Does mom need a DNR and Healthcare directive also if I am her DPOA?

Write her wishes down and ask her to sign in agreement, with two independent witnesses and you as well. If you don't,someone will challenge you and demand to be appointed Health Care Proxy and take over.

Yes, a healthcare directive is also needed. The clinic or hospital you use can provide a form for her to fill out.

DPOA does not cover end-of-life decisions.

The state I live in does not recognize living wills only health care proxies. DNR forms show only place for doctors signature no place for witness signatures and this is for only out of hospital situations. Durable Power of Attorney document is very detailed regarding medical issues, but does mention specifics in regard to end of life decisions. I know I can decide if my mother is on a life support system, but not sure about other end of life issues. I do not wish to seek guardianship to carry out these measures.

Your local Area Agency on Aging can probably answer questions about how this is handled in your state.

In Wisconsin a living will and a DNR are two very different things. Mom had a living will in place, but then we had to sign off on a DNR order based on her wishes know to use peior to her becoming unable to handle her affairs. Also in WI if the person is not wearing the DNR bracelet or chain, it nullifies the DNR request. Which is kind of hard as we can't keep the bracelet on her.

According to the National Institutes of Health (tbis is Federal - in general, Statex can enhance but not override Federal laws):),

"A do not resuscitate order, or DNR, is a medical order written by a doctor. It instructs health care providers not to do cardiopulmonary resuscitation (CPR) if breathing stops or if the heart stops breathing.

"A DNR order allows you to choose before an emergency occurs whether you want CPR. It is a decision only about CPR. It does not affect other treatments, such as pain medicine, medicines, or nutrition.

"The doctor writes the order only after talking about it with the patient (if possible), the proxy, or family."

also "If you have a DNR order, you always have the right to change your mind and request CPR."

And " Make sure to:

"Include your wishes in a living will or health care power of attorney. Inform your health care proxy and family of your decision."

further "If your doctor has written a DNR order already at your request, your family cannot override it."

in addition "You may have named someone to speak for you, such as a health care agent. If so, this person or a legal guardian can agree to a DNR order for
you."

and finally "Your doctor can tell you how to get a wallet card, bracelet, or other DNR documents to have at home or in a non- hospital setting.

"Standard forms may be available from your state’s Department of Health."

THE FULL TEXT IS AVAILABLE HERE:
http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000473.htm

As far as "enhancing", in California for example, a DNR can be established (form filled out) upon admission to a hospital or a nursing home, it does not HAVE TO be done ONLY by a doctor. It's just that the patient's wishes, stated to a doctor or written in the healthcare POA, either one when the patients are competent to either say or sign, are less likely to be subject to challenging by family members who disagree with the concept of DNR. As usual, and especially important with dementia patients, competency to choose is an issue.

If mom IS competent, make sure your wishes are documented in her health POA as well as having her tell her doctor so it in her medical chart should a question arise at a later date. If she isn't competent, the responsibility to choose falls on you as her health agent. If her wishes are not already documented, you COULD be subject to challenge. This would you really be by disagreeing family members, but a hospital or doctor would probably challenge if you'd try to initiate a DNR and your mom's health care POA clearly states that she wanted ALL life saving measures.

EVERYONE should learn from these questions and the applicable laws how important it is to put one's wishes in writing EARLY, before impairment, before questioning, before arguments.

It can't hurt. What if things happen to go haywire on the very day you're stuck in a lift somewhere? What if you're both in the same car accident? Plus it gives added weight to back up your judgements when you have to make them. Cover as many bases as you can.