Thursday, June 15, 2017

Dad was a good man, he loved people, he cared, I loved him, and his caregivers loved him. Though he was 90, unable to speak, suffering dementia and handicapped in various ways, this so called doctor interpreted. “Vegetable” had enough brains, awareness, connected to feeling, and still maintained the ability to “devise” creative ways to communicate, to express his love, his deep gratitude to those around him. ---------Wang said her father’s diagnosis of bronchiectasis — a condition that leads to gradual deterioration of the lungs — was chronic but it wasn’t terminal.---------

Julie Ali

The failure of the system is pretty clear. The DNR order is usually not told to the family. In my handicapped sister's case I was puzzled why I was getting a phone call at home about the resuscitation of my sister from emergency doctors about resuscitation. Why did the Grey Nuns Hospital doctor not have the Green Sleeve with the resuscitation order plainly spelled out? Actually the doctor did have the code order she just wanted to get me to indicate otherwise in my opinion. And why would she want me to do this? So she would not have to put the DNR in and then have the problem of this woman in BC who was apparently not told.
The thing is that there are doctors who put these orders in and who has the medical records? We don't of course. Sure there is a need for documentation of this sort of decision signed by all concerned. If not the doctor has no proof in my mind of ever telling the family.
Also why did he reverse his DNR upon the family wishes if he had told them about the order and then got the back up from the health authority for this decision? Curious.
In any case it is a bad end of life scenario. A man dies horribly. A daughter is traumatized. The doctor has to go through review and although everyone believes him why does no one also believe the daughter? Also curious.
Meanwhile we all get to find out the reality of end of life situations that aren't pretty because no one has intelligently looked at these issues and thought about patient and family rights. This issue is being seeing through the lens of power and the medical establishment. Better look with a wider lens folks. We're the patients and the patient families and we want our voices heard.
Lori Wang will never forget the image of her 84-year-old father gasping and choking on his own blood while in cardiac arrest, and her desperate attempts to get staff at…
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we are the patients and their families / but we are powerless

and lift yourself
from powerlessness
say the words of all patients
and their advocates

this too will change

and make a way
so that in the future
all of us
will have rights and are not abused

this too will change

and teach the caregiver organizations
about their responsibilities
to their residents
tell them to follow the standards of care

this too will change

and do not give up
from our voices spoken in unison
comes the political action
that will alter our powerlessness

this too will change

and say the words clearly to all of them
we must be treated with respect
do not treat us like the last in the line
we are the ones who pay for the entire system but we are ignored

this too will change

rise up from your silence
and say the words that must be said
we are the patients and their families
but we are powerless

this too will change

Julie Ali
Just now
 #Euthanasia #PrematureTermination---Why do doctors have the right to withhold care to citizens-especially citizens with handicaps, dementia and chronic illness?
When resuscitation can restore a person to life why would the resuscitation be denied?
When a DNR order is placed on a patient--you can now go through a dispute process that is internal to AHS. I have no faith in this dispute process.
The only recourse then would be the court system and if your family member is having a heart attack when are you to go to court?
This sort of end of life fiasco needs to be reviewed by the government in every part of Canada.
Doctors are not gods.
Patients need rights and external to the health authority and health ministry appeals process.
We want our voices to be heard and not ignored.
We're the patients and their families.
We will be heard --and we will change the system.

