Valid Do Not Resuscitate Order Template for the State of California

What is a Do Not Resuscitate (DNR) Order?

A Do Not Resuscitate Order is a legal document that indicates a person's wishes regarding medical care in the event of cardiac arrest. It instructs healthcare providers not to perform CPR or other resuscitative measures, allowing for a natural death without invasive medical interventions. It is crucial for individuals to discuss their wishes with family and healthcare providers to ensure their preferences are documented appropriately.

Who can request a DNR Order in California?

In California, a DNR Order can be requested by anyone who is an adult and of sound mind. Additionally, parents or legal guardians can request a DNR for a minor. It is often recommended that individuals approach their healthcare providers to initiate the process, ensuring their choices are respected and accurately reflected in their medical records.

How do I obtain a DNR Order form in California?

You can obtain a DNR Order form from a variety of sources, including hospitals, clinics, or your physician’s office. Additionally, the California Department of Public Health provides downloadable forms online. It is essential to ensure that the version you obtain is up-to-date and correctly fills out to comply with the state’s regulations.

What steps should I take to complete a DNR Order?

First, ensure discussions are held with your healthcare provider about your wishes and the implications of a DNR Order. Complete the form, providing accurate personal information and preferences. Once filled out, the form must be signed by both you and your physician. It is advisable to share copies of the signed form with family members, your healthcare team, and any primary caregivers.

Will my DNR Order be recognized in all healthcare settings?

Yes, a DNR Order completed in compliance with California law should be recognized by all healthcare providers across various settings, including hospitals, nursing homes, and home care services. However, it is crucial to maintain copies of the DNR Order readily accessible and to inform all healthcare providers of its existence to avoid any confusion during a medical emergency.

Can I change or revoke my DNR Order after it has been made?

Yes, an individual maintains the right to change or revoke a DNR Order at any time, as long as they are of sound mind. To do so, notify your healthcare provider, and be sure to destroy any copies of the previous DNR form. It's important to create and distribute a new DNR Order form to ensure that your updated wishes are clearly communicated to all relevant parties.

What should I do with my DNR Order once it is signed?

Once your DNR Order is signed, you should keep it in a safe, easily accessible location. Inform family members, friends, and caregivers about its whereabouts. It may also be beneficial to carry a wallet card indicating the existence of the DNR Order, as this can be particularly helpful in emergencies.

How does a DNR Order interact with other advance directives?

A DNR Order is one component of advance healthcare planning, which may also include a living will or a healthcare power of attorney. It specifically addresses resuscitation wishes, while other directives may outline overall medical treatments and decision-making preferences. It is wise to ensure all forms are consistent and clearly express your healthcare wishes to avoid any potential conflicts or confusion.

1. Failing to have the form signed by a physician. A Do Not Resuscitate (DNR) Order must include the signature of a licensed medical professional to be valid.

2. Not communicating the decision to family members and loved ones. It is crucial to discuss one’s wishes with close relatives to avoid confusion during emergency situations.

3. Using an outdated version of the form. It is imperative to utilize the most recent version of the DNR Order to ensure compliance with current laws.

4. Neglecting to include personal information clearly. Complete and accurate identification information helps avoid any potential misunderstandings.

5. Overlooking the importance of date and time. The DNR Order must clearly state when it goes into effect.

6. Signing hastily without understanding the implications. Individuals should be fully informed about what a DNR Order entails before signing.

7. Using generic language that may lead to misinterpretation. Specific wording regarding the type of medical interventions desired (or not desired) is essential.

8. Forgetting to review and update the order periodically. As health conditions and wishes change, so should the DNR Order.

When preparing healthcare directives, several documents may accompany the California Do Not Resuscitate (DNR) Order form. Understanding these forms can help ensure that your healthcare wishes are clearly communicated and respected. Below is a list of related documents that you may find useful.

