"Hello, my name is Dr. [Name], I'm one of the doctors looking after your mother. Thank you for taking the time to speak with me."
"To begin, it would be helpful to hear your understanding of how your mother has been recently, during this time in hospital."
"Thank you, that's a very clear picture. As part of planning ahead for all our patients, especially those who are more frail, we feel it's important to discuss what we would do in the unlikely event their heart were to stop. This involves an emergency procedure called CPR, or resuscitation. Is that something you've heard much about before?"
"It's often not like it appears on television. Would it be okay if I explain what it involves and why we need to talk about it now?"
"CPR is what we do to try and restart the heart after it has stopped. It's a very physical and invasive treatment. It involves very forceful and deep compressions on the chest, sometimes using electric shocks, and often placing a tube down the throat to take over breathing."
"For a person who is frail and has several significant health problems like your mother, the chances of this procedure being successful are unfortunately extremely low. More than that, the process itself can cause harm, such as breaking ribs or causing brain injury, and can be very distressing."
"Because of this, the whole medical team has discussed your mother's case. We have come to the conclusion that if her heart were to stop, attempting CPR would not work and would only cause her harm and distress. Therefore, we feel it is in her best interests to put a 'Do Not Attempt CPR' form in her notes."
"I need to be very clear about this next point, as it's the most important. This decision is only about the single act of CPR if her heart stops. It absolutely does not mean we will stop any other treatment."
"We will continue to give her the very best care. If she gets another chest infection, we will treat it with antibiotics. If she is in pain, we will give her pain relief. All her usual medications and care will continue exactly as before. This is not about 'giving up'; it's about ensuring any treatment we give is kind, dignified, and genuinely helpful."
"I realise this is a great deal to take in, and that this is a very difficult and upsetting conversation to have. How are you feeling after hearing all of that?"
"To help me be sure I've explained things clearly, could you tell me back in your own words what this DNACPR decision means for your mother's treatment going forward?"
"Thank you. It is a sad thing to discuss, but it is important for planning. We will make sure this decision is clearly documented. Please don't hesitate to ask if you have any more questions at all."