Too difficult to believe

After the government won the vote on school dinners this week and the way they conducted the local authorities discussion on tier three.
No, I would not be surprised!

Windrush, brexit, cladding, Russian influence, austerity, that has put us in more debt, the u-turns, and so on.

Never mind food banks, and finally the care homes fiasco.

In my part of the world, they are already getting frail and vulnerable people to sign DNR forms which ensure they do not see the working end of a ventilator They have gone round the care homes and the special schools, and also those in receipt of Adult Services care packages at home. The GP's are next to be visited.

The excuse is that ventilators are brutal pieces of equipment that cause more damage than cure. They will, however, use oxygen and CPAP equipment but that does not need intensive care admission and is done in a normal ward.

I was given this treatment last year where they took a nebulizer and connected it to the O2 supply and it worked for me. From what I understand, using a ventilator requires a coma to be chemically induced and this also carries great risk.

I am going to stick my neck out and say that decisions will have to be made on the viability of ventilating someone. This is reality and the same as making clinical decisions with any other medical procedure. What is the point of ventilating someone who will be dying anyway, or is at more risk of death due to ventilation?
I write this as an obese asthmatic who knows that my chances of being first in line for a ventilator are virtually nil.
I see nothing terrible about them making provision for having a difficult tick list of things to think about when choosing whether to ventilate or not, or any other procedure.
Knowing the consequences and possible outcomes of ventilation, for example, means people have the opportunity to make an informed decision beforehand, just as we do with other conditions.
Why is it considered sinister? The sinister thing would be to make those decisions with no previous discussion with people who are vulnerable.
I cant see the medical staff going along with involuntary euthanasia (murder) on behalf of the government - I think that goes too far and is against all we have seen so far from the medics.
DNR discussions are nothing new. Cancer patients and others with critical illnesses or incurable conditions have had to deal with the discussion for decades, including people I know.

So what am I missing here - I want fact, not speculation and alarmism on this one.

PS Ventilation, like CPR can do more harm than good with frail elderly patients.

These decisions are made all of the time not just for Covid patients. There sometimes comes a point when further medical intervention is not going to help the patient and, TBH, some patients have signed DNRs that the medical staff, and the patients families, have to honour. It is difficult but we have to accept that not everyone will make it despite everybody’s best efforts. There also seems to conspiracy theories everywhere which are making a stressful situation worse. This time last year nobody could have envisaged the Covid crisis and its affect on the worlds population and it’s unfortunate timing that it’s coincided with the Brexit negations etc and causing the UK and EU government officials to be sidetracked. It’s also true that the worlds economies inc the UKs’ will be in debt for a number of years but what is the alternative? I don’t envy them but wish them luck!!

DCUKMod said:

Oldvatr, who are "they"?

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Care homes, Govt and NHS?

https://www.ageuk.org.uk/latest-press/articles/2020/04/age-uk-response-to-dnr-forms/

https://www.amnesty.org/en/latest/n...government-failures-during-covid-19-pandemic/

https://www.telegraph.co.uk/news/20...-blanket-do-not-resuscitate-orders-residents/

Was all over the news at the start of the pandemic although interestingly harder to find these days...

It's only a conspiracy theory whilst "theoretical" ...

Daphne917 said:

These decisions are made all of the time not just for Covid patients. There sometimes comes a point when further medical intervention is not going to help the patient and, TBH, some patients have signed DNRs that the medical staff, and the patients families, have to honour. It is difficult but we have to accept that not everyone will make it despite everybody’s best efforts. There also seems to conspiracy theories everywhere which are making a stressful situation worse. This time last year nobody could have envisaged the Covid crisis and its affect on the worlds population and it’s unfortunate timing that it’s coincided with the Brexit negations etc and causing the UK and EU government officials to be sidetracked. It’s also true that the worlds economies inc the UKs’ will be in debt for a number of years but what is the alternative? I don’t envy them but wish them luck!!

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I agree but I just hope they don't start lowering the threshold specifically in relation to Covid or we'll be lucky to get a ventilator if required once we hit 60!

DCUKMod said:

Oldvatr, who are "they"?

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The local health authority at the County level. i.e. the CCG. My wife was persuaded to sign one while in hospital for a chronic condition (COPD) and this determined her care from that moment on. When we called the ambulance then their records showed this and they were then limited in their treatment.

