Free Do Not Resuscitate Order Form for Arizona

What is a Do Not Resuscitate Order (DNR) in Arizona?

A Do Not Resuscitate Order (DNR) in Arizona is a legal document that allows a person to refuse resuscitation efforts in the event of a medical emergency. This means that if a person’s heart stops beating or they stop breathing, medical personnel will not perform cardiopulmonary resuscitation (CPR) or other life-saving measures. The order is typically used by individuals with terminal illnesses or those who wish to avoid aggressive medical interventions at the end of life.

How do I obtain a DNR form in Arizona?

To obtain a DNR form in Arizona, individuals can download it from the Arizona Department of Health Services website or request a copy from their healthcare provider. It is important to ensure that the form is the most current version. Once completed, the form must be signed by the patient and a physician to be valid.

Who can sign a DNR order?

A DNR order can be signed by the patient themselves if they are of sound mind and able to make their own medical decisions. If the patient is unable to sign, a legally authorized representative, such as a healthcare proxy or family member, may sign on their behalf. It is essential that the person signing the order understands the implications of the decision.

Is a DNR order valid in all healthcare settings?

Yes, a DNR order is valid in all healthcare settings in Arizona, including hospitals, nursing homes, and at home. However, it is crucial to ensure that the order is clearly visible and accessible to medical personnel. Carrying a copy of the DNR order or wearing a medical alert bracelet can help ensure that healthcare providers are aware of the patient’s wishes.

Can a DNR order be revoked?

Yes, a DNR order can be revoked at any time by the patient or their authorized representative. To revoke the order, the individual should destroy the original document and inform their healthcare provider of the change. It is advisable to create a new order if the patient’s wishes change regarding resuscitation.

What should I discuss with my doctor before completing a DNR order?

Before completing a DNR order, it is important to have an open discussion with your doctor about your medical condition, prognosis, and treatment options. Understanding the implications of a DNR order and how it aligns with your personal values and wishes is essential. Your doctor can help clarify any questions and provide guidance on end-of-life care decisions.

Are there any other documents related to end-of-life decisions I should consider?

Yes, in addition to a DNR order, individuals may want to consider creating an advance directive or a living will. These documents outline your preferences for medical treatment and appoint someone to make healthcare decisions on your behalf if you become unable to do so. It is advisable to discuss these documents with your healthcare provider to ensure they align with your wishes.

1. Not including a date on the form. A DNR order must be current to be valid.

2. Failing to sign the form. Without a signature, the order cannot be enforced.

3. Not having a witness present when signing. Arizona law requires a witness to validate the order.

4. Leaving out critical medical information. Ensure that all relevant medical history is included.

5. Using unclear language. Be specific about the wishes regarding resuscitation.

6. Not discussing the order with healthcare providers. Communication with medical staff is essential.

7. Forgetting to update the order if circumstances change. Review the DNR regularly.

8. Not providing copies to family members. Ensure that loved ones are aware of the order.

9. Failing to check state-specific requirements. Each state may have unique regulations regarding DNR orders.

10. Neglecting to include a designated healthcare proxy. This person can help communicate your wishes if needed.

When considering end-of-life care options, it's essential to have a comprehensive understanding of the various documents that may accompany an Arizona Do Not Resuscitate (DNR) Order. Each of these forms serves a unique purpose, ensuring that your healthcare preferences are respected and followed. Below is a list of other important documents that are often used alongside a DNR Order.

• Advance Directive: This document allows individuals to outline their preferences for medical treatment in the event they become unable to communicate their wishes. It can include specific instructions about life-sustaining treatments and appoints a healthcare proxy to make decisions on one's behalf.
• Living Will: A living will is a type of advance directive that specifically addresses the types of medical treatment an individual wishes to receive or not receive if they are terminally ill or in a persistent vegetative state.
• Healthcare Power of Attorney: This document designates a trusted person to make healthcare decisions for you if you are unable to do so. This individual can ensure that your wishes, including those stated in your DNR, are honored.
• POLST (Physician Orders for Life-Sustaining Treatment): A POLST form translates your healthcare preferences into actionable medical orders. Unlike a DNR, which focuses solely on resuscitation, a POLST addresses a broader range of treatment options.
• Patient Advocate or Surrogate Designation: This form allows you to designate someone to advocate for your medical wishes if you cannot communicate them. It ensures that your voice is heard in critical healthcare situations.
• Do Not Intubate (DNI) Order: Similar to a DNR, a DNI order specifically instructs medical personnel not to insert a breathing tube in the event of respiratory failure, allowing for a more tailored approach to end-of-life care.
• Comfort Care Order: This document outlines the desire for palliative care, focusing on comfort rather than curative treatment. It prioritizes pain management and quality of life in the final stages of illness.
• Organ Donation Form: If you wish to donate your organs after death, this form allows you to express your intent. It can be included with other end-of-life documents to ensure your wishes regarding organ donation are clear.

Understanding these documents can empower you and your loved ones to make informed decisions about healthcare preferences. By preparing these forms in advance, you can ensure that your wishes are respected and that your loved ones are not left to make difficult decisions during emotionally challenging times.

