Let me start by saying that I'm not a doctor and I'm in no way qualified to speculate in your sister-in-law's case.

Some months back, my prostate group (mainly cancer patients but also other prostate sufferers) had a guest speaker - sorry can't remember from where.  Among other things, the speaker talked about DNR notices, and how everyone as they get older should consider whether or not they want to fill in a DNR notice.  He said that most rescusitation attempts are unsuccessful and the attempt itself may cause more suffering to the patient if ribs are broken in the attempt and the patient only manages to hang on for a  few more days. (Of course, some resuscitated patients do go on to make a full recovery). 

This paragraph from the Resuscitation Council sums up the situation:

CPR involves chest compressions, delivery of high-voltage electric shocks across the chest, attempts to ventilate the lungs and injection of drugs. The likelihood of recovery varies greatly according to individual circumstances; the average proportion of people who survive following CPR is relatively low. Unfortunately, expectation of the likely success of CPR is often unrealistic. Attempting CPR carries a risk of unwanted adverse effects, which some people do not wish to take, especially if their individual likelihood of benefit from CPR is very low and likelihood of harm substantial. When the heart stops because a person is dying from an irreversible condition, attempting CPR will not prevent death; for some it may prolong or increase suffering. Healthcare professionals are aware that conversations about dying, and about whether or not CPR will be attempted are very sensitive and potentially distressing. As a consequence there has been stand-alone professional guidance on CPR decision-making since the 1990s.
 

Since the guest speaker, I've noticed that more older people are being asked to consider what they want to happen if the need arises. Personally at 63 I'm not ready to go just yet, but I may well feel differently if I ever get to 83, or I find myself in the last stages of a terminal illness. 

Food for thought, definitely. 

Hi Colleen,

The GP probably wants to discuss DNR with her while it still isn't an urgent issue and she isn't emotionally upset. He is just being thorough and is acting in her best interests. Without a DNR in place it will be assumed that she wants to be resusitated in the event of a heart attack or something similar. Some people would prefer to die of a heart attack than of cancer, he is just checking and recording whether she is one of those people. 

It is an inconvenient truth that any of us who have a Stage 4 diagnosis (including me) are more likely than the average person to be in a situation where a DNR might be useful. You shouldn't read any more into this than that the GP is doing his job properly and getting her medical record up to date.

Best wishes
Dave

Hi Dave

Thank you for your reply. I am sorry to hear of you diognosis, hope you are doing well and have a good Christmas. I found you reply reasuring and I do believe she would better making this decision while she is of sound mind. Just a shock to us all. thanks again for you reply. I will keeping my fingers crossed for you.

Regards

Colleen

Hi Colleen,

I'm doing well thanks - I was lucky enough to respond unusually well to my chemo. This will be my fifth Christmas since my diagnosis when I was told that I might not see Christmas 2013 - so every week feels like a bonus :-)

Wishing you and your family the best Christmas possible.

Dave :-) 

Hi bobbyboy

Doctors and medical workers get somewhat laid-back when it come death and illness, and hence tend to forget that the anxious patient will read far more into their words and motives than the doctors ever expect. I'm sure we've all watched in fear as the doctor pokes and prods us with a poker face, and then read far more into the silence as the doctor mulls over the diagnosis - only to be told that our illness can be cured with a short course of tablets. 

Sometimes health workers can get too matter-of-fact and forget who they're dealing with.  I recall shortly after my diagnosis, my wife freaked out in the doctor's waiting room when a video came on exhorting us to think about end of life planning. Honestly! What were they thinking??  I actually raised an informal complaint with the practice manager about this appalling lack of sensitivity and the videos were stopped. 

So, it's quite possible your sister-in-law's doctor has a prosaic and benign reason for wanting to discuss this issue fairly soon, but in our anxiety we read far more into it than was ever meant. 

That is exceelnt Dave I am happy for you. I have decided to stop worrying (for now) and enjoy Christmas with her. Hope you have a very happy Christmas

Colleen

Hi Telemando

The doctor was very caring in the way he delt with my sister-in-law. I think it was just a shock for us all. Another stark reminder I suppose. I feel a little less anxious now and will wait and see what the next doctors appointment brings. Thanks for you reply and putting things into perspective.

Colleen