Oldvatr said:

In my part of the world, they are already getting frail and vulnerable people to sign DNR forms which ensure they do not see the working end of a ventilator They have gone round the care homes and the special schools, and also those in receipt of Adult Services care packages at home. The GP's are next to be visited.

The excuse is that ventilators are brutal pieces of equipment that cause more damage than cure. They will, however, use oxygen and CPAP equipment but that does not need intensive care admission and is done in a normal ward.

I was given this treatment last year where they took a nebulizer and connected it to the O2 supply and it worked for me. From what I understand, using a ventilator requires a coma to be chemically induced and this also carries great risk.

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My own experience of DNAR forms is as follows.
My Aunt aged 94 had mild dementia and in September 2019 she had a dementia check and was said to be capable of making her own decisions and I was to allow her to do that, even if I thought the decisions were the wrong ones. Even though I held a Health and Welfare Power of Attorney I could not enforce my wishes onto her until she was adjudged to be incapable of making her own decisions. I asked the dementia nurse if I could, for instance, order Meals on Wheels for her and the answer was no, not if she doesn't want therm. To which my Aunt said 'I don't' lol

In November 2019 nothing had changed with her mental health but she had a minor fall at home and was taken to hospital. When she was discharged there was a DNAR form with her discharge notes. It had been completed by a hospital doctor who had ticked the boxes to say that my aunt had dementia and was incapable of signing her own form, that there was no Power of Attorney and no next of kin. To say I was shocked is an understatement. I had had many calls from the hospital about her care, each one saying that she had said I was her next of kin. She had provided them with my name and phone number herself. I asked her about the form and she said she had told them she didn't want to bother with that because the Power of Attorney (that she had signed 9 years previously) stated that I was to make any of these decisions on her behalf.

My aunt suffered another fall a month later. When she was discharged there was another DNAR form signed by a different doctor. I telephoned her own GP and arranged to complete a new one with him. She fully understood what she was doing and was quite capable of making that decision. The 3 of us thought the time was right to do it.

Why did I bother getting a new one signed? Because wherever possible this has to be the patients own choice. I could foresee a situation where this might happen to a different old lady who changed her mind and later wanted to cancel the DNAR, maybe she would want to live long enough to see her relatives one last time etc. By writing that the elderly have dementia and can't make their own decisions ( and therefore can't overturn the DNAR) when this is patently not true is to my mind a criminal act. How can it be right that I was a legal attorney and couldn't force my will onto her yet a doctor could falsify forms and overturn her wishes at the drop of a hat?

So from the hospital doctors' point of view my aunt had no hope of coming through a reasonably bad illness yet....

I put my aunt's details into the risk calculator from this thread.

https://www.diabetes.co.uk/forum/threads/diabetes-specific-risk-calculator.177539/

According to that she had a 1 in 13 chance of dying of Covid and a 1 in 19 chance of needing a hospital admission.
Well she only survived with Covid for 5 days and at the onset I would have put her risk of dying of it at something like 19 out of 20.

So I don't believe the Q risk score is accurate, it plays down the real risks. Surely being 94 in itself is a higher than 1 in 13 chance of dying of Covid? Then add the heart failure and other conditions...who are 'they' kidding? Too much reliance on algorithms and not enough common sense? Or lulling us into a false sense of security?

ianf0ster said:

The thing I find scary about all this is that:
1. The Nightingale hospitals were hardly used, so there should have been no reason to restrict ICU admission purely by age.
2. They apparently often didn't even admit the over 80's to non-ICU wards and try them on CPAP - preferring to neglect them completely!

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This is just my speculation, but I dont think they have enough medical people to staff the nightingale hospitals for seriously ill patients.

The NHS closed its doors to very many people, covid sufferers, cancer patients, people needing operations etc. How is this not being overwhelmed? People were told to stay at home to save the NHS. Some died because of this.I thought the NHS was meant to heal the sick, not turn them away in droves to give some warped illusion of coping. So fed up with this government.

Please, please everyone think carefully before you sign a DNAR form. In the old days it used to mean ' if I die, don't bring me back'. There's more to it nowadays.

zand said:

Please, please everyone think carefully before you sign a DNAR form. In the old days it used to mean ' if I die, don't bring me back'. There's more to it nowadays.

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Would you mind expanding on this please?