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B
brerrabbit Asked August 2021

Does hospice require a Do Not Resuscitate order?

JoAnn29 Aug 2021
The whole purpose of Hospice is no resuscitation. The person is on Hospice because they are entering the final stage of their life. Hospice is to make sure the client is comfortable and pain free.

Please, make sure you understand what Hospice is. They do not hasten death. Yes, because of pain management the client may be out of it. Yes, the client has a right to be involved in their care. People have stated on this forum that the client said they didn't want any morphine at the time and the nurse gave it to them anyway. To me this was wrong.

If this is home hospice the family will do most of the care. There will be a Nurse and she should be there 2 or 3x a week. An aide comes about 3x a week to bathe. The Nurse orders the supplies needed and should be available by phone 24/7. If you do not care for the Hospice you can bring in another one.

When the client is admitted to the service, make sure two family members are there. I say this because what one doesn't hear the other may. This is a stressful time and we always don't hear everything said.

Grandma1954 Aug 2021
The Hospice I used did not require it but it was encouraged.
The form that I completed for my Husband was a POLST it goes into more detail than a DNR. It addresses CPR first. There is a choice of Attempt Resuscitation or Do not Attempt Resuscitation. (I chose No CPR)
Then It specifies Medical Interventions ranging from Full Treatment, Selective Treatment and Comfort Focused. (This is the option I chose. )
Then it addresses Medically Administered Nutrition. That ranges from Long-term, Trial and No medically administered nutrition. (This is the option I chose)

Hospice does not insert Feeding Tubes or IV's so if this is something that you would want the person would go off Hospice and can have a feeding tube placed then they could go back on Hospice. Hospice would then care for the tube, provide supplies needed. Hospice will accept a patient with a feeding tube and will provide the care that is needed. The IV would be different as that generally is not a permanent placement, once the IV was removed they could return to Hospice.

As far as the CPR goes. (personal opinion) It works on TV. It works on younger healthy people.
Done correctly CPR will most likely break the sternum and several ribs. Possibly puncturing a lung. Someone that is in a weakened state due to illness quite possibly would not survive the CPR and if they did would be in pain for weeks if not months while broken bones healed.

You can elect to not sign a POLST or DNR and Hospice will still accept the patient. This is a discussion that the admitting nurse will have with patient and family.

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NYDaughterInLaw Aug 2021
Hospice allows for natural death. The chances of someone at the end of life successfully being resuscitated, surviving, and having any meaningful quality of life afterward are slim to none.

Hospice provides the support and pain management necessary to prevent suffering at end of life. In my opinion, it is best to make it clear that the person wants a dignified and painless natural death. A DNR achieves that goal.

ElizabethY Aug 2021
It depends on the hospice.

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