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Beloved Father File:02 I’m writing this letter at 4:00 AM because I haven’t been able to sleep.
My Father, John Lisowy, died in the early hours of Feb 3, 2004.
He was being cared for in our home when he developed a wet cough (The Flu). He was suffering dementia, had his leg recently amputated some months previous had overcome some health concerns in his recovery. He wasn’t speaking, he had to be fed, but a week prior, he managed to take the hand of his caregiver, raise it to his lips and kiss the caregiver’s hand in order to show his love, respect and gratitude.
My 26 year old innocent daughter became concerned that Grampa needed some medical attention for his cough, started yelling at me, and became insistent I take him to see a doctor so they could start him on some antibiotics fearing the cough if left untreated might develop into pneumonia. I called all day trying to find a doctor that might make a home visit but in the end, had to opt for the services of the doctors at the hospital.
The folks at emergency confirmed that indeed it appeared to be an early onset of some respiratory problem, put dad on intravenous liquids and said they would begin medication. He was admitted then transferred to a room upstairs. Believing dad was in competent caring hands, I relaxed, but the following evening I was surprised to hear that no medication had even been initiated. Asking what the reason for this un-necessary delay was, I was given some poor excuse by a nervous nurse that tried to avoid eye contract. “Tests are pending” she said, “but still have not been ordered” adding that “hospitals operate more slowly”.
I spoke with Dr. Game and insisted he be started on antibiotics before his condition deteriorated, and could he please have some expectorant for flem. I also added that dad probably could use a Tylenol to ease discomfort. Instead a young attendant came by with a Morphine needle. I was surprised that morphine was prescribed him as I understood it is only used in extreme cases of pain. Uneasy, I trusted the doctor’s judgement.
An hour later my dad was thrashing. Battling, I’m assuming it was because he began feeling his lungs filling, his larynx seizing and breath constricting. He fought for his life. At 10:00 pm, dad’s salaried caregiver and her son left his bedside.
The next morning I was informed that Father died in the early hours. They explained that his breathing had become difficult, had slowed further and further until he could breathe no more. In other words, he slowly suffocated to death. His death would have been more merciful had I put a pillow over his face, but that’s murder.
If a doctor prescribes Morphine, the nurse injects it, it’s called “medicine (something good for you) and can be justified because it was carried out by a qualified “physician”. I thanked Jennifer, the one who called to announce my dads passing but I know, and I know that they know, that what Dr. Game had done to my Father was in fact initiate a Morphine death. “A doctor prescribed Euthanasia”. I’m well informed, have access to health information via Internet. I have since confirmed my suspicions through reading side affects of morphine in “The Essential Guide to Prescription Drugs”. One only needs to type in “Morphine Euthanasia” on the web and you begin to realize the enormity of the problem, that your story is only one of many. My dad wasn’t in pain, or fever. He had onset of some bronchial condition. I can’t for one moment believe that Doctors in a hospital are unaware of “Precautionary Warning” regard the proper use of Morphine.
When I opened my dad’s mouth to look inside, I saw his mouth was full of a mushy porridge like substance. It was no longer cohesive flem the kind you cough up with a chest cold. It was unlike anything I had ever seen. Contrary to what we want to believe about Morphine, my Dad did not go gently into the night.
Morphine: CAUTION: If you have asthma, bronchitis or emphysema, this drug may cause significant respiratory difficulty, thickening of bronchial secretions and suppression of coughing. Serious Adverse Affects: • Swelling of throat, vocal chords, spasm of larynx and bronchial tubes • Hallucinations, Psychosis, Disorientation, tremor and muscle twitching • Drop in blood pressure • Seizures

