Fillable Do Not Resuscitate Order Template

What is a Do Not Resuscitate Order (DNR) form?

A Do Not Resuscitate Order, commonly referred to as a DNR, is a legal document that tells healthcare providers not to perform CPR (cardiopulmonary resuscitation) or other life-sustaining treatments if a person's breathing stops or if the heart stops beating. This order is used by individuals who wish to avoid aggressive medical interventions at the end of life.

How does one create a DNR order?

To create a DNR order, an individual must discuss their healthcare wishes with their doctor or healthcare provider. The doctor will then document these wishes in the form of a DNR order. The process can vary by state, so it's important to follow the specific requirements that are in place where the individual lives. Often, the order must be signed by both the patient (or their legal healthcare proxy) and the physician.

Is a DNR order the same as a living will or healthcare power of attorney?

No, a DNR order is not the same as a living will or a healthcare power of attorney. A living will is a document that outlines a person's wishes about medical treatment if they are unable to communicate those wishes themselves. A healthcare power of attorney appoints someone to make healthcare decisions on a person's behalf if they are unable to do so. A DNR specifically addresses the use of CPR and other life-saving measures in the event of cardiac or respiratory arrest.

Can a DNR order be revoked?

Yes, a DNR order can be revoked at any time by the person it concerns. The revocation does not have to be in writing; it can be done verbally by expressing the wish to rescind the DNR order to a healthcare provider. However, to avoid confusion, it's usually recommended to document the revocation in writing and inform all parties involved in the care of the change in decision.

Where should a DNR order be kept?

A DNR order should be kept in a place where it is easily accessible to emergency personnel and healthcare providers. Many people choose to keep a copy at home in a visible location, like on the refrigerator door, and also to inform family members or caregivers of the order's whereabouts. It's also advisable to have a copy on file with one's healthcare providers and in a personal medical records file.

Who can create a DNR order?

A DNR order can only be created by an adult with the capacity to make their own healthcare decisions or by a legally appointed healthcare proxy if the individual is incapacitated. The requirements for executing a DNR vary by state, including who can sign the document, so it's important to check local laws.

Is a DNR order valid across state lines?

The validity of a DNR order across state lines can vary. While some states have reciprocal agreements recognizing DNR orders from other states, not all do. For those who travel or live part-time in more than one state, it's a good idea to understand the DNR requirements and ensure compliance in each state, or consider having a DNR order established in each state where they spend significant time.

How often should a DNR order be reviewed?

It's wise to review a DNR order periodically, especially if there is a significant change in health status, medical treatment preferences, or personal wishes. Discussing your DNR order during regular healthcare visits can ensure it continues to reflect your current wishes regarding end-of-life care.

When it comes to filling out a Do Not Resuscitate Order (DNR) form, accuracy and clarity are paramount. Mistakes in this document can have serious implications. Here are seven common errors that individuals often make:

1. Not verifying the patient's identity properly. It is crucial to ensure that all patient information matches official documents precisely to avoid any confusion or disputes.

2. Failing to get the required signatures. A DNR order must be signed by both the patient (or their legal representative) and the physician to be valid. Overlooking or missing a signature can render the document ineffective.

3. Using unclear or ambiguous language. The instructions in the DNR must be clear and unequivocal. Any ambiguity can lead to misinterpretation and unintended actions.

4. Not specifying the conditions under which the DNR is applicable. It's important to detail when the DNR should be enacted, whether during all medical situations or specific circumstances.

5. Forgetting to date the document. Dating the document is not only a legal requirement but also vital in determining its relevancy and currency.

6. Ignoring state-specific requirements. DNR orders and their requirements can vary significantly from one state to another. Not adhering to state-specific laws and guidelines can invalidate the document.

7. Not updating the document. A DNR order should be reviewed periodically and updated as necessary to reflect the current wishes of the patient and any changes in their health status or treatment preferences.

Avoiding these mistakes is essential in ensuring that a DNR order accurately reflects the patient's wishes and is legally enforceable. Thoughtful attention to detail can prevent unnecessary stress and confusion during critical moments.

