stage: 6

Resuscitation and dementia — the medical reality that makes this easier to decide than it feels

For most people in the advanced stages of dementia, attempting resuscitation is not in their best interests and is unlikely to succeed. Even if CPR briefly restarts the heart, it frequently causes broken ribs, internal injury, and brain damage from oxygen deprivation, and the person is likely to return to the same or a worse condition. The question of resuscitation should be addressed as part of advance care planning before a crisis, ideally with the person, their family, and their GP. A DNACPR notice should be in place and held with the person's records in any care setting. If no advance decision has been made and a family member is asked in a moment of crisis, it helps to know that most medical teams caring for people with advanced dementia will advise against resuscitation on clinical grounds. The most important thing is that the decision is documented clearly so that no one is put in the position of making it in an emergency.