I can’t bear to imagine the heart gripping terror my dad must have experienced when he realized something was going terribly wrong. He was always afraid of hospitals, needles. Now I have good reason to fear. Today I have a heavy heart and very mixed feelings. At 90, life didn’t owe dad anything. He was living on borrowed time. Still, I have this nagging feeling that somehow I had betrayed dad by delivering him into the hands of death. I myself feel uneasy, I feel tricked and betrayed. I’m not going to pursue dad’s “death by morphine injection” for the purpose of extracting revenge, but I just needed to share this.
When does it make it right for the medical profession to Euthanize? Does a senior with onset of bronchitis, reason enough to terminate a life. Who decides? Who gave doctors the licence to kill? I have a lot of questions and sleepless thoughts. “Maybe I should have, shouldn’t have”. If only I knew. The hospital is no longer the safe refuge it seemed. Doctors are capable of evasion and deceit. Is the world different today or is it just me? Yesterday I was naïve, trusting. Today I struggle with feelings of confusion, apprehension. There’s no easy answer, but I did need to get out of my sleepless bed and share my experience with the world.
Dad was a good man, he loved people, he cared, I loved him, and his caregivers loved him. Though he was 90, unable to speak, suffering dementia and handicapped in various ways, this so called doctor interpreted. “Vegetable” had enough brains, awareness, connected to feeling, and still maintained the ability to “devise” creative ways to communicate, to express his love, his deep gratitude to those around him.
PS: I asked to have a short version of this letter printed in “Letters to the Editor” of our local newspaper (leaving out specific names of course). They responded: “Dear Stephanie” “My condolences on the loss of your father but we really can’t run a letter containing such serious allegations. Perhaps you could raise your concerns with the hospital, AMA or the Health Ministry”. I Laughed. It seems that Euthanasia at grass roots level reporting in an uncomfortable topic even for Journalists whose mission is to uncover and report “The Truth”. I think I would get a better reception at the local police station. Then it would just die in someone’s file and I would be flagged as “a crazy and dismissed”. This makes anyone want to consider keeping a loaded gun by their bed as an alternative to being pleasantly murdered in a hospital the way my father was. This is the joke. In writing this article, I have no bitterness, no need for revenge; I don’t even outright condemn “Euthanasia” because perhaps in some “severe individual by individual cases where pain is so unbearable” it’s clearly the compassionate thing to do. My intention in writing this account is to drag this subject out of the clandestine and place it in the light. To initiate discussion, initiate clear guidelines and brainstorm solutions. My Father’s death is not a “personal family matter”. It affects all of us and our quality of life. It affects our Social Conscience, affects our Human Dignity. It affects our ability to Trust. If we’re going to use our hospitals as slaughter houses for our weak and elderly seniors then maybe we should talk about authorizing some humane forms of euthanasia instead of injecting a man with onset of bronchitis with morphine then waiting until the drug causes him to slowly drown, gag and choke on his own bronchial secretions, together with seizures. I have a need to know how many hours it took for my dad to die from the time he was first administered the lethal dose of morphine by a qualified physician at the hospital. Stephanie Baziuk
Thank you Dido For all the little things From: ===== Thank you Dido for tucking me in at night when you babysat me so many times, so long ago. I would watch you make my bed meticulously, folding in all the corners, making sure it was a bed fit for a princess. You always made me feel loved when you kissed me on the forehead and said goodnight. In the morning you would wake me up with a cup of hot chocolate and one of your famous homemade dill pickles. A strange combination of taste I still crave today. Thank you Dido for fixing my bike and my shoes all the time. You were better than any shoe smith, and your handiness always made everything run so smoothly. Thank you Dido for taking Ene, my friend Christy, and me to the lake every summer. Those memories of you walking the beach chatting with everyone are some of the dearest I hold because they revealed your soul. Kind, friendly, and so sociable. You knew every person by first name by the end of the day on the beech. Thank you Dido for letting me sit on your lap while you drove the car, letting me control the wheel down the side roads. For fun and for freedom, it was more adventure than any 7 year old could have asked for. Maybe your very early driving lessons are the reason I’ve never had and accident. Thank you Dido for always making sure I looked like a shiny penny. You took pride in seeing your grandkids looking polished. I enjoyed every shopping trip with you, and holding your hand as we walked through Woodward’s. Thank you Dido for the secret “top drawer” of your dresser, where you kept treats and gifts for Ene and me. I think you did an amazing job spoiling everyone. You gave from the heart, and I felt it every time. Thank you Dido for the gift you put aside for me for my wedding some day. The love you showed me surpassed your time on this Earth. This is very special to me. I could go on Dido thanking you forever and I will. I could never run out of something nice to say about you. I’m so glad that I was able to spend some time with you, and care for you a little in the last few months of your life. My care could only reciprocate a tiny portion of the patience you always showed me and everyone. I’m relieved that you are free from suffering now and that you are in God’s hands. You gave so many beautiful memories. The values you instilled in us will always serve as a reminder of the exceptional Dido you were. Your love will live in our hearts. Love =====
Seniors' families swamp researcher with nursing-home complaints
By Larry Johnsrude
The Edmonton Journal, August 21, 2003
Stephanie Baziuk has provided her 90-year-old father, John Lisowy, with care and love within her home.
EDMONTON - After watching her father's health deteriorate in a nursing home, Stephanie Baziuk thought there had to be a better way for him to live out his final years.
She pulled her 90-year-old father, John Lisowy, out of the long-term care facility after less than two months and built a special room in her house.
An outside caregiver spends eight hours each day with him. Lisowy also benefits from the convenience and comfort of living at home. Capital Health pays $3,000 a month for the caregiver.
"When he was in the nursing home, he was drugged all the time," she said. "He was there for four weeks before they even took him outside for a walk. He seemed distant and unfocused. He just wasn't the same dad."
Now, her father is healthy and happy, thanks to what is known as "self-managed care" offered by the Capital Health authority.
"It's the best of all worlds," said Baziuk. "It's the way I would want to be cared in my old age."
Yet according to a new study, home care -- and not long-term care -- appears to be the weak link in Alberta's network of services for seniors.
The report, by University of Alberta nursing professor Donna Wilson, found that seniors living in nursing homes tend to be healthier and cost the health-care system less than those staying at home and receiving care from nurses and other caregivers who drop by regularly.
"I was as surprised by it as anyone else," Wilson admitted. "We think of people in long-term care as being the frailest and sickest of all our seniors."
Since the report was made public, she has been inundated with calls from people complaining about the poor service and bad experiences of family members living in seniors' homes.
"I'm not saying that doesn't happen, but it does appear that those instances are in the minority."
At the same time, Wilson's findings are no reason for the provincial government to reverse its policies of encouraging seniors to live at home, she said.
"What it tells me is that home care is too little, too late," she said. "People don't start receiving home care until they're sick, until they've had a stroke, an accident or a chronic illness. Maybe they should start getting home care earlier as a way of keeping them healthy."
Long-term care and home care aren't an either/or proposition. Regional health authority staff decide whether seniors are capable of living on their own with the help of home care or if they require long-term care.
Analysing 12 years of Alberta Health data, Wilson found that seniors receiving home care are three times as likely to end up in hospital as are those in long-term care homes.
They stay in hospital an average of 16 days, compared with less than three days for those in nursing homes.
Diane Mirosh, executive-director of the Alberta Long-Term Care Association, said she's not surprised.
She said nursing homes offer many of the same services as hospitals but at a fraction of the cost.
"Our residents get nursing, physical therapy, recreational therapy, regular meals, visits by nutritionists and regular visits by doctors," she said. "A lot of these people would be in hospital if they didn't have long-term care."
She said the cost of long-term care averages $125 a day per resident, of which residents pay $42. The remainder is covered by government-funded seniors programs or by Alberta Health, which pays for nurses and other health professionals.
By comparison, it costs $1,100 a day to keep a patient in a hospital. Alberta Health covers the total cost.
It is unclear whether the per-resident cost of nurses in long-term care homes is less than per-person home-care costs, because the Capital Health Authority doesn't make those comparisons.
A spokesman for Capital Health said the study could result in more resources going into home care.
"We're always looking for ways to improve the system," said Ed Greenberg.
Health and seniors department officials said they want to study the report before commenting.


