Review

DNR Order and Elderly

Volume: 3 Number: 3 December 28, 2017
EN

DNR Order and Elderly

Abstract

Cardiopulmonary resuscitation is a choice that must be made between the return of life and the end of life. It is still a matter of controversy when and where cardiopulmonary resuscitation will be implemented, and this discussion has brought the "Do Not Resuscitate" order to the agenda. For this reason, "Resuscitation" and "Do Not Resuscitate" order lead to many ethical and legal dilemmas. The "Do Not Resuscitate" order, which is a difficult decision to make, becomes more difficult in the old age when ethical problems are frequent. Because of chronic diseases and deterioration in cognitive functions, the ability to make decisions about health practices of elderly individuals who are becoming increasingly dependent in terms of physical and psychosocial dimensions are also diminishing. In addition, lack of awareness, sensory/emotional barriers and communication deficits prevent elderly people from participating in health care decisions; it makes difficult to determine care target among the elderly and health professionals. Especially to be adequate to the needs of nursing care for the elderly, the problems related to "Do Not Resuscitate" instruction which is an important part of end-of-life maintenance need to be solved. For this purpose, the "Do Not Resuscitate" order should be handled by health professionals and lawyers in a versatile manner and necessary legal arrangements should be made.

Keywords

Elderly,Nursing,Do Not Resuscitate,DNR Order

References

  1. 1. Akpınar A, Ersoy N. Life-sustaining treatment: when should it be withheld or withdrawn?. Turkish Journal of Oncology 2012; 27(1):37-45.
  2. 2. American Heart Association requests that this document be cited as follows: Neumar RW, Shuster M, Callaway CW, Gent LM, Atkins DL, Bhanji F, Brooks SC, et all. Part 1: executive summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015; 132(2):315-367.
  3. 3. American Medical Association (2016). Do-Not-Resuscitate Orders. Accessed June 20, 2016, at http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion222.page.
  4. 4. American Nurses Association (2012). Nursing Care and Do Not Resuscitate (DNR) and Allow Natural Death (AND) Decisions. Ascessed February 21, 2016, at http://www.nursingworld.org/MainMenuCategories/EthicsStandard s/ Ethics-Position-Statements/Nursing-Care-and-Do-Not-Resuscitate-DNR-and-Allow-Natural-Death-Decisions.pdf.
  5. 5. Association of PeriOperative Nurses (2010). AORN position statement on perioperative care of patients with do-not-resuscitate or allow-natural-death orders. Accessed 12 February, 2016, at http://www.aorn.org/PracticeResources/ AORNPositionStatements/.
  6. 6. Cherniac EP. Increasing use of DNR orders in the elderly worldwide: whose choice is it? J Med Ethics 2002; 28:303-307.
  7. 7. Chevaux F, Gagliano M, Waeber G, Marques-Vidal P, Schwab M. Patients' characteristics associated with the decision of “do not attempt cardiopulmonary resuscitation” order in a Swiss hospital. Eur J Intern Med 2015; 26(5):311-316.
  8. 8. Cicekci F, Atıcı SS. The evaluation of the results of cardiopulmoner resusitation associated with code-blue. Genel Tıp Dergisi 2013; 23(3):70-76.
  9. 9. Fadıloğlu C. Advance directive in geriatrics. Ege Journal of Medicine 2014; 53(10):48-52.
  10. 10. van de Glind EM, van Munster BC, van de Wetering FT, van Delden JJ, Scholten RJ, Hooft L. Pre-arrest predictors of survival after resuscitation from out-of-hospital cardiac arrest in the elderly a systematic review. BMC Geriatrics 2013; 13(1):1.
Vancouver
1.Burcu Çuvalcı, Sevilay Hintistan. DNR Order and Elderly. Mid Blac Sea J Health Sci. 2017 Dec. 1;3(3):32-40. doi:10.19127/mbsjohs.338904