Advanced care planning allows people to ensure their wishes regarding medical treatment will be respected if they are in an emergency situation or unable to express their care preferences due to incapacitation.
An advance directive can be drafted outlining who a person trusts to be in charge of their healthcare decisions if they are unable to participate in their own care for some reason, with a living will offering detailed information on their preferences for treatment in a range of potential medical situations. However, there is another consideration beyond those involved in advance directives: the Do Not Resuscitate order.
What Is A Do Not Resuscitate Order?
A Do Not Resuscitate Order, or DNR, is a legally-binding doctor’s order stating that no steps will be carried out to restore breathing or a patient’s heartbeat if they experience respiratory or cardiac arrest.
This is typically set up well before an emergency occurs, whether a patient feels strongly about not wanting to be resuscitated in general or as part of the planning carried out by patients who have a life-limiting illness.
A DNR is an order that refers specifically to cardiopulmonary resuscitation, or CPR. It does not offer guidance on how other potential treatments should be handled, such as pain medication or nutrition.
What Is Resuscitation?
CPR is a treatment that is typically given to a patient when their breathing or blood flow stops. Many people are most familiar with the simple procedure that involves mouth-to mouth breathing and pressing on the person’s chest, but there are other methods that may also be used for resuscitation. For example, an electric shock may be given to restart the heart and breathing tubes might be used to open up the airway. Some medicines might also be given to resuscitate a patient.
How Does A Do Not Resuscitate Order Work?
Whether a patient chooses to pursue a DNR or their named health care proxy makes this decision on their behalf, it is a good idea to meet with the patient’s physician to discuss all aspects of choosing or deciding against DNR orders.
When a patient obtains a DNR, it is placed in their hospital chart. A DNR only affects whether the patient will be given CPR; palliative care will generally be continued unless the patient decides otherwise.
Who Needs A Do Not Resuscitate Order?
Every competent individual has the right to refuse lifesaving medical treatment for any reason, and advance care planning can ensure this right is respected if a person becomes incapable of participating in their own care decisions.
If you are opposed to the idea of being resuscitated, have religious objections, worry it may negatively impact your quality of life or are concerned about the potential risks of undergoing processes like CPR, you might choose to request a DNR order.
CPR can indeed save lives, but older or frail people may suffer broken bones, damage to their brain or other organs, or they may be rendered unable to breathe without a ventilator. CPR is generally more successful in younger, healthier patients, and most people who get DNR orders are already in poor health.
If, on the other hand, you do wish to receive CPR, there is no need to do anything as this is the standard course of treatment when a person stops breathing. By default, doctors will always do whatever they can to save a patient unless a DNR or other type of order is in place.
How Do You Get A Do Not Resuscitate Order?
If you decide you wish to have a DNR order put in place, inform your doctor. Your doctor is required to follow your wishes or transfer your care to a physician who is willing to carry them out.
The doctor will fill out a form for a DNR order and add it to your medical record. Your physician may also provide instructions on getting a bracelet, card or other documents to keep at home or in non-hospital settings declaring your wishes. Some states’ health departments also have standard forms that can be used.
It is a good idea to inform your family of your decision to avoid conflicts should a situation arise where you must be resuscitated.
What If I Want To Change My Decision?
If you get a DNR but later change your mind and decide you do want to be resuscitated, get in touch with your doctor or health care team immediately. You should also inform your family and caregivers of your decision right away. If you have any documents that include the DNR order, destroy them to avoid confusion.
Talk With Harbor Light Hospice For More Info
If you would like to learn more about the various aspects involved in a Do Not Resuscitate order, get in touch with the compassionate team at Harbor Light Hospice for guidance through this very important decision.