Richmond woman said she wasn't consulted over 'do not resuscitate' order for dad, 84

Published on: October 16, 2016 | Last Updated: October 16, 2016 4:09 PM PDT
Lori Wang is the only child of 84-year-old Zaixing Wang, poses for a photo with a picture of her dad who died last year in Richmond, BC, October, 12, 2016. A doctor placed a Do Not Resuscitate order on his file but Wang claims the family didn't agree to the order.
Lori Wang is the only child of 84-year-old Zaixing Wang, who died last year days after a doctor signed a do not resuscitate order. Wang claims the family didn't agree to it. RICHARD LAM / PNG
Lori Wang will never forget the image of her 84-year-old father gasping and choking on his own blood while in cardiac arrest, and her desperate attempts to get staff at Richmond General Hospital to help him.
But she said nurses refused to do cardiopulmonary resuscitation on Zaixing Wang because a doctor had written a Do Not Resuscitate order on his medical chart after assessing him in the emergency department on Sept. 21, 2015.
“The blood was pouring out of his mouth and I pressed the red button, but no one came so I ran into the corridor shouting for help. This is when I learned they wouldn’t resuscitate him. The nurses were just wiping his blood away,” she said.
“He choked on his own blood from the lungs, when resuscitation needs to be conducted immediately without delay. And yet, standing by his bed watching him gasping for air and turning blue, the nurses refused, even at my repeated and desperate request, to lay a finger to help him.
“Instead, the assigned attending nurse spent those critical few minutes debating with me why my dad would ‘not make it,’ that he was a ‘no code,’ and asked me to contact my mom to deliver the bad news.
“I simply could not fathom how this could happen in the hospital when medical professionals were in arm’s reach.”
Lori Wang said she wasn't consulted by a doctor at Richmond General Hospital before a Do Not Resuscitate order was written on her 84-year-old father's medical chart. When he went into cardiac arrest in front of her, nurses refused to revive him, she said.
Lori Wang said she wasn’t consulted by a doctor at Richmond General Hospital before a Do Not Resuscitate order was written on her 84-year-old father’s medical chart. When he went into cardiac arrest in front of her, nurses refused to revive him, she said. RICHARD LAM / PNG
After pleading with the nurses to help save her father, Dr. Edgar Lau, the internist and respirologist who had placed the Do Not Resuscitate order on Zaixing Wang’s medical chart, was called.
Wang said her father was revived with CPR around 10 minutes after he went into cardiac arrested. However, he never regained consciousness and died on Sept. 29.
Lau would later tell two review panels looking into the case that he had explained his treatment plan to the family, which would have included putting a DNR order on Wang’s chart in the event of “acute cardiopulmonary deterioration,” given his “poor pulmonary reserve.”
In the recently completed reviews, both the College of Physicians and Surgeons and Vancouver Coastal Health Authority’s Patient Care Quality Office accepted Lau’s statement that the doctor had that conversation with the family.
But Wang said the doctor never told the family a Do Not Resuscitate order was being placed on her father’s medical chart, and “now it’s his word against mine.”
According to the review by the College of Physicians and Surgeons, the signature of the patient or substitute decision maker is optional for a DNR form.
If this is truly the hospital’s policy not to require a family member’s signature on a DNR order, it’s really flawed
Coastal Health spokeswoman Anna Marie D’Angelo said a physician doesn’t require a family’s consent for a Do Not Resuscitate order for someone who is very ill with complex conditions.
“They need to discuss it with the family, certainly, but it’s not a consent decision,” said D’Angelo. “If you don’t agree (to having a Do Not Resuscitate order), there’s a dispute process to get a second opinion.
“The focus is always the care and comfort of the patient, what treatments can be tolerated by a severely ill person with complex medical challenges, and whether a treatment will be beneficial. This information, including the patient’s and family’s responses, are documented in a patient’s chart. It is generally accepted in Canadian health care that medical doctors need not offer interventions that they do not consider will benefit a patient.”
Wang said her father’s diagnosis of bronchiectasis — a condition that leads to gradual deterioration of the lungs — was chronic but it wasn’t terminal.
“I feel they can basically sign someone’s life away,” she said. “The family needs to give clear, informed consent. I didn’t sign anything and my dad didn’t sign anything. Why would we even take him to hospital if it wasn’t to seek treatment?
“For any other tests my father needed I had to sign, but for something as serious as a DNR I didn’t have to sign. If this is truly the hospital’s policy not to require a family member’s signature on a DNR order, it’s really flawed.”
Wang said her father was admitted around 10:30 a.m. to Richmond Hospital after coughing up blood. His respiratory arrest happened after he had been transferred to a hospital ward around 5 p.m. and just an hour previously a nurse had seen him well enough to go to the washroom unassisted.
Wang questions why Lau failed to meet the family that day to directly spell out the full range of medical options and prognosis for recovery, which she felt would have been high if he was given CPR immediately in the event of a cardiac arrest.
She said the DNR order was made when she had left her father’s bedside to retrieve personal items for him. At that point, she said, she received a phone call from Lau, but she said the conversation was about his condition only, with no mention of a DNR order.
Lau’s statement to the College of Physicians and Surgeons conflicts with Wang’s recollection.
“Dr. Lau noted it would have been better to speak with Ms. Wang in person, but another important consideration is being able to reach a decision (on whether to place a DNR order) relatively early in the hospital course, before an emergency occurs. Dr. Lau noted he believes he had explained the process over the telephone to Ms. Wang in adequate detail, in plain words. Dr. Lau believed that Ms. Wang understood the indications of the order, although this appears to be incorrect,” according to the College’s review.
Wang said the DNR order was reversed after Lau was called during her father’s cardiac arrest and she told him directly she wanted her father to be saved. But by that time about 10 minutes had passed without any medical intervention for her father, she said.
Lau then initiated a “code blue” and supervised staff who administered CPR. Wang said although her father was revived, he suffered brain damage and died eight days later.
“It just feels my dad died when he could have been saved. He had been hospitalized before after coughing up blood and there was never a DNR on his chart, ever,” Wang said.
The College of Physicians and Surgeons review noted Lau “acted quickly and appropriately by telephoning his primary contact person, Ms. Wang, to discuss level of intervention and to complete the MOST (Medical Orders for Scope of Treatment — no CPR) form. The (review) Committee commented that the timing was reasonable, and commended Dr. Lau for initiating the conversation early in the patient’s hospitalization. The Committee accepted the statement of Dr. Lau: that he had no reason to doubt that Ms. Wang understood their discussion.”
Coastal Health’s Patient Care Quality Office review stated: “It is believed the decision to contact next of kin was appropriate and that a no code status was an appropriate decision based on the medical condition of your father.”
However, the review panel for Coastal Health did add that while the nurse was following the physician’s order, it was “inappropriate for engaging in a debate … during this time.”
Wang also filed a complaint with the College of Registered Nurses of B.C. regarding the nurses’ actions that day, but has not yet received a response.

