Just Learned Mom Has a DNR

[lonegreywolf20]

But their ashes must be interred at a cemetery or the local parish is supposed to refuse to do the Mass without an indication as to the final destination of the ashes. Which is typically the contract one has signed with the cemetery. No scattering the ashes or splitting them up or any of that is allowed.

That is not what my mom wants. I know that much and neither does my step-dad. I am going to follow their wishes, whatever they may be. My mom doesn’t want Catholic funeral, so getting permission from the local parish necessary.

 

[TheLittleLady]

Catholics can be cremated and get the funeral Mass treatment. But their ashes must be interred at a cemetery or the local parish is supposed to refuse to do the Mass without an indication as to the final destination of the ashes. Which is typically the contract one has signed with the cemetery. No scattering the ashes or splitting them up or any of that is allowed.

Actually, ashes must be interred or buried at sea. There is no stipulation this burial must be in a cemetery.

There are many times (parish worker for many years here) when the family is not yet ready to inter the ashes of their loved one. There are times when the cremains will be carried out of state, or out of the country, for their final internment. This is not unusual nor is it forbidden.

The Pastor will help the family, will not push them. until they are ready. In all of my years, knowing many parishes, pastors and Catholic cemeteries, no one has ever denied a funeral Mass because the ashes were not going to be directly interred in a cemetery.

 

[lonegreywolf20]

That makes me feel a bit better, thank you!

 

[Zzyzx_Road]

That is not what my mom wants. I know that much and neither does my step-dad. I am going to follow their wishes, whatever they may be. My mom doesn’t want Catholic funeral, so getting permission from the local parish necessary.

You meant not necessary. If no Catholic funeral or memorial Mass, then of course do whatever the deceased wanted.

Actually, ashes must be interred or buried at sea. There is no stipulation this burial must be in a cemetery.

Regarding the bolded, I’ll leave this here from the US Bishops
http://usccb.org/prayer-and-worship/bereavement-and-funerals/cremation-and-funerals.cfm
Key quote (emphasis mine):

The cremated remains of a body should be treated with the same respect given to the human body from which they come. This includes the use of a worthy vessel to contain the ashes, the manner in which they are carried, and the care and attention to appropriate placement and transport, and the final disposition. The cremated remains should be buried in a grave or entombed in a mausoleum or columbarium. The practice of scattering cremated remains on the sea, from the air, or on the ground, or keeping cremated remains on the home of a relative or friend of the deceased are not the reverent disposition that the Church requires.

One may find parishes that do their own thing, but they may not be in keeping with accepted practice according to the bishops.

 

[TheLittleLady]

The practice of scattering cremated remains on the sea , from the air, or on the ground, or keeping cremated remains on the home of a relative or friend of the deceased are not the reverent disposition that the Church requires .

One may find parishes that do their own thing, but they may not be in keeping with accepted practice according to the bishops.

I never mentioned scattering anywhere, burial at sea is a valid option. One can inter ashes at sea, you simply sink the entire container.

I never mentioned keeping ashes at home, I mentioned delaying internment. As we speak, my husbands ashes are waiting at the funeral home until we arrange internment out of state.

And as you see, there is no requirement for a cemetery. There is much ground in which ashes may be buried.

ETA you will also notice that there is no statement that a funeral is to be refused because of the manner of disposition of ashes. Canon law is clear about when a funeral may be refused:

Can. 1184 §1 Church funeral rites are to be denied to the following, unless they gave some signs of repentance before death:

1° notorious apostates, heretics and schismatics;

2° those who for anti-christian motives chose that their bodies be cremated;

3° other manifest sinners to whom a Church funeral could not be granted without public scandal to the faithful.

§2 If any doubt occurs, the local Ordinary is to be consulted and his judgement followed.

Can. 1185 Any form of funeral Mass is also to be denied to a person who has been excluded from a Church funeral.

 

[JimG]

If informed consent is required in order to give treatment, then why, if one has a comatose patient who is dying, would medics be allowed to shock, do CPR, and take other extraordinary measures if the patient is unable to consent? Why can the attending physician not make a medically based decision that further treatment is useless? From what I have read here, keeping a DNR handy seems to be the only way to protect oneself from being subjected to measures which may do more harm than good.

Posters here have described measures that can harm the patient and make life worse even if resuscitated. How many ordinary patients are capable of judging such medical outcomes or even knowing what they will want when the time comes?

In the case I mentioned, my brother in law was released from the cancer center precisely because they had done all they could and the prognosis was terminal. Yet somehow the family did not realize that. It became clear to me that was the case, in reading their clinical notes after he died. They thought they were communicating to the family but they weren’t making it clear. I don’t think anyone wanted to just say that they were sending him home to die. It still seems to me that the medical professionals have delegated a lot of decisions to the patients, family, and lawyers, that they are not prepared to make.

