Trying to decide whether or not our 99-year-old mom should be DNR. She's in fairly good health but mainly concerned about her ribs being broken and physical pain if she had an event that required resuscitation. Shes 4 feet 10 inches and weighs approx 110. Looking for anyone with personal experience with elderly resuscitation.
As a ( now retired) nurse I did CPR more often 35 years ago on the elderly than the last 20 years of my career , because it was learned that it does not work . On the rare occasion it worked , people were left with a poor quality of life . I’ll get to more on that later . But this is why it has become more common for the elderly to choose DNR .
When a 99 year old’s heart stops it’s most likely not going to start again . I’ve done CPR on little old ladies in their 90’s
Their rib cage is like pressing on a bag of pretzels or potato chips , I would hear the ribs breaking .
I have done CPR on some “ younger than 99 “ old people who survived only because they were already in the hospital where you had the medications , oxygen etc .
However , it took a lot out of them . They had , pain from broken ribs etc . Many never fully recovered , very weak , ended up in a nursing home anyway . Many would also often end up having a stroke soon after CPR . Or had brain damage from oxygen deficit before and during CPR . Some who survived never regained consciousness , ended up on a ventilator brain dead , not able to breathe on their own . We used to say they were unlucky to have survived .
If it was my 99 year old Mom I would let her leave her very long life in peace , letting her have a natural death .
CPR is rarely like in the movies .
CPR works best when the victim's heart has stopped due to a "non-medical" reason - ie. drowning, electrocution, being struck in the chest at that exact wrong millisecond in the cycle of the heart's beating (like Damar Hamlin of the Buffalo Bills), etc. At 99, chances are the health issue that stops your mom's heart will not be able to be reversed by resuscitation, or defibrillation, or anything of that nature. If her heart shuts down because her body is failing, you can have a medical team of EMT's, nurses and a cardiologist standing right next to her, and it likely won't make any difference.
Does mom have cognitive decline? If not, what does SHE think of the idea of a DNR? My mom had CHF, and happily and willingly signed off on a DNR, because she understood her heart was failing, and all of the pounding on her chest was not going to "cure" that. Your concerns about the damage CPR can do - especially to an elderly person - are valid, but if mom is still of sound mind, it is ultimately her decision. The only thing you can do is mention the possible damage and pain she might likely endure if she has CPR performed on her, and then let her decide.
There is a good possibility the sternum will be fractured.
There is a good possibility that when the ribs are broken one of the broken ribs might puncture a lung.
IF she survives the episode that results in CPR being done will she recover from broken ribs and maybe a punctured lung.
Personally I would not want CPR done if I were 99 years old and 110 pounds
I think you might want to stop at your local Fire Department and ask one of the Paramedics what they would do if this were their mom. I would bet that the answer would be no CPR.
Actually a POLST (goes by other names in some States) but the POLST is more detailed in giving directions as to what should or should not be done.
Life is hard enough, let alone when I’m frail with broken ribs.