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Cat John Stevens
As a patient, it is my decision and my right to decide - not my families. A family should not be required to sign a DNR. The right is the patients. The focus should always be the decision of the patient and his / her one immediate decision maker. The rest of the family can go to hell. The real flaw in the system - is no prevention. Anyone over age 65 should have clear medical directives already in place. The MOST (Medical Orders for Scope of Treatment) should not be decided each trip to the ER - this is too late.
LikeReply1Oct 18, 2016 7:53pm
Lori Whitney · 

It was her fathers decision to end his life when nature is ready. He should have informed her but no intervention was wanted so none was given.
LikeReply1Oct 18, 2016 3:33pm
Julie Ali · 

There is no mention made of the father asking for no resuscitation; this was a decision made by the doctor. As is the case in BC, doctors in AB can unilaterally impose do not resuscitate orders on patients. A court order would be required to avert this and who is able to go to court in an emergency? It's euthanasia and families are at a disadvantage lacking the medical records and also the knowledge of such practices.
LikeReply13 mins
Wayne Robertson · 

he would have signed the document that is what he wanted
UnlikeReply2Oct 18, 2016 5:06am
Su Chan
No signature required? At least a signature from the family to acknowledge that the doctor had told them about the DNR decision.
Julie Ali · 

No signature is required. It is a medical decision. This is how the health authority sets it up. Very expedient decision making.
LikeReply4 mins
Christine Minot · 