• Physician Orders for Life-Sustaining Treatment (POLST): This document goes beyond a DNR order. It outlines a patient's preferences for various types of medical treatment, such as intubation and feeding tubes, in situations where they might be unable to communicate their wishes.
• Advance Healthcare Directive: This is a comprehensive form that allows individuals to appoint a healthcare proxy and outline their preferences for medical care. It covers a wide range of medical treatments, not just those related to resuscitation.
• Power of Attorney for Healthcare: This form designates someone to make medical decisions on your behalf if you can’t make them yourself. It provides guidance to healthcare providers about your care preferences and can be particularly important when time is of the essence.
• Living Will: A living will specifies what types of medical treatment an individual does or does not want in the event they are unable to communicate their choices. It focuses on end-of-life decisions and can provide clarity for family and healthcare providers.
• Health Information Authorization: This document grants permission for healthcare providers to share your medical information with designated individuals. It can help family members or healthcare proxies access necessary medical details when making decisions on your behalf.
• DNR Comfort Care Order: Similar to a DNR, this form emphasizes that while resuscitation efforts should not be made, other comfort care measures should be implemented to ensure the patient's quality of life during their final moments.
• Emergency Medical Services (EMS) DNR Form: This specific form is often carried by individuals wishing to ensure their DNR order is recognized by emergency medical personnel. It ensures that for any medical emergencies, their wishes regarding resuscitation are clear.

These documents play a crucial role in ensuring that your healthcare goals and preferences are honored. Having them in place can provide peace of mind for both you and your loved ones during difficult times.

The California Do Not Resuscitate (DNR) Order form closely resembles a living will. A living will allows individuals to express their wishes regarding medical treatment in scenarios where they are unable to communicate. Both documents focus on health care decisions, particularly during critical moments. They emphasize personal preferences about intervention and care, thus providing clear instructions to healthcare providers and loved ones.

Another document similar to the DNR is the Physician Orders for Life-Sustaining Treatment (POLST). POLST is a medical order that outlines a patient's preferences for life-sustaining treatments, including resuscitation. Unlike a DNR, which specifically addresses resuscitation, POLST can cover a broader range of medical interventions. Both documents require physician approval and aim to ensure that a patient's wishes are honored during medical emergencies.

The Healthcare Power of Attorney is also comparable to a DNR Order. This document designates a person to make healthcare decisions on behalf of someone else when they are unable to do so. While a DNR focuses specifically on resuscitation preferences, the Healthcare Power of Attorney encompasses a wide array of healthcare choices. Both documents provide essential guidance to medical professionals during difficult situations.

A Do Not Intubate (DNI) order is yet another document that aligns with the principles of a DNR. A DNI specifically indicates that a patient does not want to be intubated if they stop breathing or their breathing becomes inadequate. Similar to a DNR, this document communicates specific wishes regarding life-sustaining measures. Both documents prioritize patient autonomy and care preferences during critical health circumstances.

The Advance Healthcare Directive combines elements of both a living will and a healthcare power of attorney. It allows individuals to outline their wishes for medical care and designate someone to make healthcare decisions on their behalf. This document helps ensure that healthcare providers respect the individual's desires in a variety of medical scenarios, including those addressed in a DNR.

A Psychiatric Advance Directive (PAD) also bears similarity to a DNR Order, though it specifically relates to mental health treatment. This document allows individuals to express their preferences for treatment or refusal of treatment when they are unable to make decisions due to mental illness. Like a DNR, PADs enable individuals to maintain control over their healthcare, emphasizing patient wishes amid potentially vulnerable situations.

The Do Not Hospitalize (DNH) order is another closely related document. This order communicates a patient's wish to avoid hospitalization in certain circumstances, especially during end-of-life care. While the DNR focuses on resuscitation, the DNH addresses the broader context of care settings. Both documents serve to align healthcare providers with patient preferences, fostering a more compassionate approach to treatment.

Another relevant document is the Comfort Care Order. This document outlines the goal of providing comfort rather than aggressive treatment for terminally ill patients. Similar to a DNR, it signifies a transition in the approach to care, prioritizing quality of life over curative measures. Both documents navigate the complexities of end-of-life care and affirm the importance of respecting patient choices.

