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Hangingon61 Asked April 2018

In our wills we have a paragraph that states our wishes should we become incapacitated, something to the effect of “we want no extreme measures taken to prolong our life.” Is that a “DNR”?

My mom is currently in the hospital after taking a fall. She is terminal (breast & posible brain cancer). We have it in both of our wills a paragraph that states our wishes should we become incapacitated, something to the effect of “we want no extrema measures taken to prolong our life”.. Is that a “DNR”? If not, what do I need to do to get one for my mom? And I’m assuming I’ll need to give that to the doctor whose currently taking care of my mom while she’s in the hospital. Their plan is to transfer her to a rehab facility. I’m also assuming the rehab place will need a copy of the DNR as well?? Please, any advice on this & how to proceed. We are both each others POA for health & finances (in our wills we had made up together at the same time 10 yrs ago). Thank you.

cwillie Apr 2018
The problem with having that kind of directive in a Will is that in all probability nobody is going to look for it until after you pass. If you have funeral directions in your Will that could also pose the same problem - grieving family does not always consider their inheritance until after several days have gone by.

SueC1957 Apr 2018
A DNR is just a Do Not Resuscitate order

Ask the hospital for a POLST form. This form outlines more than just DNR (do not resuscitate ).
It's bright pink with black lettering. She can pick from whatever choices for her ending care she wants.
It will become part of her chart and will be noted on the front of the chart to not resuscitate.

Because transfers to other facilities can be hectic, make sure the rehab has the copy and understands her wishes. Have them show it to you.

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Arleeda Apr 2018
It is also important to include a gastric feeding tube among the procedures you do not want, if you do not. The MD wanted to put one in my husband (with moderate dementia) after a major stroke that left him unable to walk or speak clearly and with a loss of central vision so that he could not watch TV or read. I had seen my stepfather gradually lose his mind when he was totally paralyzed but with gastric feeding tube. My husband and I both knew we did not want that.

NurseMeg Apr 2018
Yes, your wishes stated in your will are consistent with "DNR, but hospital staff have no way of knowing what is in your will. You need to have the actual DNR form (POLST is the new version) in the chart/ medical record, which must be signed by both your mother and her physician. The POLST covers all levels of intervention requested, from "do everything" to "no heroic measures" to "do not resuscitate." You will need to make several copies, to have on hand for ambulance rides, other facilities, readmission, etc. If your mother is no longer able to sign the form for reasons of dementia/ incompetence, then whoever is assigned to be her Health Care Power of Attorney (HC-POA) will need to sign it. The Social Worker at the hospital is the best person to ask for this form. Make sure, once it is in place, that the staff are reminded about it whenever plans & decisions are made. Most hospitals will place a DNR wristband on a pt. with this kind of POLST selection, and place a bright orange or red sticker on the person's chart. But now, with computer charting, it is difficult to tell quickly if a patient is DNR, and sometimes staff will err on t he side of "do everything," much to the dismay of the patient & their family. So be clear, don't hesitate to remind staff, and share this information with others involved with her care---don't assume it is being communicated to all services. You should also know that the moment a patient enters the OR, a DNR is automatically rescinded---all patients who are under the supervision of a surgeon in the OR are considered "FULL CODE," so keep that in mind when making any decisions about surgeries/ procedures. A DNR order can always be rescinded or revoked by a patient or their HC-POA. So putting one in place now does not mean you cannot make any changes down the line, if you choose.

Grammyteacher Apr 2018
Yes to above, but I think it can be different colors in different states. It is Orange in my state. We have 3 on my mom. One is taped to her bedroom door. One is in my purse along with a copy of POA. One is in the motorhome from when we did a bit of travel.

I know my step mom, with no known medical issues, also has them in both cars and her home. She informed me of this.

freqflyer Apr 2018
Hangingon61, is your Will a "Living Will" which has your wishes if you are in a hospital, etc.? If it is in a regular Will, as cwillie had mentioned, no one will see it until after you pass.

It is better to have a "Medical Directive" drawn up by an "Elder Law Attorney", this legal document gives directions on your care. My parents both had such a document and it was such a great guideline for me to follow. I also have such a document for myself.

needtowashhair Apr 2018
You need to have POLST form filled out and signed by a doctor. A health care directive is more like a request, they can respect it or ignore it. A POLST is a medical order, they have to honor it.

Etheljr Apr 2018
You might consider requesting the treating physician order a palliative care consult. During that consultation they will be able to clarify your mothers options and assist your family in seeing her wishes are respected.

balancedCaring Apr 2018
My understanding is that the only thing a DNR forbids is to re-enliven the patient with CPR (cardiopulmonary resuscitation) or ACLS (advanced cardiac life support). Other than that, the doctors and nurses are obligated to help improve the existing medical issue.

A DNR notice can be shown on a paper (different colors in different states), or on the wrist of the patient as a bracelet, if they live in a ALF, nursing home care or are in the hospital.

The DNR paperwork is normally within the patient's medical history which is transferred when the patient is transferred.

GardenArtist Apr 2018
Second Arleeda's advice on tube feeding. For my father's situation, this is more of an undesirable intervention than CPR would be.

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