The most important ‘What if…?’ question

An important part of Caring is thinking through the ‘What if…?’ questions.

I was reminded of this in an interesting programme on Radio 4. It was with Joan Bakewell talking about End-of-Life Care. Specifically, how to make sure that the emergency services carry out your loved one’s wishes.

One example was a lady whose Mother had a nice supper. Then, forgetting she’d had it, had another nice supper. A couple of hours later unexpected, and peacefully, she passed in her daughter’s arms. But the ambulance had already been called and the paramedics had arrived.

Now, bear in mind they didn’t know the lady, and their job is to save lives. So, one of them immediately went back to the ambulance to get the resuscitation kit. The lady said she didn’t want that for her Mother, but their answer was “it’s what we do”.

The only reason she was able to stop them trying to resuscitate her Mother, was because she was able to show them her Enduring Power of Attorney document which she had ready access to. This meant she had the authority to make decisions about her Mother’s treatment; and the resuscitation was abandoned.

Enduring Power of Attorney and a Do Not Attempt Resuscitation form, also known as a Living Will, are readily available online or through a solicitor and your GP can also explain what it means. These are important things to consider with a loved one you are caring for, while they are still of clear mind.

CPR (cardiopulmonary resuscitation), especially where defibrillator paddles are used on the chest, is a brutal intervention; and the figures for being discharged following CPR are not what the television dramas would have us believe. The chances of broken ribs are particularly high, especially if the patient is already frail, and a prolonged time in intensive care is likely. It’s also very distressing to witness. However, unless you have the authority to make such a decision for the person you are caring for, the paramedics have no option but to carry out CPR.

Even if you do have these forms, where are they? If you were faced with this situation and you can’t produce them, then you have no authority still. Having them in a ‘special place’ is all well and good as long as the paramedics know where the special place is. Your region may have a scheme – such as The Red Bag, or a tin – for such things and paramedics know to look for this. But, we’re talking minutes here, and they haven’t got time to hunt for something that may or may not exist.

You can stick labels all over the house, one on the coffee table, one on the television etc., telling of its existence and where it is, but supposing you’re out of the house? You have to actually be able to produce it there and then.

Until such time there is a central database where this information is recorded, it’s down to you; and accessibility and speed are of the essence.

You may think it’s difficult to address these things with your parents and, hopefully, you’ll never need them, but it’s a conversation well worth having and acting on. I’ve known parents who were only too pleased, and reassured, that someone they trust is going to be in charge when it matters most and did ask the question “What if the paramedics or doctors want to give you CPR?”.

If you are in the process of thinking about the ‘What if…?’ questions for the ones you care for and are struggling with how to deal with them, please feel free to contact me to see how I can help.

I wish you well.

Caroline