Elderly people sometimes want a DNR if they suffer from chronic illnesses and are concerned that their quality of life will suffer if they require resuscitation. A Do Not Resuscitate (DNR) order is another kind of advance directive. A DNR is a request not to have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing. Unless paramedics or other emergency staff is given other instructions, they will try to resuscitate any patient whose heart has stopped or who has stopped breathing. The exact rules for obtaining a DNR and for proving its validity vary widely from state to state.
If you have a heart attack or other medical condition that would appear to compromise your mental abilities, how would you tell someone you don't want to be resuscitated? Once your mental capacity has been substantially compromised, it is possible for a physician to determine that you lack sufficient mental capacity to provide informed medical consent. If the physician considers that your mental capacity is diminished, it will be too late for you to instruct the medical staff not to resuscitate you. These orders must be made when you are healthy.
The directions in your living will are only followed when your doctor believes you are in a terminal state and will not recover from your illness or injury. The directions in your DNR are effective the moment you sign them and do not require any type of medical condition to be present for the DNR to be effective. If the paramedics or other medical personnel cannot locate your DNR, they will make an effort to save your life. You can help the paramedics make the right treatment choices in several ways:
- Participate in the Vial of Life program. It's a nationwide effort to assist emergency personnel to administer proper medical treatment for you when you can't speak for yourself.
- A Vial of Life sticker is placed on your door. This sticker tells a paramedic to look for your DNR and other medical information in a vial or plastic bag placed in your refrigerator or freezer. . Paramedics are trained to look there for DNR documents.
- Some states authorize the use of identification bracelets or tags as a way for you to notify medical personnel that you have signed a DNR. Although all states authorize the use of a DNR, some states require special paper to be used when printing as a means of authentication.
Once you complete a DNR, make sure your physician and others are aware of your wishes. Give a copy of your DNR to your primary physician and request the information be added as part of your medical records. If you are in a hospital, make sure a copy of your DNR is included with your medical chart. Keep a copy of the original in your estate planning files.
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