• Advance Healthcare Directive: This document allows individuals to outline their preferences for medical treatment in advance, particularly in situations where they may be unable to communicate their wishes. Like a Do Not Resuscitate Order, it provides guidance to healthcare providers about the patient's desires regarding life-sustaining measures.
• Living Will: A living will specifically addresses end-of-life care decisions. It details the types of medical treatment an individual does or does not want, similar to a Do Not Resuscitate Order, which focuses on resuscitation efforts.
• Healthcare Proxy: This document designates a trusted person to make medical decisions on behalf of someone who is incapacitated. While a Do Not Resuscitate Order provides specific instructions, a healthcare proxy allows for flexibility in decision-making based on the patient's known wishes.
• Physician Orders for Life-Sustaining Treatment (POLST): POLST is a medical order that outlines a patient's preferences for life-sustaining treatments. It is similar to a Do Not Resuscitate Order in that it is actionable and guides emergency medical personnel in urgent situations.
• Do Not Intubate (DNI) Order: A DNI order specifies that a patient does not wish to be intubated or placed on a ventilator. Like a Do Not Resuscitate Order, it communicates a specific medical preference to healthcare providers.
• Comfort Care Order: This order focuses on providing comfort rather than aggressive treatment. It aligns with the philosophy behind a Do Not Resuscitate Order, prioritizing the patient's comfort over life-sustaining interventions.
• End-of-Life Care Plan: An end-of-life care plan outlines the overall approach to care as a person nears death. It can include preferences for resuscitation and other medical interventions, similar to the directives provided in a Do Not Resuscitate Order.
• Medical Power of Attorney: This legal document gives someone the authority to make healthcare decisions on behalf of another person. While it does not specify treatment preferences like a Do Not Resuscitate Order, it empowers a designated individual to advocate for the patient's wishes.
• Do Not Hospitalize (DNH) Order: A DNH order indicates that a patient should not be taken to a hospital for treatment. This is similar to a Do Not Resuscitate Order in that it reflects the patient's wishes regarding the type of care they wish to receive.

When filling out the Arizona Do Not Resuscitate Order form, it is crucial to approach the task with care and understanding. Here are some important dos and don'ts to keep in mind:

• Do discuss your wishes with your healthcare provider to ensure clarity.
• Do have a conversation with your family and loved ones about your decision.
• Do fill out the form completely and accurately to avoid any confusion later.
• Do keep a copy of the completed form in a safe place and share it with your healthcare team.
• Don't leave any sections blank, as this could lead to misunderstandings.
• Don't assume that verbal instructions are enough; written documentation is essential.
• Don't forget to review and update the form periodically to reflect any changes in your wishes.

Understanding the Arizona Do Not Resuscitate (DNR) Order form is crucial for making informed healthcare decisions. However, several misconceptions can lead to confusion. Here are six common misunderstandings about the Arizona DNR Order form:

1. A DNR order means no medical care will be provided.

   This is not true. A DNR order specifically pertains to resuscitation efforts in the event of cardiac arrest. Other medical treatments and interventions will still be provided as necessary.

2. Only terminally ill patients can have a DNR order.

   This misconception overlooks the fact that anyone can request a DNR order, regardless of their health status. It is a personal choice that reflects an individual's wishes regarding resuscitation.

3. A DNR order is permanent and cannot be changed.

   In reality, individuals can change or revoke their DNR order at any time. It is important to communicate any changes to healthcare providers and ensure that the latest version is available.

4. A DNR order is only valid in a hospital setting.

   This is a misconception. An Arizona DNR order is valid in various settings, including at home, in assisted living facilities, and in hospice care. It is essential to have the order readily available in all locations.

5. Family members can make DNR decisions on behalf of a patient.

   While family members can advocate for a patient's wishes, only the individual or their legally designated representative can complete and sign a DNR order. Clear communication about wishes is key.

6. A DNR order is the same as a living will.

   This is incorrect. A DNR order specifically addresses resuscitation efforts, while a living will outlines broader healthcare decisions and preferences regarding end-of-life care.

Clarifying these misconceptions can help individuals make informed decisions about their healthcare preferences and ensure that their wishes are respected.

Filling out a Do Not Resuscitate (DNR) Order form in Arizona is a critical step in ensuring that your healthcare preferences are respected. Here are some key takeaways to consider:

• Understand the Purpose: A DNR order instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) if your heart stops or you stop breathing.
• Eligibility: The form is intended for adults who have a terminal illness or a condition that significantly limits their life expectancy.
• Consult with Healthcare Providers: Before completing the form, discuss your wishes with your doctor. They can help clarify your options and ensure you understand the implications.
• Complete the Form Accurately: Fill out all required fields carefully. Incomplete or unclear information can lead to confusion during a medical emergency.
• Signatures Matter: The DNR order must be signed by you or your legal representative, along with a physician’s signature to be valid.
• Keep Copies Accessible: Once completed, keep copies of the DNR order in accessible locations, such as your home, hospital, or with your primary care physician.
• Review Regularly: Your health status and preferences may change over time. Regularly review and update your DNR order to ensure it reflects your current wishes.

Taking these steps can provide peace of mind, knowing your healthcare preferences will be honored. Make sure your loved ones are aware of your decisions, as this can facilitate discussions during challenging times.