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Anticipatory Care Plan

Discussion in 'The Lounge' started by Catriona, Aug 24, 2017.

  1. LesleySM

    LesleySM Well-Known Member

    But they do it. I only found out my accident 5 minutes after Dave died that they'd filled in a DNAR form . I wasn't supposed to read his notes and barely had time to open them and see the form before the nurse snatched them off me

    A friend who is also a nurse told me I should complain as Dave wasn't competent to sign the form I should have been asked to agree to it.

    Very mixed feelings on that on one hand I'm a bit glad someone else made the decision for me, I don't know if I could have effectively signed Dave's death warrant. On the other hand I sometimes wonder if I'd been asked and said to try and save him would he have been okay? I know survival from CPR is poor but at least I would feel everything had been tried and I hadn't just given up on him
    MJB likes this.
  2. SqueamishOssifrage

    SqueamishOssifrage Well-Known Member

    My ACP is to keep my old service revolver in working condition.
  3. Footloose

    Footloose Well-Known Member

    I'm tempted to demand that I'm ever seen wearing those 'tracksuit' style pants elasticated at the bottom of the legs and around the waist or with a tie-up cord, I should immediately be humanely 'Put Down'!
  4. Learning

    Learning Ethelred the Ill-Named

    I understand that I received CPR after suffering an out of hospital VF event before my heart was rebooted with a defibrillator which was already on site. The chances are that if defibrillation had only been attempted after an ambulance crew arrived then I would have died, or worse still survived with serius brain damage. A lot depends on the cause of the failure of our systems. If that cause is temporary then CPR has some chance of working.
  5. Catriona

    Catriona Well-Known Member

    I know exactly how you feel about it Lesley.
    It's a fine line, isn't it, when doctors can decide amongst themselves whether a life is worth fighting for. My husband didn't sign one either. Three doctors got together, muttered at the end of his bed, lifted the covers and asked him to lift his legs. Since he was out of it, it was a pretty futile request.
    Then everything got switched off, he was given massive doses of drugs in his neck and he died very shortly afterwards. I try not to think what really happened was he was 'put down', but that is what happened.

    I really don't know what to do. I will delay it. Hopefully since my affairs, Will etc are with a local lawyer all should go to plan.
  6. LesleySM

    LesleySM Well-Known Member

    He had sepsis but they'd only just started him on dialysis just a few hours before they were filling in the forms and calling me with the bad news. He was actually improving most of his antibiotics had been stopped, all his U&E's where either normal or heading that way and his inflammatory markers were ditto. They day before they were telling me they just had to find out where the infection was and within 3-7 days he'd be moved to a ward and the dialysis was just because whilst his renal function was getting better it wasn't improving as much as they liked so it was to give his kidneys a break for a day or two

    And if you need CPR then an ICU is probably the best place to need it.

    I still can't shake the feeling they gave up too soon as I say at least if I had been allowed to discuss the options I would feel like I'd done everything I could but I got a call out of the blue at 6.15 in the morning and it was presented as a "done deal" they'd even switched off dialysis before I got there

    Also if I win the lottery I'm going to pay for that ICU to have more side rooms. 16-bed ICU and one relatives room where staff can meet relatives. After Dave died, I had to sit in there (yes I know I could have sat with him but I was waiting for family and trying to gather my thoughts- the odd bit was they seemed surprised when they asked if I wanted to be there when the porters took him away and I said no- like I want to see him zipped into a body bag?) and just a few feet away a doctor was telling a couple their son was out of danger. I felt so much like a mourner at a wedding feast I went for a fag
  7. steveandthedogs

    steveandthedogs Well-Known Member

    True. I know it wouldn't be binding, but it might annoy somebody!

  8. MJB

    MJB Well-Known Member

    My wife is a first-aider in the supermarket she works in. An elderly gentleman collapsed in the foyer as my wife walked into the store. She immediately started CPR after finding no pulse. Shortly after his carer appeared and started berating my wife as the gentleman had a DNR document in his wallet. Like anyone is going to start rummaging through a dying man's pockets in a public place before starting first-aid.
  9. Footloose

    Footloose Well-Known Member

    That would also be one hell of a 'tricky' situation (to put it mildly) if your wife had known about this DNR document; if she had done as per the DNR, the odds are she could have ended up being sacked, maybe then ending up as an unfair dismissal case in a Court? If the incident also surfaced on the likes of Twitter or Facebook, the Pro-Lifers and Freedom of Choice factions would have a field day!
    steveandthedogs likes this.
  10. Geren

    Geren Well-Known Member

    If it not actually the healthcare equivalent of 'power of attorney', is it actually just a little bit like a birth plan? I had a birth plan. It said that I wanted to wait for labour to start on its own. It stated that I wanted to be able to walk about during labour. It said that I only wanted gas and air. It stressed my desire for as 'natural' a birth as possible.

