Elderly feel pushed into signing DNR forms, warn charities
‘Blanket decisions’ over treatment options for older patients are unacceptable, care organisations say
ELDERLY people are being pressured into signing documents that would leave them exempt from receiving CPR, care charities have warned.
A coalition of organisations have highlighted “shocking” examples where “blanket decisions” appear to have been made regarding the treatment options available for vulnerable and older people.
Older people claim that they have felt pressured into signing Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) forms, that “many of the people affected have experienced fear and anxiety”, and “that their lives and wishes do not matter. This is shameful and unacceptable”.
The open letter has been signed by signatories including the chief executives of Age UK and Independent Age.
They added: “Difficult and painful decisions will need to be made in the weeks ahead, but these must be made on a case-by-case basis, taking account of the risks and benefits, and people’s own wishes, through honest discussions between patients, doctors and families.
“Whether or not to sign a DNACPR form is an individual’s decision, and they have a right to make that decision without feeling pressurised.
“We do not underestimate the significant pressures being faced by all staff working across our health and social care sectors at this difficult time, but it is crucial that we continue to protect people’s fundamental human rights.”
Their open letter follows unprecedented warnings issued last week by the Care Quality Commission, the healthcare regulator, the British Medical Association, the Care Provider Alliance and the Royal College of General Practitioners, who branded the policy as “unacceptable”.
“It is unacceptable for advance care plans, with or without DNAR [Do Not Attempt Resuscitation] form completion, to be applied to groups of people of any description,” they stated.
“These decisions must continue to be made on an individual basis according to need.” There have been numerous examples across the UK of the forms being sent to vulnerable and elderly people.
One 85-year-old woman was called by her GP, who asked if she wanted to go to hospital if she developed coronavirus or if she would sign a “do not attempt CPR” form.
The woman, who has several longterm health problems but still enjoys life, “felt mortified and was extremely upset when she received a letter with a form in a few days later”, Age UK said.
Another GP surgery in Maesteg, a town in Bridgend County Borough, Wales, asked patients with “significant life-limiting illnesses” to sign the form in case they contracted coronavirus.
Cwm TAF Morgannwg University Health Board has since apologised for any distress caused.
Nicola Sturgeon, Scotland’s First Minister, has also said that no one should be forced into making decisions on signing the forms.
Her calls came after a family criticised NHS Tayside when they learned their 86-year-old grandmother agreed
‘Many have experienced fear and anxiety and that their lives and wishes do not matter. This is shameful’
to a DNACPR request from her GP surgery.
The open letter from the elderly care charities added: “It would be completely unacceptable to abandon these rights in favour of taking blanket, discriminatory decisions.
“It is also crucial that governments and health services across our four nations carefully consider the ways they can provide stronger leadership and guidance – to ensure that people’s rights are upheld and communication with vulnerable people is handled in a far more sensitive way to avoid further worry and upset as we navigate the difficult path ahead of us.”
Its signatories include Caroline Abrahams, the charity director of Age UK, Deborah Alsina, the chief executive of Independent Age, Jane Ashcroft, the chief executive of Anchor Hanover, Helena Herklots, the older people’s commissioner in Wales, Victoria Lloyd, the chief executive of Age Cymru, Eddie Lynch, the older people’s commis- sioner in Northern Ireland, Donald Macaskill, the chief executive of Scottish Care, Linda Robinson, the chief executive of Age Northern Ireland and Brian Sloan, the chief executive of Age Scotland.