When is the appropriate time to make the change from being “full code” to being “no code”? Full code means that when your heart stops, and you have died, medical professionals or paramedics will do everything medically possible to try and restart your heart. No code means that if your heart stops, medical professionals or paramedics will NOT try to restart your heart. They will let a person stay dead. They will not intervene and try to bring them back.

This sounds very harsh so let's explore this idea further. We are conditioned to think that a call to 911 can help us no matter what the emergency is and to think that the doctors will always be able to "fix" me. 

Because everyone dies, whether or not we want to admit it, there will come a point when the medical system will "fail" us. It will be our time to die. When the doctors have said, "I can't fix you" it is time to reconsider what medicine can do for us. 

Medicine and medical technology can prolong our life but not indefinitely and it is generally at the expense of our quality of living. Or we can reframe how we think of medicine, using it as a tool to provide comfort, dignity and support as our final life experience unfolds.

If I stuck my finger in a light socket and my heart stopped, I would want you to call 911. The paramedics could probably restart my heart and I would return to my normal life and activities. 

If my body is filled with a disease that the doctors have said they cannot fix, my heart stops, and I do not have a No Code order or DNR, DNAR form completed and signed by a physician, the paramedics or doctors are bound by their profession to try to start my heart again. And they may succeed BUT in most cases I will not be as able as I was before my heart stopped. My disease will still be non-fixable. I will die again in a short time. 

And in that short time there will be continued decline of my body, continued progression of the disease, the pain will remain and there may be increased pain from fractured bones due to the resuscitation efforts. 

Life will have less quality. What is quality? Is it heart beating, lungs exchanging air, kidneys working all with the help of machines, quality? OR is quality thinking, feeling and interacting? Something to think about.

Something More About...  Do I Want FULL CODE or a NO CODE?

Pages 12-15 of BY YOUR SIDE, A Guide for Caring for the Dying at Home, covers end of life decisions that need to be made before they are needed.  POLST, Advance Directives, DNR, DNAR and Durable Power of Attorney information is laid out clear ways. 

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Jessie H.

Thank you for sharing. This ties in well with the IG post and comments about post-code trauma. Thank you for normalizing death and EOL choices for your audience.
BK Books replied:
Hi Jessie, thanks for the kind words. Blessings! Barbara


Always enjoy reading your posts,I cared for my deceased husband while reading many of your pamphlets!
BK Books replied:
Patricia, I am honored that my materials and words have been of help to you during the caregiving time with your husband. Blessings to you. Barbara

natalie levinson

Excellent articles—all.
Husband was in hospice in a hospital.
So very thankful for their care..6 years ago.

Natalie 90 yrs independent still and enjoying it!

BK Books replied:
Hi Natalia, “90 years, independent still and enjoying it”, good for you. Blessings to you. Barbara


Very well said. I learned more about this when my husbands Aunt had a DNR and was living at an Assisted Living facility. They found her on the floor and called 911. Their duty is to try to save her. The facility did not tell them she had a DNR. But anyway they got to the hospital and they called her sister, her medical advisor, and she was not angry with the rescue people. She went to visit her fallen sister at the hospital and then asked to remove life saving devices. She was well into her 80’s.
Then just a few years ago, we had found this sister on the floor of her house and 911 was called. I don’t think she had a DNR, so all medical procedures went accordingly. However in the state she was in, we knew it wouldn’t be long, so choose to remove devices and was planning to move her to a hospice facility the next day, but she passed in the night.
Another instance, in 2007 my dad, had gone into the hospital and had a surgery to help the peritinitis of the intestine. I did not know much then, but he and I looked at each other and we both nodded it’s okay. I gave him my approval. That night he had to have a breathing tube put in. He did not have a DNR, so the hospital was going to do everything possible. After the family met the next day we decided to cease all devices and he passed within a minute.
These are tough choices, but families also have to take in consideration if they wake up and get a little better what kind of care will they need and what kind of quality life will it be for them.
I have learned so much since my Dad has passed away and am not afraid to talk about death. I have learned much from your blogs as well. Keep it up. God Bless.
BK Books replied:
Hi Anita, Your life situation with your aunt and father reflect what so many people today are faced with. Thank you for sharing. Blessings! Barbara

Lolita Silicani

Thank you for the great reminder. And a hard decision to make at times, for sure.
BK Books replied:
Hi Lolita, thank you for your comments. Blessings! Barbara

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