do you want to be resuscitated?

Here is my advice to all of you: get your affairs in order. By that I mean, have a conversation with your parents about what they would want done if they were suddenly taken critically ill. Do they want to be resuscitated or placed on machines?
Case in point: I had a 55 year old man today who lived in a nursing home after having several strokes. He was actually doing very well and could walk around where he wanted to and even leave the nursing home with someone. This morning he was found unresponsive. He had a massive head bleed.
When he came into the ER the paperwork from the nursing home said that he was a full code. So he was intubated. He was put on infusions, had tubes put in every orifice. He was completely unresponsive, but we were obligated to do everything for him. Turns out he had a legal guardian/conservator. We assumed he had no family. When the legal guardian arrived he said that he knew the patient did not want extraordinary measures. Whaaat? This guy worked for some private company that apparently employs people to be legal guardians. He was going to have his company fax the paperwork to us. Well it turns out that he had spoke to the patient about not being resuscitated and the patient clearly stated he did not want to be put on machines to keep him alive. The guardian wrote some kind of note about it, but never had him formally sign anything. So the conversation was moot. For this session speaking with the patient for a little over an hour about resuscitation and then doing nothing about his wishes - charge: $120.00. The paper he gave us was actually a bill. what a cluster f--k.
So we put in a call to the NH to see if patient had any family. Pretty soon I hear from the mother of the patients children who will be heading down. Then I hear from his uncle. Pretty soon son (in his 20's) shows up with the patients "pastor".
So ER doc goes to talk to family who hem and haw about what should be done with patient Apparently the family still had a say in his life even though he had a legal guardian. The legal guardian would go by what they wanted. A neurosurgeon had come down to see the patient and had informed the family that the patient would have a dismal outcome with surgery. However, family decides that they want everything done for the patient - they want him to have the surgery. So off he goes to surgery. Will he survive the surgery? Who knows....if he does he will probably be in a vegetative state.
I wondered what is the point of having a legal guardian if they are not going to make the decisions? When asked about that, the guardian said: Terry Schiavo (a woman who was in a vegetative state for years and the husband wanted to let the patient die and the family didn't - controversy went on for months in the national press). According to the legal guardian, he and his company could not risk the potential legal action that the family could bring.
This whole thing could have been avoided if the legal guardian had done his job. It seems to me that one of the main jobs of a legal guardian when someone is in a nursing home is to determine resuscitation status and provide documentation. It almost seems like the company should be held accountable in some way for this. This poor man is now going to be put through major surgery and a lengthy ICU stay and all because the guardian never communicated his wishes.
After speaking with the nursing home the nurse there told me that the family was completely dysfunctional, which is probably why he had a guardian in the first place. So now this dysfunctional family will be making all the decisions for the patient.
Take my advice: get your affairs in order, communicate with your spouse, your parents. Awful things happen when you least expect it.