 

[CilladeRoma]

Patients need to be pro-active, and realistic.
Yes, talking about these things is difficult, but it must be done.
And again, we are talking about certain cases. It is not appropriate for a healthy 25 y.o to have a blanket DNR order.

I will ask again, why do you think that people who know nothing about us, except what they read in a medical chart should be making decisions for us? We all must advocate for ourselves and our loved ones, that is our job. The professionals job is to help give us the answers we need to make informed decisions.

 

[lonegreywolf20]

If informed consent is required in order to give treatment, then why, if one has a comatose patient who is dying, would medics be allowed to shock, do CPR, and take other extraordinary measures if the patient is unable to consent?

I’m not sure anything I say will help you to understand. All I can do is to say look up the difference between informed consent and implied consent. It may answer your above question.

 

[BlueMaxx]

Im just gonna copy and paste my post from another thread…it might illuminate and take some fear and misinformation out of the difference between shocking a patient and pacing a patient…

MSH
NREMTP/Flight Medic and a bunch of other letters that mean nothing to most folks…

I am totally against the new protocol of rescue breaths…and personally think it was because people were less apt to perform cpr if they had to do mouth to mouth…and trust me from experience, having someone ralph in your mouf is not a day at the beach
But the brain and blood needs 02.

Doing CPR on frail people and children sucks, you hear and feel the chest and rib cartilage breaking and it is like, well, its like a horrible mixed feeling of knowing you’re hurting someone but also trying to save their life. Like having to do an IO (intraosseous infusion, think taking a corkscrew and trying to go through the leg bone of an infant to get to the center, not too far and just far enough to get a line flowing) IV line on an infant or being so desperate on an elderly patient, and having failed to get a line anywhere on their extremities opt for a carotid IV…each scenario is about a 1000% on the rectal pucker scale.

I heard about the count of the song Staying Alive, always cracked me up, mostly due to the irony…but after you go past being an EMT or Advanced EMT and become the Paramedic you sort of leave the mechanics (compression and respirations) to whomever crew\volunteers you have on hand because your so busy trying to intubate the patient and get a line going, getting the EKG pads on and trying to read a scribbly line from the monitor because CPR and that thing printing looks like a linear etch-a-sketch or getting pacing pads if needed all while packaging the patient on a body board with all the straps and wires and IV lines and a temperamental stretcher…and getting them to the truck…but it’s whether scoop and go on a trauma victim in which CPR is mostly useless or its a medical where you do have a shot at getting the patient back it still is a skill I would like to know but never haft to use again.

Also now there are so many AED’s about everywhere which is a good thing…most people don’t realize you do not shock a patient in asystole, contrary to almost every tv show out there…a flat line means no electrical activity, no current, nothing to shock.
V-Fib and some forms of A-FIb are shockable…and normally when a person is having a heart attack you have maybe a 3 minute window when the heart is going from chest pain ("Hey! I’m having troubles here!) to a fib then to a state of asystole.

 

[BlueMaxx]

Think of a bowl of jello and how it jiggles, that’s what your heart is doing…the electrical impulses are just firing all over the place without any coordination…we want to stop that in v-fib…When in the normal route the SA node sends the signal down the line where there are a few stops (like the NA node, etc) telling the muscles to the chambers to shock and contract but they are in all sorts of disarray…shocking stops all the electrical activity and allows the SA node (or as I think of him, the train conductor) to start sending the signals down the line in the correct fashion…sort of like doing an alt/control/delete to reset your computer. It does not always work so you do a set of three shocks, go to the drugs and up your jules on the defibrillator. Try again…sometimes you start to get some activity so you apply what are known as pacing pads, one on the front, one on the back, and try to “capture” the electrical activity that is present and then pace it yourself…it is doable. but I have had limited results. Sometimes the drug set we carry can chemically pick up the slack.
But it is a very limited window…so if it is an electrical based heart attack and having an AED close by it can and will save a lot of lives…instead of having to wait like the “old” days for the EMS crew to drive and you miss that window…then your trying to do some things chemically to get the heart to “wake up” (atropine/epinephrine) and if it is in fib some lidocaine to help it chill out.
Some folks in A-Fib who are conscious we give an actual medicine, adenosine asystole, and chemically do what the shock normally does. It is so weird telling a patient, “Ok, now you’re going to feel very weird in a moment because I am going to give you this medicine that will stop you heart for the briefest of moments”…that is always a unique conversation.

Now, if it is mechanical and someone has a massive heart attack and blows out a ventricle, has an occlusion, or busts out an artery then there isn’t much you can do save go through the motions and high tail it to the ER.

 

[BlueMaxx]

I think of the heart as a pump…and it has two halves, electrical and mechanical. The signals to the pump telling it to contract are messed up or mechanical and the pump itself has broken to where sending a signal is pointless, there is nothing for the electrical activity to contract.