Lastly, the Medical Order for Life-Sustaining Treatment (MOLST) is akin to the DNR as it also serves as a medical order for individuals with serious illnesses. Like POLST, MOLST reflects a person’s wishes regarding various interventions, including resuscitation efforts. Both documents aid healthcare professionals by conveying clear instructions on how to respect a patient's desires during critical care situations.

When filling out the California Do Not Resuscitate (DNR) Order form, it's important to understand the details that guide your decisions. Here are some critical points to keep in mind:

• Do's:
• Ensure the form is signed by the appropriate medical provider.
• Discuss your wishes with family members and next of kin before completing the form.
• Keep a copy of the signed DNR order in an easily accessible place.
• Review the document regularly to confirm that it still reflects your wishes.
• Use clear and specific language to express your preferences on the form.

• Don'ts:
• Don't fill out the form in a hurried manner; take your time to understand each section.
• Don't sign without consulting with your healthcare provider.
• Don't forget to inform all caregivers of your DNR order.
• Don’t assume that verbal communication of your wishes is enough; always fill out the form.
• Don’t leave the form in a location where it cannot be found when needed.

Misunderstandings about the California Do Not Resuscitate (DNR) Order form are common. These misconceptions can lead to confusion about end-of-life decisions. Here are five of the most prevalent misconceptions:

1. A DNR means no medical care will be given.

   This is not true. A DNR only specifies that no cardiopulmonary resuscitation (CPR) should be performed in the event of a cardiac or respiratory arrest. Patients will still receive other necessary medical treatments and care.

2. A DNR is only for terminal illnesses.

   While many people associate DNR orders with terminal illnesses, this is a misconception. Individuals can choose a DNR order regardless of their health condition, based on their personal wishes for resuscitation.

3. A DNR must be signed by a physician.

   In California, while it is advisable to have a physician's signature for a DNR order to be effective, it is not a strict requirement. Individuals can express their wishes through a DNR form, but clinical staff usually prefer a physician's involvement for clarity.

4. Once a DNR order is established, it cannot be changed.

   This is a misconception. A DNR order can be revoked at any time. Individuals have the right to change their minds about their end-of-life preferences and should communicate any changes to their healthcare providers.

5. A DNR is valid in all settings.

   A DNR order is typically only valid in out-of-hospital settings unless specified otherwise. In hospitals, specific protocols may apply, and individuals must ensure that their wishes are clearly documented in the hospital records.

When it comes to filling out and utilizing the California Do Not Resuscitate (DNR) Order form, understanding the key aspects can help ensure that your wishes regarding medical interventions are respected. Here are some important takeaways:

• Purpose of the DNR Order: The California Do Not Resuscitate Order form is designed to communicate a person’s desire not to receive cardiopulmonary resuscitation (CPR) in the event of cardiac arrest.
• Eligibility: The form can only be completed by individuals who are at least 18 years old, or by a parent or guardian for minors.
• Completion Instructions: The form should be filled out in detail, clearly indicating the individual's choices regarding resuscitation efforts.
• Signing the Form: The document must be signed by the individual or their authorized representative and should be dated to confirm its validity.
• Witness Requirements: A DNR Order form needs to be witnessed by either one person or notarized, depending on the choice of the signatory.
• Availability: It is important to keep the DNR Order accessible. Carrying a copy in a wallet or having it visibly placed in the home can help medical personnel locate it quickly during an emergency.
• Notification: Make sure that family members, caregivers, and healthcare providers are aware of the DNR wishes and have a copy of the form.
• Periodic Review: It is advisable to review the DNR Order periodically, especially if there are changes in health status or personal wishes regarding medical care.
• Legal Protections: A valid DNR Order is recognized by medical professionals and provides legal protection for healthcare providers who follow the patient's wishes regarding resuscitation.

Understanding these key points can assist in ensuring that your preferences regarding life-sustaining treatment are respected throughout your healthcare journey.