When planning for future medical care, individuals often use a variety of legal documents in addition to the Do Not Resuscitate (DNR) Order form. These documents are essential in ensuring a person's healthcare wishes are known and respected, especially in situations where they cannot communicate their desires themselves. Below is a list of common documents that are typically used alongside a DNR order. Each plays a crucial role in comprehensive healthcare planning.

• Living Will: This document specifies an individual's preferences regarding medical treatment in situations where they are unable to make decisions due to illness or incapacity. It often covers topics such as the use of life-support systems, pain management, and other critical care decisions.
• Healthcare Power of Attorney: Also known as a healthcare proxy, this document appoints another person to make medical decisions on an individual's behalf if they are unable to do so. This appointed agent works in concert with healthcare providers to ensure that the individual’s medical and health care preferences are honored.
• Physician Orders for Life-Sustaining Treatment (POLST): POLST forms complement DNR orders by providing more comprehensive instructions regarding emergency and other medical treatments. These are especially useful for individuals with serious illnesses, detailing which treatments they do or do not want beyond cardiopulmonary resuscitation (CPR).
• Medical Orders for Scope of Treatment (MOST): Similar to the POLST, the MOST is a doctor's order that outlines a patient's wishes concerning life-sustaining treatments. It is typically used for individuals with advanced illnesses and specifies preferences for treatments like antibiotics, artificial nutrition, and hydration.
• Last Will and Testament: While not directly related to medical decisions, a last will and testament is important for outlining how an individual's assets and affairs should be handled after their death. This document can provide peace of mind and prevent legal complications for surviving family members.
• Organ and Tissue Donation Registration: This expresses an individual's wishes regarding organ and tissue donation after death. It can be included in driver's licenses or state ID cards and ensures that these wishes are carried out without placing the burden of decision-making on the family.
• Emergency Contact Form: Though not a legal document, an emergency contact form is crucial. It provides healthcare professionals with contact information for the individual's chosen representatives, ensuring family members or designated proxies can be reached quickly in an emergency.

Understanding and preparing these documents in advance can significantly ease the burden on individuals and their loved ones during challenging times. It ensures that healthcare wishes are respected and that decision-making processes are as smooth as possible when critical situations arise. Planning ahead with these documents provides clarity, control, and peace of mind for everyone involved.

• Living Will: This document, much like a Do Not Resuscitate (DNR) order, allows individuals to state their wishes regarding medical treatment in the event that they are no longer able to communicate their decisions due to incapacity. Both documents are utilized to guide healthcare providers on the preferred interventions (or lack thereof) based on the patient's predetermined wishes. However, a living will is broader, often covering a range of medical interventions beyond resuscitation.

• Healthcare Power of Attorney (POA): Similar to a DNR, this legal document enables an individual to designate another person (an agent) to make medical decisions on their behalf should they become unable to do so. While a DNR specifically addresses the issue of not undertaking resuscitation efforts in life-threatening situations, a healthcare POA encompasses a more extensive array of medical decisions. The link between them lies in their common purpose of ensuring that medical care aligns with the individual's values and wishes.

• Advance Directive: An advance directive is essentially a combination of a living will and a healthcare POA. It outlines a person's healthcare preferences, including desires about life-sustaining treatment when facing a terminal illness or permanent unconsciousness, similarly to a DNR. However, it also allows for the appointment of a healthcare proxy to make decisions when the individual is unable to. This document and a DNR both serve as tools for communicating a person's wishes regarding medical treatment.

• POLST Form (Physician Orders for Life-Sustaining Treatment): A POLST form is similar to a DNR in that it is intended for patients with serious health conditions and makes clear what medical treatments a patient does and does not want towards the end of life, including the desire to avoid or receive resuscitation. Both are physician orders that become part of the patient's medical record. Unlike a DNR, which specifically addresses resuscitation, the POLST form can provide broader instructions on life-sustaining treatments.

