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Lookup NU author(s): Dr Felicity DewhurstORCiD, Professor Barbara HanrattyORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
© The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.Background: COVID-19 brought additional challenges to Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision-making, which was already a contentious issue. In the UK, reports of poor DNACPR decision-making and communication emerged in 2020, including from the regulator, the Care Quality Commission. This paper explores the experiences of people who discussed DNACPR with a healthcare professional on behalf of a relative during the coronavirus pandemic, with the aim of identifying areas of good practice and what needs to be improved. Methods: a total of 39 people participated in semi-structured interviews via video conferencing software or telephone. Data were evaluated using Framework Analysis. Findings: results are presented around three main themes: understanding, communication and impact. Participants’ understanding about DNACPR was important, as those with better understanding tended to reflect more positively on their discussions with clinicians. The role of relatives in the decision-making process was a frequent source of misunderstanding. Healthcare professionals’ communication skills were important. Where discussions went well, relatives were given clear explanations and the opportunity to ask questions. However many relatives felt that conversations were rushed. DNACPR discussions can have a lasting impact—relatives reported them to be significant moments in care journeys. Many relatives perceived that they were asked to decide whether their relative should receive CPR and described enduring emotional consequences, including guilt. Conclusion: the pandemic has illuminated deficiencies in current practice around DNACPR discussion, which can have difficult to anticipate and lasting negative consequences for relatives. This research raises questions about the current approach to DNACPR decision-making.
Author(s): Tomkow L, Dewhurst F, Hubmann M, Straub C, Damisa E, Hanratty B, Todd C
Publication type: Article
Publication status: Published
Journal: Age and Ageing
Year: 2023
Volume: 52
Issue: 6
Online publication date: 05/06/2023
Acceptance date: 02/04/2021
Date deposited: 25/07/2023
ISSN (print): 0002-0729
ISSN (electronic): 1468-2834
Publisher: Oxford University Press
URL: https://doi.org/10.1093/ageing/afad087
DOI: 10.1093/ageing/afad087
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