Too many elderly patients become entrapped in the lack of a distinction between Do Not Resuscitate and Do Not Treat, says "Rural Doc" Alan Lindemann, MD
ELGIN, ND, March 02, 2023 /24-7PressRelease/ -- Do-not-resuscitate orders are common among the elderly, as patients and their families seek to avoid extraordinary measures to prolong life that can lead to suffering and indignity. Yet there's a big difference between DNR and not treating senior patients who might otherwise return to health, says "Rural Doc" Alan Lindemann, MD.
"When it comes to being very old or being very sick, I have too often seen the do-not-resuscitate (DNR) order interpreted as an order not to treat a patient," he says in an article titled "Breaking the Silence – A Doctor's Plea for Clarity in End-of-Life Care." "It is frighteningly easy for a patient in the nursing home or a sick, elderly patient in the emergency room to lose his or her autonomy."
Research links DNR with higher death rates. For instance, a Harvard Medical School study found DNR orders doubled the death rate for surgical patients, despite fewer complications.
In his recent article on KevinMD, Dr. Alan shares how medical misinterpretation of DNR orders led to death in several cases, including:
• An 84-year-old man in a nursing home where Dr. Alan was caring for patients had rectal bleeding. "I sent him off to the next larger hospital so he could get a colonoscopy and a transfusion. I called the next morning to see how he was doing and when we might expect his return. I was told because he was so old, he 'didn't want treatment,' and they decided to let him die."
• An 86-year-old nursing home resident had a kidney infection due to a kidney stone. Dr. Alan sent her to a larger hospital to have her kidney stone addressed and her infection treated. "The next day, when I called to see how she was doing, I was informed that they had decided not to treat her and to let her die because she was so old and so sick."
In contrast, while working in a hospital, Dr. Alan met a 95-year old man suffering from urosepsis. He had a long conversation with the man's three daughters about whether he should vigorously treat their father. They asked, "Can you return our dad to the state he was in before he got sick?" Dr. Alan responded "Yes, I think I can," and they agreed to treatment.
"I treated the man with urosepsis, and the next morning he had been restored to the condition he had been in before he was sick. Everyone was happy. Five years later, I saw him in my waiting room when he was 100 years old."
"People in North Dakota live a long time, possibly because many are farmers who often work in the fields until they are 80," Dr. Alan writes. "In any case, I have seen far too many elderly patients become entrapped in the lack of a distinction between 'Do Not Treat' and DNR."
About Dr. Alan Lindemann: "Rural Doc" Alan Lindemann, M.D. is an obstetrician and past winner of the Rural Health Care Provider of the Year award. He formerly served as Clinical Assistant Professor at the University of North Dakota as a clinical faculty member and preceptor with medical students in rural rotations. During his time as a professor, he earned several acknowledgements, including OB-GYN Outstanding Clerkship Teaching Awards, Excellence in Teaching Award, Outstanding Volunteer Faculty Award, and Preceptor of the Year Award two times. Dr. Alan is the co-author of "Modern Medicine: What You're Dying to Know," a book about how corporate medicine, pharmaceutical companies, and insurance companies have taken over the practice of medicine from physicians. Originally intended to help consumers navigate the health care system, the book today describes just what consumers have lost in the takeover of physician care by corporations. He is inspiring women to learn how to steer their own pregnancies and deliveries, as well as their long-term overall health, with helpful resources at his new website PregnancyYourWay.com.
To request an interview with Dr. Alan, contact Michelle Tennant & Klaudia Simon, Wasabi Publicity, Inc. 828.817.4034 ibookinterviews@gmail.com. For more information visit dralanlindemann.onlinepresskit247.com.
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