Completing a Do Not Resuscitate (DNR) Order form is a critical process that requires careful attention to detail and thorough understanding. Following the right steps and avoiding certain mistakes can ensure your wishes are respected and legally acknowledged. Here’s a list of dos and don'ts to consider:

• Do thoroughly review each section of the form to ensure understanding of its contents and implications.
• Do consult with a healthcare provider to discuss the medical aspects of the DNR order and how it affects emergency care.
• Do ensure that all required signatures are obtained, including that of the patient (if possible), a witness, and a qualified healthcare professional.
• Do verify that the information on the form is accurate and clearly written to avoid any potential misunderstandings.
• Don't leave any sections incomplete; unanswered questions may invalidate the form or cause delays in its enactment.
• Don't sign the form without fully understanding the consequences of a DNR order.
• Don't forget to discuss and share the completed form with family members or caregivers who might be involved in emergency situations.
• Don't neglect to make multiple copies of the signed form. Keep the original in a safe but accessible place, and distribute copies to appropriate parties, such as family members and your primary care doctor.

When discussing a Do Not Resuscitate (DNR) Order, several misconceptions often arise. These misunderstandings can complicate the decisions individuals and families face regarding end-of-life care. Below are five common misconceptions clarified to provide a better understanding:

• Misconception 1: A DNR Order affects all medical treatments. One common misconception is that having a DNR Order means withholding all medical treatments. In reality, it specifically instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if the heart stops or if breathing ceases. It does not prevent receiving other forms of medical care, such as pain management, antibiotics, or nutrition.

• Misconception 2: DNR Orders are permanent and cannot be changed. Another misconception is the belief that once a DNR Order is in place, it cannot be revoked. However, DNR Orders can be updated or canceled at any time based on the patient's or their legally authorized representative's wishes. Communication with healthcare providers is key to making any changes.

• Misconception 3: Only older adults need a DNR Order. The decision to have a DNR Order is not age-specific. It is based on an individual’s health condition and personal preferences regarding end-of-life care. People of any age with severe chronic conditions or terminal illnesses may consider having a conversation about DNR Orders with their healthcare provider.

• Misconception 4: DNR Orders are only for people in hospitals. While DNR Orders are often associated with hospital stays, they are applicable in any setting, including the individual's home, nursing home, or during transport in an ambulance. The key is ensuring that the DNR Order is accessible and that family members and caregivers are aware of the individual’s wishes.

• Misconception 5: Health care providers will not work as hard to save a patient with a DNR Order. There's a concern that by agreeing to a DNR Order, healthcare providers might not provide the best possible care. This is not the case. The decision to not perform CPR does not affect the quality or level of care provided to manage pain or other conditions the patient may have. Healthcare professionals are committed to offering compassionate and appropriate care, respecting the wishes expressed in a DNR Order.

Understanding the facts about DNR Orders can help individuals make informed decisions about their healthcare preferences. It is important for patients, along with their families and healthcare providers, to engage in open discussions about the objectives of care and treatment preferences at the end of life.

A Do Not Resuscitate (DNR) Order is a legal form used by individuals who wish to decline emergency medical care such as CPR (cardiopulmonary resuscitation) in the event their heart stops or they stop breathing. Understanding how to properly fill out and use this form is crucial for it to be effectively implemented. Here are six key takeaways regarding the Do Not Resuscitate Order form:

• Before filling out a DNR order, it's important to consult with a healthcare provider. They can help explain what the form means and ensure it matches the individual's healthcare wishes.
• The DNR form must be signed by the individual (or their legal healthcare representative) and a doctor or licensed healthcare provider. This ensures that the order is both voluntarily and richly informed.
• Once completed, the DNR order should be easily accessible, typically kept in a place where emergency responders can see it, like on the refrigerator or near the patient's bed.
• In case the person changes their mind, they should communicate their new wishes immediately to their healthcare provider to have the DNR order revoked or altered.
• Make several copies of the DNR form. One should stay with the patient, one with their healthcare provider, and another with any close family members or caretakers. This ensures all relevant parties are informed of the patient's wishes.
• DNR orders might differ from one state to another in the United States, making it essential to follow the specific requirements outlined by the state where the patient resides or is receiving care.