DNR - How do I make this decision?

I'm a bit weepy today. I went to see Bill at the VA Memory Care. It was a ______ visit. I'm trying to fill in the blank with an adjective, but I don't have one. It was not pleasant. It was not fun. It was not happy. Bill only wants to get out and ride around. Unfortunately, I hurt my shoulder and did not want to lift the wheelchair or worry about catching him if he falls. So we sat in his room and "talked." 

He doesn't talk. He asks questions. The same ones over and over. How are the kids? How are you? Then, he says, "I want to take you out to lunch." I explain, again, that I can't today. He says that he'll drive. I remind him he has no license. Then he sits and stares until the session starts all over again. And again. And again. 

After I got home, I began to think about the question that the VA asks me every month. Do you want a DNR on Bill? I always say no. But, am I doing the right thing? I don't know. This afternoon, I searched the internet for information on when to put a DNR on a loved one. Here are the answers I got: 

Deciding when to place a Do Not Resuscitate (DNR) order on a loved one with Alzheimer's Dementia is a deeply personal and challenging decision. It involves considering their current health status, quality of life, and their previously expressed wishes if they were able to make their preferences known.

Here are some factors that might help guide your decision:

### 1. **Stage of the Disease**

   - **Early to Mid-Stage:** If your husband is still able to engage in life meaningfully and has some level of independence, you might feel that resuscitation would be appropriate if it could extend his life with a decent quality.

   - **Advanced Stage:** In the advanced stages of Alzheimer's, when the ability to communicate, recognize loved ones, or perform basic functions is significantly impaired, many people consider a DNR. At this point, resuscitation might prolong life without improving the quality of that life.

### 2. **Overall Health**

   - If your husband has other significant health issues, such as heart disease or chronic conditions that could lead to sudden cardiac or respiratory arrest, it’s worth considering how these conditions might interact with his dementia. Sometimes, the presence of severe comorbidities makes the decision clearer.

### 3. **Quality of Life**

   - Consider what your husband’s quality of life is like now and what it might be in the future. If resuscitation were to occur, would it lead to a meaningful recovery, or would it likely result in more suffering? For example, if he were to be resuscitated, but with diminished capacity afterward, would this be what he would want?

### 4. **His Wishes**

   - If your husband ever expressed his wishes regarding life-sustaining treatments before his diagnosis or in the early stages, those wishes should guide your decision. If he has an advance directive, living will, or had conversations about his preferences, they should be honored.

### 5. **Family Input**

   - It can be helpful to talk to your children or other close family members about their thoughts and feelings. They may offer insights or support that can make the decision less burdensome.

### 6. **Medical Advice**

   - Consult with his doctors. They can provide insights into his prognosis and help you understand what resuscitation might entail for someone in his condition. Palliative care specialists can also offer guidance focused on comfort and quality of life.

### 7. **Emotional Readiness**

   - Are you emotionally prepared to make this decision? It’s okay to seek support from friends, family, or a counselor. It's a heavy burden, and you don't have to carry it alone.

### 8. **Ethical and Spiritual Considerations**

   - Reflect on your ethical and spiritual beliefs, and how they align with the idea of a DNR. Your faith community or spiritual advisor might provide valuable guidance.

There's no single "right" time, as every situation is unique. It’s about finding the right balance between honoring your husband's dignity, respecting his wishes, and considering the emotional and physical toll on both him and you.

After reading this, I could only cry. . .