In 2000, my high school hosted a class reunion for all of its twentieth-century graduating classes. It was actually attended by some folks who graduated in the late 1920s; everyone from my graduating class of 1958 was about 60 years old at the time of the reunion.
As we sat around tables with “1958” on a little flag, one of the first questions we had for each other was whether our parents were still alive. Many folks were clearly concerned about how to deal with aging parents.
Through the miracle of the Internet, I stayed reconnected with many of my classmates, and the issue of parents in nursing homes or assisted-living facilities became a recurring theme. Shopping for Medicare supplementary insurance, considering when to take away dad’s car keys, and helping the surviving parent when the other dies became common discussions. Many of us were not only looking after our own affairs, but also the financial and life issues of our parents as well.
The goal of our Money Forever newsletter is to help our readers have enough money to last the rest of their lives, and sometimes that means addressing “life issues” by sharing experiences of people who are a little ahead on the learning curve.
When my wife and I were married in the late ‘80s, her father was in the advanced stages of Parkinson’s. After asking his permission to marry his daughter and promising to take care of his girls (wife, daughter, and granddaughter), he reached out, trembling, to shake my hand. By that time, almost anything that touched his hands and feet caused him severe pain. When my wife trimmed his fingernails and toenails, this once proud man would cry out in pain.
We moved the wedding to the nursing home chapel, which was the least we could do for such a fine man. The staff wheeled his bed into the small chapel and we all crowded in for the marriage ceremony. My wife snuck him a piece of cake when we went back to see him the next day. He had a feeding tube, but he managed to swallow a few small pieces of cake and icing with a huge smile on his face.
A few weeks later his suffering stopped, and mercifully he passed away. After the funeral my wife mentioned, “That’s actually the second time Daddy died.”
“Huh, he died twice?” It seems he had a heart attack and died, but then they zapped him with the paddles and revived him. My wife mentioned that they had a “DNR,” but it was ignored. What the heck is a DNR?
A DNR– Do Not Resuscitate – is a form that notifies emergency medical personnel that they should not bring you back to life. My father-in-law had one ever since his Parkinson’s progressed to its final stages. I asked why it had been ignored. My wife assumed it was because it hadn’t been filled out properly. Even though he’d lived three more years and seen his daughter remarry, he’d endured three more years of terrible suffering, and we wanted to learn from that experience.
Almost a decade later, my stepfather moved into an assisted-living facility. He was 90 and had all his mental faculties, but couldn’t drive or live on his own. We brought up the DNR issue, signed all of the proper forms, and the administrator of the facility told us everything was in order – so I thought, “OK, good; we got them filled out right this time.”
About three years later, we got an emergency call that Dad was in the hospital. We raced to the hospital and discovered he’d passed out in the assisted-living facility. They had called 911, and he was rushed to the hospital in an ambulance. He was awake and alert when we arrived, and I asked what happened. He told me that he was walking down to have lunch when he thought he was a little tired. He stopped to rest, sitting on a piano bench in an alcove in the hall. The next thing he remembers was being in an ambulance with an emergency responder screaming at him and zapping him with the paddles like you see on TV. Sounded to me like he was revived just like my father-in-law had been years ago.
The doctor came in, examined Dad, and looked at all his charts. He said there was nothing medically they could do for him and suggested hospice care, meaning death was imminent. We all signed the necessary forms and were told he’d be transported to the hospice facility the following Monday.
Then I went down to the emergency room of the hospital to find out what had happened with Dad’s DNR. The head of the emergency room nursing gave me quite an education.
From there I went to the assisted-living facility to ask the same administrator what had gone wrong with the DNR we had filled out and signed – with her assistance and reassurances – a few years earlier.
She thumbed through his file for about ten minutes, and when she got almost to the bottom she pronounced, “Here it is!” very proudly.
I then proceeded to tell her the folks in the emergency room said that the DNR must be displayed where they can immediately find it – a copy over the head of the patient’s bed and on the back of the door as a minimum. The emergency personnel are not going to search around for it. If they do not see it, they are going to do their job and revive the patient, which indeed they did.
At that point I told her the story about what Dad last remembered, thinking he would take a rest and sit on a piano bench. I then asked the lady, “Wouldn’t that be a peaceful, wonderful way to die?” I proceeded to tell her he was now in the hospital, very frightened, and knowing that next Monday he was headed to hospice to die. I told the administrator that because of their ineptitude, they took his peaceful death away from him. I stopped and let her reflect on that for a moment, as she was truly concerned – maybe about Dad or maybe about a lawsuit.
We didn’t sue, but I did point out to her that she likely has the same problem with every person they have in the facility, and they better doggone sure get with theEMTpeople to get it corrected.
Dad died shortly thereafter, peacefully in his sleep. He never made it to hospice. We came back to clean out his room. I was assured that the situation had been dealt with, and she showed me evidence of what was now displayed in many of the other patients’ rooms.
Here’s what I learned. Each state and area is different. Several of our friends asked us about our experiences and how they might handle the situation as they were putting their parents in a home. At our suggestion many went to the emergency room at the local hospital and over to the fire station where the ambulances are housed, and did their due diligence regarding the proper procedures for a DNR. They did not want to experience what my wife and I and our fathers had gone through. I strongly suggest that if anyone is thinking about a family member or friend going into a home, do your homework locally. I cannot emphasize enough, after seeing both of our fathers endure both physical and emotional suffering that you need to do your homework.
One of our friends mentioned to us, after doing her research, that had we done everything the nurse in the ER told us, they still would have revived Dad. He was sitting on a bench 150 feet from his room, and there was no way they would have run down to his room and searched for a piece of paper. She is probably right. Our friend ordered a MedicAlert bracelet for her father with DNR instructions clearly engraved. The DNR instructions for emergency personnel must be proper and immediately available. It was less than a year later that she called us to thank us. They got it right!
Retiree advocate Dennis Miller saved his own retirement by working with investment experts to develop a strategy that significantly outperforms today’s puny interest rates. Every week he shares his experiences in retirement and offers timely investment insights in his free e-letter, Miller’s Money Weekly. To learn more, click here