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DeathDear Carol: My family is having a serious disagreement over signing papers for our mom who has just entered a nursing home. I have Power Of Attorney and am favor of signing a Do Not Resuscitate (DNR) form for Mom. She has always told us she didn’t want to linger when her time came. While she is going into the nursing home for physical, she is showing some signs of early stage dementia so it’s important that we get this done. My brother and sister both think that a DNR is cruel and that it’s like killing Mom. They think that everything should be done to keep her alive as long as possible. Her POA even states that she doesn’t want to be kept alive at all cost. Because of this, I think I can push through the DNR, but I feel bad because my siblings are upset. I know that they don’t want to see Mom suffer unnecessarily but they feel guilty taking this formal step. How do I get through to them that there’s a point where people allowed to go? CD

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Wonderful, Linda! Sometimes having someone outside of the family explains helps. The family dynamics can get in the way of a clear head. I'm glad it worked out for you.

Dear CD,

I was my Mom's POA for Health Care. When she was in a nursing home, we had a meeting with one of the advisors there to discuss the DNR they would have on file. I invited my siblings, stressing how important it was. My sister didn't show up and my brother got there an hour late, after it had been discussed and Mom had decided and signed.

The advisor had gone over each item (intubating, dialysis, resuscitation, etc.) and explained them to Mom until she understood. It was amazing to watch this professional. She was so aware and understanding of Mom's Alzheimer's and could tell when she understood or was confused! Each item was a separate "Yes" or "No" answer, and she went over them one at a time. When we were done, she explained that Mom had answered as many people do, "No" for the invasive procedures. Her answers weren't unreasonable.

Mom got tired & I wheeled her to Bingo in the dining hall. Then my brother got there. The advisor explained to him what was decided and how, and that she believed (and I agreed) Mom understood. He saw the document and was given a copy.

Fast forward six months to Mom being in hospital due to bladder cancer and sepsis. All three of us were there and they were asking about intubating Mom. All the staff knew I was the POA. My brother in law (who abuses my sister) started arguing that Mom couldn't have understood making that "No" decision. This ... from the man who for over 10 years kept claiming nothing was wrong with Mom.

Anyway, as he and my sibs were discussing this, I stepped away to speak with the nurse who would be doing the procedure. I explained there were extreme family dynamics involved and she asked me what I wanted her to tell them. I said, "the truth." Then she went back to explain it to them.

It was absolutely one of the hardest, most heart-wrenching moments of my life ... stepping away to let them come to an understanding about it. But I was prepared to pull POA to enforce the DNR, if necessary. Fortunately, when the time came, I didn't have to. They were able to listen to the professional and ultimately realized it wouldn't change the impending outcome.

I don't know if my experience will help you or not, but I am praying and hoping you and your family will come to agreement.

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