This is not right to let the patient dye like that in the hospital!
Robert Holloway
This story is horrible for the family but even with a DNR order what happened to ensure the patient does not suffer and is comfortable,,, something wrong with this picture. In BC we have special authority granted to a legal guardian to speak for the patient which ot my mind means you get my signature on the DNR form when it is deemed necessary
LikeReply1Oct 18, 2016 12:52amEdited
Julie Ali · 

It makes no difference. Doctors rule. You would have to go to court. You have no ability to overrule the doctors otherwise.
LikeReply3 mins
Betty Ann Oakley-Corey · 

This is murder!
Mark Husereau · 

They did not kill him, He died and they did nothing about it because it was his time to die and stay dead.SMFH
LikeReplyOct 17, 2016 9:32pm
Julie Ali · 

Mark Husereau If you withhold life saving measures you are letting the patient die. If you do this knowing the patient wants to live and could live if you provided the life saving measures than what do you think is being done here? Euthanasia.
LikeReply3 mins
Jennifer Ann
Very sorry for her loss and can understand how traumatic that was for her to witness but human dignity and avoiding uneccesarty pain and suffering should be the number one reason for providing medical care or not. When animals are extremely ill people are considered cruel to keep them alive. At least that much respect (if not more) should be afforded to a terminally ill and suffering person. Very sad though. My thoughts go out to the daughter.
LikeReply1Oct 17, 2016 4:57pm
Dimitri Pavlović
I believe the doctor properly informed her. She doesn't want to believe it because she lost her dear father. That is 100% understandable. It's part of the grieving process. Blame. Her father was very ill. Sometimes we can be selfish and don't want them to go. What kind of quality of life would he have had? He would be stuck in a bed with 24/7 care. At least he left with his pride in tact. Yes. I have PERSONALLY been through this.
LikeReply1Oct 17, 2016 4:36pmEdited
Juan-Carlos Pinto · 

If I get to that stage in my life..I hope that they let me go..quality of life should prevail over life no matter what.
LikeReply2Oct 17, 2016 4:34pm
Kathie Boyd · 

I am very sorry for your loss. We should all learn from this harrowing incident: think about, talk about and document what's important at the end of our lives, for ourselves and our parents, now; don't wait.
LikeReply1Oct 17, 2016 4:29pm
Carmen Stevenson
So sorry for your loss. I always thought you had to sign a DNR form if you do not want the patient resuscitated!
LikeReply1Oct 17, 2016 2:17pm
Tal Xiar · 

My mom was admitted to VGH because she fell and had a hairline fracture in her pelvis. This, coupled with her diagnosis of dementia, led the ER doctor to immediately discuss the DNR order with me. Fast forward 6 months later, her team of doctors at an acute care facility also discussed that, and another 9 months later a different doctor at VGH asked me about it again. So in my experience, they communicate this very well.

The other question is: why are dementia patients with only mild physical ailments being pushed out-the-door, out of hospital beds, rushed out of waiting queues for residential care, and being treated like pets we euthanize via a DNR. Right or wrong, that is the *feeling* I get.
UnlikeReply2Oct 17, 2016 1:35pm
Crystal Hope
How completely awful.. I would be heartbroken
Christie Todosychuk Totten · 

I also think a DNR or MOST decision/discussion does not mean a family thinks that no intervention will be taken. I'd have assumed (I guess incorrectly) that measures would have been taken for the patient to be comfortable.
LikeReply2Oct 17, 2016 1:02pm
Winnie Hwo
A lot of assumptions are made here - daughter not knowing what her dad wanted, family members changed their minds, children not respecting parents' wishes....the bottom line is , Mr. Wang died a horrible death. He was left to choke on his own blood, in front of her loving family. The doctor did change his mind eventually and resuscitated Mr. Wang. He died eight days later after medical intervention was made. I do not doubt Ms Wang and all the loving children in the world with aging parents that when the time comes, we need to let go. But letting go doesn't mean seeing your parents suffer horribly. If anything needs to be improved, it would be how to make sure DNR is administered in a non-brutal and humane manner.
LikeReply3Oct 17, 2016 12:44pmEdited
Layla Irish
It is difficult to watch someone die - especially if it is one's relative and when it is a dramatic end with visible blood and discomfort. Some diagnoses contribute to a difficult end and there is no getting around it. DNRs are never designated lightly - and sometimes there is no prediction on how dramatic it can be. Sometimes, short of euthanasia - there is no getting around it. Lay people aren't always around to see a lot of those endings.
LikeReplyOct 17, 2016 4:11pm
Diane To
Lester This sounds all too familiar to you
Sam Israel
My own reaction is somewhere in the middle: I fully understand the nurse's need to follow the doctor's directive, I fully understand the Doctor's medical decision given the facts as presented, and I fully understand the daughter's disbelief that an DNR can be administered without a signature from a patient or a family member. What I don't understand is why hospitals are not prepared for patients or family member's changing their minds at moments like these. I hope this tragic experience brings about necessary changes to end of life protocols.
LikeReply3Oct 17, 2016 12:07pm
Layla Irish
There is a protocol but people ignore going through it with their family.
LikeReply1Oct 17, 2016 4:12pm
Vicki Graves · 