    One induced labour and a c/section under general anaesthetic later...
    Catriona likes this.
  11. Catriona

    Catriona Well-Known Member

    I think these actions only become important if you are lying comatose in hospital with little chance of recovering to a healthy life. Acute episodes in public are, in my opinion, in the lap of the gods. If you recover, fine. If not, then you got your wish.
  12. Catriona

    Catriona Well-Known Member

    Ha! Such is life.
    Yes, I think it is similar to that birth plan you had. However, as was shown for you, it went a bit pear-shaped and other actions were necessary.

    I mean, take an example of being cut badly in an accident and carted off to hospital.
    I certainly wouldn't want to refuse a blood transfusion if that would save my life!
    I can see is is difficult to pick out the situations where I would not want some attempt made to resuscitate me. I can only envisage the situations where I would be certain to ask, if I could, that the machines be switched off.
  13. RogerMac

    RogerMac Well-Known Member

    I carry a yellow card in my wallet saying i am on warfarin therapy and I rather hope that if I am involved in an RTA someone does go through my pockets and finds it
    Catriona likes this.
  14. MJB

    MJB Well-Known Member

    Likewise, I carry my insulin passports, but if my heart has stopped I'd rather they started CPR and let someone later down the line worry about any medication or underlying health issues.
  15. dream_police

    dream_police Well-Known Member

    Absolutely. CPR is the priority, every minute of delay vastly reduces your chances of survival.
  16. LesleySM

    LesleySM Well-Known Member

    I only carry a plastic tag on my keyring to alert anyone should I be unconscious for any reason that my pets are home alone and they should look in my purse where I have prominently displayed a yellow card detailing my cats names and the contact details for my friend Jim who has spare keys to the flat and has agreed to take my cats in if anything happens to me
  17. Malcolm_Stewart

    Malcolm_Stewart Well-Known Member

    Does anyone use " I C E " before key telephone numbers?
  18. Catriona

    Catriona Well-Known Member

    Since my neighbour rings me up if he doesn't see my blinds open before 7am - I don't need to use ICE (in case of emergencies).

    By the way - just how much data about you do you want online and accessible to ... whom? How long before this affects your treatment by health officials? How long before Insurance issues arise? What are the legal ramifications on families? Wills? Property?
    I'd like to think it would mean more spent on keeping people in their own homes. People Keeping their own homes!
    The care system is in disarray. Local cottage hospitals have gone. Centres of excellence could be far away from home. There are no efficient Local Authority care systems in place. People bed-block in hospitals because the care system can't cope. The extended family is gone.

    No, I'm too wary to add yet more fuel to the medical file.
  19. Catriona

    Catriona Well-Known Member

    It will soon be possible to enrich the core ECS data set with more detailed information required for patients with palliative care needs. The work on this Palliative Care Summary or ePCS is now being extended to support electronic sharing of Anticipatory Care Plans. Clinical leads for ECS, Palliative Care, Long Term Conditions and adults with Learning Difficulties are collaborating to reach a consensus on a common electronic Anticipatory Care Plan form that will be detailed enough to be clinically helpful, yet concise enough to be used in a variety of clinical situations.

    This electronic system will allow basic information about demography, diagnoses, drugs and allergies to be uplifted from GP systems and updated weekly. Fields such as information on current situation, care and support, recommendations and alerts for use by Out of Hours services, palliative care and end of life preferences require to be completed as and when they are relevant to the person, their situation and the stage of their condition.

    The above is an excerpt from the Scottish Government's website re ACPs.

    When does helpful information become obligatory information to be accessed by all 'interested' parties? Our input will be minimal.
  20. Malcolm_Stewart

    Malcolm_Stewart Well-Known Member

    A quick Google for "ACP" showed that most of the published stuff was based in Scotland - perhaps the rest of Britain is behind, or not as prepared in this respect, or more concerned about data breaches. Certainly, until you started this thread I'd never heard any mention.
    Catriona likes this.

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