In our state depending on the situation the Paramedic in coordination with the ER doc can call it in the field…we’re talking about usually the elderly and there is no suspicious circumstances…sometimes for the families sake who might be there we give 'er the old college try and work our butts off and get to the ER…but we know the score…we just want the family to know we tried our hearts out.

The main thing is to keep your cool…I always told my patients…

“I want you to relax and not worry, the only time you need to worry is if you see me worried”

Then I would look them straight in the eye, give them a big old grin and say:

“And your not gonna see me worry”

It really calms them, although inside your all sorts of panic…you just gotta keep it cool for their sake.

After the run then you casually stroll out under the canopy with your partner and with a shaky hand light a smoke and let it all come out…never take it home.

I carry a non-rebreather with me in the truck and a homemade first responder kit for things that I might need…

Hope this helps someone…

Cheers,
M

 

[JimG]

I will ask again, why do you think that people who know nothing about us, except what they read in a medical chart should be making decisions for us?

Because they do not know the implications of what is in the medical chart. They do not know the things which have been presented by people in this thread who do have medical knowledge. I know people who when presented a list of possible care options, would have no idea how to choose. They have no experience of such things and no idea of the implications of their choice. Those with medical expertise do know the implications. I have read through living wills and healthcare POA’s, and it always struck me that it is difficult to try to make a choice of what is to be done for something that has not yet occurred, and that the variety of situations that may occur are not clearcut. We are asked to make medical decision before the fact, not knowing the particulars or the variables, and when we get to the point that the POA is needed, the situation may not be what we had in mind.

 

[lonegreywolf20]

I heard about the count of the song Staying Alive, always cracked me up, mostly due to the irony

Well, Another One Bites The Dust can also be used, so…

Hope this helps someone…

Thank you! I did my best as an EMT-B. I have been an EMT-B for 18 years and Medics can still out explain me, especially when it comes to cardiac.

 

[lonegreywolf20]

@BlueMaxx Maybe this?

 

[Minks]

@lonegreywolf20
@BlueMaxx

I thank both of you for giving us perspectives that, otherwise, we may not have had the opportunity to learn about.

I thank you, also, for pledging and devoting such a large portion of your lives to the hectic and underpaid lightning-speed decisions and solutions that usually keep us together long enough to be treated by doctors and their hospital staffs.

BlueMaxx, you had me shaking with laughter a few times, but we can see that you and lonegreywolf—and by extension, your fellow emergency techs worldwide—are extremely dedicated and affected by those precious and fractured moments with your patients. May God bless all of you.

I salute you.

 

[lonegreywolf20]

Thank you very much for the kind words!

 

[TheLittleLady]

It is our duty to be informed about the world around us, that includes our medical treatment. We do not just pick a random doc out of the phone book, show up and say “do to me what you will”. I interview doctors as I would interview anyone else I am going to do business with, I research this person, the facility, their statistics, other patients, etc.

When my loved one or I have to go in an ambulance, I have clear records what hospital I choose in my town (If I am out of town, all alone and unconscious, I would be at the mercy of the nearest hospital, I do realize that). We have chosen a PCP who knows well our overall desires. She is not just a stranger, she is the head of our health team.

For our pet, we have selected a vet who knows what our philosophy is about vet care. I see many people put animals through undue suffering and spend thousands of dollars when the rational, compassionate thing to do is to put the pet down. People who refuse preventative care for their animals then respond to the results in a completely emotional manner. When you get a pet, you need to understand the responsibility.

That responsibility is far greater for your own and your family’s medical care. Have the conversations, even when you are young. Young people die. Young people are in accidents or have sudden onset grave illnesses. When you talk about those things before they happen, you will not have that pain and confusion when things get emotional.

When my husband died, at age 53, we had already discussed literally everything. I was able to walk through that day, through the Spiritual, business and medical part of death without the need to make any decisions because the plan was already in place. What a blessing that was.

My son and my parents and my co workers and my parish know my precise desires.

You would be picky about your contractor if you were building a home, your physicians are more important than your builder.

For a huge percentage of Americans, what they know about advanced critical medicine they learn from TV or outrage articles on the internet. This is sad, parishes need to do more to help people prepare.

May the Lord grant us a restful night and a peaceful death.

 

[TheLittleLady]

Amen, amen.

In recognizing this, see if there is an annual White Mass in your area. This is a Mass that honors those in the medical professions. Every community ought have an annual “Thank You”.

 

[CilladeRoma]

Yes, 1000 times! :clap:t3:

 

[angel12]

The way I look at it, it is the best gift I can give my family.

It is, believe me. My husband never would do that. When doctors/nurses tried to talk to him about it, he’d always tell them that I would “take care of it.”
Well, I did. And I know I made the right decision. But it’s so very hard. And not just at the time – it’s been over 2 years, and it still makes me cry.