing-how-doctors-die-can-change-end-of-life-discussions\n\n(Just a FYI: The article notes that conversations between doctors and patients about end-of-life are not covered under Medicare. That changes in January when conversations are billable under Medicare, which hopefully means the conversations about end-of-life care will happen often.)


Hi Michelle, I'm so sorry to hear about your husband. Having a DNR is certainly a very personal decision, and certainly one that needs to be given some serious thought as medical personnel are required to act (or perhaps better stated, NOT act...) if one is in place. My Dad has always been very verbal about wanting one, and has had one in place for several years now, while my Mom did NOT want one. Dad decided to put his in place long before he had any type of illness, simply because he feels you never know when something could happen - car accident, unexpected heart attack, etc. So I guess my stance is, if you want one, it's never \"too early.\" If you are unsure if you want one in place or not, then yes, it is definitely too early - you need to come to peace with that first.\n\nGood luck in your decision, and with his care. This is a very difficult journey filled with a lot of really difficult decisions...


Oh Gosh. That is a hard decision and so is trying to figure out when is the right time.\nSo many things went through my mind in regard to your husband's situation.\nHow old is he? \nAre they treating his depression?\nAre they sure he won't progress anymore after the stroke? I've heard recovery can continue for years.\nHow did they diagnosis his dementia? Did they do CAT scan?\nHow bad is his vascular dementia? Vascular dementia can ebb and flow. (my mother in law had it and after 1-1/2 years in Hospice got better and was discharged)\nWhat is the quality of his life?\nWhat are his wishes?\n\nFor my husband in regard to his mom, the decision was very difficult. But it came down to what was best for his mom. Was he keeping her alive just because he couldn't let go? By the time he agreed to DNR she was so frail and fragile, doing any recitation probably would have been extremely painful, if not kill her. \n\nI would say there is no rush. It's a big decision and you shouldn't let anyone pressure you into it.\n