I lost my grandmother about a month ago. While we were sad at her funeral, it was as much a relief as anything- one family member joked, "if she were a dog, we would have put her down months ago." She was in pain, in a nursing home, in diapers, and had little clue what was going on around her. It wasn't really her laying in that nursing home bed the last time I visited her in June. We all knew she would never make it out of the nursing home. Fortunately, it didn't last that long.
Shortly thereafter I sat in on a CE class regarding CPR initiatives. And I have to say that I didn't pay much attention in class. I spent most of my time wondering if it's right to be resuscitating many of the people we resuscitate.
While my medical director correctly pointed out that it's not my job to judge who gets resuscitated and who doesn't (which wasn't entirely my implication, but he's right, nonetheless), having been through a recent loss that was actually more comforting than any other loss I've ever experienced, I'm not convinced that paramedics should be resuscitating everyone. I don't know the best way to make this happen, other than to encourage people to think about it early.
I'm a bit hypocritical though. While I've talked with my husband and mom about it, I don't have anything in writing saying what my final wishes are. At 27 years old, I know that if there is no chance of me surviving an event without a majority return of function, I'd like to be allowed to die with dignity. But without it written down, would my family respect my wishes? Would they feel greedy NOT giving me every opportunity to survive? Would they feel guilty for making decisions on my behalf, and assume that I want everything done to keep me alive, regardless of what I have told them?
I hope not. But it happens. And that's why we have double-sequential cardioversion, an ungodly number of drugs, and are now back to working arrests for hours. Unfortunately, a majority of these arrests will occur in nursing homes, or in private homes of patients who, if they had been asked right before they died, would probably rather have been left peacefully- not have ribs violently cracked with CPR, not have a breathing tube shoved down their throat, and not costing their loved ones grief, shattered hope, and lots of money. Or, worse, they're resuscitated but with a brain injury, and now live as vegetables in a nursing home, never to be functional again.