You have to know what your parents wishes are - my dad didn't want to linger in a horrible body - thank goodness he had a doctor who understood - at 85 he was ready to let the pneumonia take him -
LikeReply6Oct 17, 2016 11:20am
Veronika Jose
Rib-crushing CPR is the last thing I would want for my beloved elderly parent. I speak from experience....I "heard-felt" the cracking of fragile bone when administering cardiac massage.
LikeReply8Oct 17, 2016 10:59am
Layla Irish
Exactly! Doing CPR on elderly always includes broken ribs and other horrible end of life suffering. It would be different if I were younger.... but at 84??? Even if one can shuffle to the bathroom 10 minutes beforehand, doesn't necessarily guarantee survival.
LikeReply2Oct 17, 2016 4:17pm
Julie Ali · 

Lalah Lovato However if the citizen wishes to live why would we not provide this assistance? My dad wants to live and his wish to live should be honoured. I see no difficulty in not resuscitating if this is the written request of the citizen.
However I do see a problem with doctors unilaterally deciding death in this way.
In my sister's case, she did not even meet the requirements of having insight into the DNR order. Why would any doctor do this sort of decision of a DNR for a handicapped citizen with repeated respiratory problems when they don't do a DNR for a citizen who has a drug overdose repeatedly?
It's a good question and indicates at least to me the stigmatization faced by the handicapped citizen in our society.
Legislation should be in place to regulate DNR just as it is in place for death by doctor.
LikeReplyJan 25, 2017 8:28am
Veronika Jose
Julie Ali ....Regulation does exist & is observed by the medical community....aside from all the emotions, explanation to support realistic expectations in this area is best practice. Health Care works hard to provide support even for a palliative infection is treated, a broken bone is mended, a laceration is sutured.....however, the pain & trauma of CPR I would not wish upon those that I love...especially with advanced age & medical conditions. There is virtually no benefit to prolonging Life....only painful suffering.
LikeReplyJan 25, 2017 9:48am
Ginnie Anglin
For those people who have aging parents, discuss their healthcare wishes no matter how uncomfortable it makes you. By doing this you can be sure if and when the time comes you are making the right decision and won't have to endure the heartache this family went through.
LikeReply9Oct 17, 2016 10:52am
Christie Todosychuk Totten · 

From the article it doesn't sound like the parent was the one consenting to DNR. The family's position is that the doctor didn't even discuss the DNR with them. The doctor's position is that he did discuss it with the daughter. The doctor never even claimed that the patient himself was okay with the DNR.
LikeReply1Oct 17, 2016 12:58pm
Cory Young
I'm guessing that her father probably didn't speak English so the doctor had to talk to the daughter. Maybe she didn't fully understand what the doctor was telling her?
LikeReplyOct 18, 2016 1:37am
Julie Ali · 

Cory Young Or maybe he did not tell her and indicate an appeal process?
In my sister's case we did not know of the original DNR order until we got her medical files. Once the first doctor put it on her file it should have been removed in a time sensitive way.
Instead the DNR stayed on her file for five years and we had doctors tell us she was DNR over this period like parrots.
We had a nightmare experience of trying to lift the DNR.
My sister is alive today. If we had not fought for her life (she has a personal directive indicating she wants to continue living with full resuscitation as her request)--she would be dead.
This poor state of affairs in Alberta indicates to me at least that handicapped citizens without advocates or family are at risk of similar DNR orders and premature termination.
LikeReplyJan 25, 2017 8:30am
Dorothy Sterling · 

Most families "get cold feet" when the end comes and then want everything done because they are scared. At the end I see the nurse is the one taking the bulk of the blame and you wonder why we leave in droves.
LikeReply26Oct 17, 2016 10:43am
Layla Irish
Yes. For sure. I am already gone. Left early.
LikeReplyOct 17, 2016 4:00pm
Jou L Ma
Doctors cannot be forced to perform pointless rescuscitations.
If the patient was competent , a discussion with the family is sensible , but not obligatory.
The MOST form is NOT a no CPR form , it is a level of intervention form.
The term DNR is no longer used in BC, so it is a term the doctor would NOT have used,
LikeReply5Oct 17, 2016 8:21am
Alison Stevens · 

