Research shows that talking about resuscitation is difficult but worthwhile

By Anne Finucane
Research Lead, Marie Curie Hospice, Edinburgh

Anne Finucane, Research Lead, Marie Curie Hospice, EdinburghThere is a growing awareness that staff caring for people with a terminal illness need to discuss Do not attempt cardiopulmonary resuscitation (DNACPR) decisions with patients. It is an issue that has come into particular focus following a recent Court of Appeal judgement that patients and/or their families need to be consulted before a DNACPR decision is made.

DNACPR decisions are made to prevent the distress caused by performing inappropriate CPR attempts.  A DNACPR decision may be taken because it is felt that CPR would not work or because the patient does not want CPR to be attempted even if it might be successful.

Research which took place at the Marie Curie Hospice, Edinburgh, prior to the recent court ruling, concluded that palliative care staff found discussions about resuscitation challenging, and they were sometimes anxious about broaching the subject with patients for fear of causing distress. However, patients and families usually responded well to these conversations, and some were relieved to have had a discussion about their future and end of life care. As a result, staff found it worthwhile to discuss DNACPR decisions with patients, despite the challenges.

Face-to-face interviews were held with 11 staff in the hospice. Staff mentioned that a change in the patient’s condition was often what prompted them to have a discussion about resuscitation. Staff also felt it was important to start discussions about DNACPR within the context of broader conversations about end of life care and the future.

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