The call comes at any hour: “Your mother is in an ambulance on the way to the hospital.”
I grab the DNR File and go, anticipating that she will survive the latest calamity just as she has for the past 86 years. Her mind and body are frail but her heart is strong, and her determination to live should be studied for medical research because she’ll outlive all of us.
I use dark humor as my own survival technique, so accept my apology if this seems offensive. Only daughters of invalid parents can understand the experience of being the Keeper of the DNR File, a responsibility I willing, respectfully accept. But sometimes, when I’m speeding away with The File, I yell at the universe because she has suffered too much and I can’t do anything except carry the instructions that prove she has chosen Do Not Resuscitate.
If you are designated as the Keeper of the DNR File, that means you’re probably the only daughter. Somehow sons aren’t willing or able to assume the responsibilities.
Here is what you’ll need:
- A POST Document – the Idaho Physician Orders for Scope of Treatment – that outlines what lifesaving procedures the patient wants. The form is signed in advance by the patient and a doctor and includes choices from Allow Natural Death to Use Aggressive Intervention. There should be an additional category for Survivors of the Great Depression. These people redefine the human capacity for survival.
- A copy of the Living Will designating you at the Power of Attorney over Health Care. This role can lead you to drink. More.
- A photo identification of the patient. My mother no longer drives – there was that unfortunate incident when she drove through the garage wall – but you can get a non-driver, photo ID at the Department of Motor Vehicles. If you have any problems at the DMV, just threaten to leave your mother sitting there in her wheelchair and walk away. Works every time.
- A detailed inventory of all medications including doses. This list will cause you to throw down your plate of maple bars and enroll in multiple exercise programs while you still have time.
- Copies of health insurance information including Social Security number, Medicaid number, and any supplemental insurance details. Then toss in some medications (chocolate, vodka) for yourself because it can be a bumpy ride.
For my mother’s DNR file, I also include some spiritual music because she likes it and because it keeps me from dissolving into a puddle of mush when she revives and doesn’t know who I am or why I’m there.
That’s when I pray for an extra jolt of my mother’s tenacity for me because I’m dangerously close to jumping out of the hospital’s top floor window.
Last month my mother suffered a stroke and we got all the way to POST Section C: No Feeding tube. No IV fluid. No Antibiotics. The Hospice staff told me she had 72 hours to live and to make funeral arrangements so I did. Then after 50 hours without food or water she opened her eyes and said, “Hi!” Cue spiritual music. Avoid the windows.
Each calamity is traumatic.
Over the past 16 years there have been serious car accidents, a broken back, a broken hip and other broken bones, severe falls which resulted in concussions, and numerous bruises, stitches, slurring of words, bouts of pneumonia, extreme confusion, dementia issues, and several stays in various rehabilitation facilities. It truly breaks my heart to see her in these situations, and all I can do is hold her hand, play music, read to her, and just be there. Several times the medical staff has counseled me in hushed tones that she wouldn’t live. I usually chuckle and say, “Just watch.”
I don’t mean to be flippant about my mother’s health. As I explained, I use humor to cope with stressful situations. I also use it for all other occasions. When my own DNR File is passed to my children, I will include special instructions: If I can’t have any quality of life, put a red clown nose on my nose, pull the plug, and enjoy a grand party with abundant music, laughter, and chocolate. And, don’t forget the Cabernet.