Yes the term DNR is used in BC. Walk into an ER and you'll hear it used all the time.
LikeReply2Oct 17, 2016 12:41pm
Mandy L Ludlow
Ya my nanny had to make the call on a DNR at richmond general when my grandpa was at the end. It's a hard decision. The conversation between the daughter and the doctor could have been misunderstood. I know during that time with my grandad I was so overwhelmed with emotion I didn't actually hear a lot what people were saying.
LikeReply2Oct 17, 2016 12:59pm
Jou L Ma
Alison Stevens Not any more. I work in an ER in BC.
LikeReplyOct 17, 2016 6:50pm
Jou L Ma
Mandy L Ludlow Sorry for your loss - it sounds like that's exactly what happened here.
LikeReplyOct 17, 2016 6:51pm
Mark Husereau · 

Jou L Ma Nobody calls the IV Fluid Code 8 anymore either
LikeReplyOct 17, 2016 9:28pm
Jou L Ma
Mark Husereau
I've never heard that one in 15 years.....
LikeReplyOct 18, 2016 9:56pm
Julie Ali · 

You are quite correct that doctors can't be forced to do resuscitation but if the requirements for DNR are not present then I guess they are not doing their professional duty when they do not resuscitate are they?
In other words, doctors are human beings and can make mistakes about the viability of a patient. When they do make mistakes, no one seems to hold them to account.
When they decide that a patient is not worth keeping alive, no one also holds them to account.
It is very difficult to appeal such orders (if at all) and going public in Alberta is the only way I have discovered to contest these decisions.
It's not right that doctors make decisions for handicapped patients and those without insight based on costs to the system.
LikeReplyJan 25, 2017 8:33am
Cheri Sutherland
Sounds like the College of Physicians and Surgeons are covering the Drs. butt for him and same with Coastal Health. This is why a DNR order should always be signed, to protect eveyone involved especially the patient.
LikeReply1Oct 17, 2016 1:04am
Jou L Ma
Ther is no longer such a thing as a DNR order.
LikeReply1Oct 17, 2016 8:22am
Kitkat Cadorniga
Jou L Ma actually, it is still called a DNR but it has more options. so like DNR-M1, M2, or M3. then there's also the CPR (full code)
LikeReply2Oct 17, 2016 2:34pm
Winnie Hwo
This is horrific and unacceptable. I feel so sorry for Ms Wang and her dad. Thank you Van Sun for publishing this story. We all have parents, many aging. No one should have to go through this experience and this is certainly not what our doctors are trained to do.
LikeReply5Oct 16, 2016 10:36pm
Scott Henderson
So you believe you should be able to order doctors to resuscitate patients with little to no chance of survival, because you want them to?
LikeReply2Oct 17, 2016 3:31pm
Winnie Hwo
Scott Henderson alleviate the pain and suffering.
LikeReplyOct 17, 2016 3:37pm
Layla Irish
From the sounds of it, he was put through needless torture by his family. I would be very upset if my family brought me back with a health history and prognosis like that. A DNR designation is NEVER given lightly.
LikeReply2Oct 17, 2016 4:03pm
Scott Henderson
If You believe resuscitation is a pain free and pleasant ordeal, I'm thinking you need to better inform yourself Winnie Hwo.
LikeReply5Oct 17, 2016 4:09pm
Julie Ali · 

Scott Henderson I believe if the doctor is making a mistake it is our obligation as citizens to hold them to account and contest their decisions.
Doctors are not gods.
They are human beings.
We aren't slaves.
We can make decisions and think.
If doctors do make a mistake, other doctors support their decision of DNR.
Famlies have no one to support them.
So we have to go public.
Why would we stay silent?
My handicapped sister is alive today because we spoke in public.
But what about the other citizens who are prematurely terminated as she nearly was?
LikeReply1Jan 25, 2017 8:35am
Jesus Parkes
DNR's are in place for a reason. While in this case there was some grey area, in the end the physician was correct. RIP.
LikeReply6Oct 16, 2016 9:30pm
Val Isaac Reed
Absolutely correct. While it is hard for relatives to understand, there is no point in trying to resuscitate elderly patients who cannot survive because of their complex medical system failures.
LikeReply4Oct 17, 2016 2:02pm
Julie Ali · 

Val Isaac Reed But who are doctors to decide that complex medical system failures are now end game? If a patient can be restored to life -even handicapped and sick-who are doctors to decide early death for them?
LikeReplyJan 25, 2017 8:36am
Julie Ali · 

The gray area is often very large. In the case of my handicapped sister, intubation would have brought her back to life. Why would any doctor deny this?
It is a good question. Maybe because the doctor was tired of the repeated hospital visits due to the non-compliances found at the continuing care facility where my sister resided?
You can't imposed DNR orders without proper medical investigation to rule out other problems which were present in this case but no one bothered to look into.
I had to do the investigation to show the problems.
I had to bring these issues up to the GOA.
Three health ministers farted around while my sister went through hell.
It is not right.

And why is the gray area so large for the handicapped versus the non-handicapped citizen?
LikeReplyJan 25, 2017 8:38am

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