There is a difference between your in-hospital “do not resuscitate” order and the one in your general Advanced Directive
THE OTHER DAY I wrote about a lot of end-of-life things you need to be thinking of when a loved one is going into a final decline, or before.
One thing I missed was the “Do Not Resuscitate” order. More specifically, the “out of hospital” DNR.
Your advanced directive most likely does not contain this. In fact, it may not even contain a DNR for in the hospital. There is a good reason for this. Most people to advanced directives when they are healthy and there are instances where someone, if resuscitated, can go on for many more years.
Our DNR section is specific, but also requires, or implies by language, that the designated agent (me in my wife’s case) must sign off along with a doctor. I am going to assume that if my wife is in the hospital in her current state and should need resuscitation that we will have covered that verbally and under the terms of the advanced directive and DNR.
An out-of-hospital DNR is different and the one I signed today and am taking to Connie’s care center is a part of hospice. When you bring hospice in curative care ends and palliative, or comfort, care begins. It is very possible that Connie’s end will come at the care center. It’s possible she could go into some state that normally would be reversed by resuscitation.
With this document the care center staff, and any summoned EMTs, will know not to perform any resuscitative acts. This does not, preclude giving oxygen to provide comfort or, for instance, to suction out the patient’s throat if they swallowed something or have phlegm.
So, if you have a loved one in a care center, particularly under hospice, be aware of the out-of-hospital DNR. Our hospice provided gave me one. That may not always be the case.
Rich Heiland, has been a reporter, editor, publisher/general manager at daily papers in Texas, Pennsylvania, Illinois, Ohio and New Hampshire. He was part of a Pulitzer Prize-winning team at the Xenia Daily (OH) Daily Gazette, a National Newspaper Association Columnist of the Year. Since 1995 he has operated an international consulting, public speaking and training business specializing in customer service, general management, leadership and staff development with major corporations, organizations, and government. He also writes the blog stuffonmymind.blog. Semi-retired, he and his wife live in West Chester, PA. He can be reached at [email protected].