Attorney-Approved Do Not Resuscitate Order Document for California

Detailed Instructions for Using California Do Not Resuscitate Order

In California, a Do Not Resuscitate (DNR) Order is a crucial document for individuals who wish to decline resuscitation efforts in the event of a cardiac or respiratory arrest. This form allows patients to make their end-of-life wishes known in advance, ensuring that these wishes are respected by medical personnel. Completing this form is a significant step that requires careful consideration and a clear understanding of the process. Below, you'll find a step-by-step guide designed to help you fill out the California DNR Order form accurately and effectively.

1. Begin by obtaining the most recent version of the California Do Not Resuscitate Order form from the California Emergency Medical Services Authority website or a local healthcare provider.
2. Read the form thoroughly to ensure understanding of the implications and legal effect of signing a DNR Order.
3. Enter the patient's full legal name at the top of the form where indicated.
4. Provide the patient's date of birth in the designated space.
5. If applicable, include the patient's identification number which could be either a driver's license number, state identification number, or medical record number.
6. In the section provided, document the patient’s address, including street name, city, state, and zip code.
7. The form must be signed by the patient to indicate their decision to forgo resuscitation efforts. If the patient is unable to sign, a legally-authorized representative may sign on the patient’s behalf.
8. Ensure that the form is also signed by a physician. The physician’s signature indicates that the patient has been informed about the nature and consequences of the DNR Order and that the patient’s decision has been discussed with them.
9. Record the date on which the form is signed by both the patient (or representative) and the physician to ensure that the document is correctly dated.
10. Keep the completed DNR Order in a prominent location and inform family members, caregivers, and medical personnel of its existence and location.

After the form is properly completed and signed, it becomes an active medical order. It is essential to review and, if necessary, renew the DNR Order periodically, especially if the patient's health status changes. Healthcare providers should also be consulted regularly to ensure that the patient's end-of-life wishes are still accurately represented by the document. Patients and their families must understand that a DNR Order can be revoked at any time by the patient, through a verbal or written statement expressing the wish to rescind the order.

What is a Do Not Resuscitate Order (DNR) in California?

A DNR is a legal document in California stating that a person does not want to receive cardiopulmonary resuscitation (CPR) if their heart stops beating or they stop breathing. This order is used to communicate a person's wishes regarding end-of-life medical treatment to healthcare professionals.

Who can request a DNR in California?

The following individuals can request a DNR:

• An adult with the capacity to make their own healthcare decisions.
• A legally appointed decision-maker for someone who is unable to make their own decisions.
• For a minor, a parent or legal guardian can request a DNR on their behalf.

How can someone obtain a DNR in California?

To obtain a DNR, the individual or their authorized representative must discuss their wishes with a healthcare provider. The healthcare provider will then fill out the California DNR form, ensuring it meets all state-specific requirements. Both the individual (or their representative) and the healthcare provider must sign the form for it to be valid.

Where should the DNR form be kept?

The DNR form should be easily accessible to emergency personnel. Common places include:

• With the individual at all times, such as in a wallet or purse.
• In a visible location within the home, like on the refrigerator or by the bedside.
• Filed with the person’s medical records at their doctor’s office or healthcare facility.

Does a DNR expire in California?

In California, a DNR order does not expire. It remains in effect until it is revoked. However, it’s recommended to review and discuss it regularly with healthcare providers, especially if the individual's healthcare situation changes.

How can a DNR be revoked?

A DNR order can be revoked at any time by the individual or their legally authorized representative. This can be done by informing the healthcare provider verbally or in writing. Destroying the physical copy of the DNR form and informing all relevant parties of the revocation is also advisable.

Filling out the California Do Not Resuscitate (DNR) Order form is a critical step for individuals who wish to ensure their healthcare preferences are respected in emergencies. However, mistakes during this process can lead to unintended outcomes. Below are seven common errors to avoid:

1. Not having the form signed by a licensed physician. The DNR order must be signed by a physician to be valid. Without this signature, the form may not be recognized by healthcare providers.

2. Failing to use the patient's legal name. It's crucial to use the exact legal name of the person for whom the DNR order is intended. Mismatched or informal names can create confusion during medical emergencies.

3. Forgetting to date the form. The form must be dated to show when it was completed. A missing date can question the current validity of the DNR order.

4. Not discussing the decision with family members. Failing to communicate the decision to have a DNR order can lead to confusion and conflict among family members during emergency situations.

5. Omitting patient or agent/representative signatures where required. Some forms require the patient or their legal representative to sign, confirming their agreement to the DNR status.

6. Not keeping the DNR form in an accessible place. Once completed, the DNR form should be kept where it can be easily found by family members or emergency personnel, such as in a visible location or with personal documents.

7. Assuming the form is permanent without review. It's important to review and, if necessary, update the DNR order periodically, especially if the patient's health status or wishes change.

By avoiding these mistakes, individuals can ensure their healthcare wishes are clearly communicated and can be properly followed by healthcare providers in critical moments.

When facing the delicate circumstances that lead one to consider a Do Not Resuscitate (DNR) Order in California, it's worthwhile to know that there are several other documents that can complement this decision. These documents are designed to ensure that an individual's healthcare preferences are fully recognized and respected. Here is a brief overview of some key forms that often accompany a DNR Order, providing a more comprehensive approach to end-of-life planning.

• Advance Health Care Directive (AHCD): This document allows individuals to outline their healthcare preferences and appoint an agent to make medical decisions on their behalf if they are unable to do so. It's broader than a DNR as it can cover a range of treatments and conditions.
• Physician Orders for Life-Sustaining Treatment (POLST): The POLST complements a DNR by providing more detailed directives about end-of-life care preferences across various scenarios, not just resuscitation. It's especially useful for individuals with serious illnesses, as it guides emergency medical personnel and other healthcare providers.
• Medical Power of Attorney (MPOA): This legal document designates someone to make healthcare decisions on behalf of the individual if they become incapacitated. While similar to the agent role in an AHCD, the focus of an MPOA is often broader, covering a wide range of medical decisions beyond end-of-life care.
• Living Will: A living will specifies an individual's wishes regarding the use of life-sustaining treatments if they are terminally ill or in a permanent vegetative state. It covers conditions not specifically mentioned in a DNR and can guide healthcare providers and loved ones in making difficult decisions.
• Last Will and Testament: Although primarily a tool for estate planning, a Last Will and Testament can also include final wishes regarding funeral arrangements and the handling of the body, complementing the healthcare-focused directives of a DNR.

Understanding and preparing these documents in advance can provide peace of mind for individuals and their families, ensuring that their healthcare and personal preferences are honored. Consulting with legal and healthcare professionals can help navigate these important decisions, creating a compassionate and comprehensive approach to end-of-life planning.

The California Do Not Resuscitate (DNR) Order is quite similar to an advance healthcare directive in its function of guiding medical personnel on how to approach a patient's care at critical moments. Both documents allow individuals to make decisions about their medical treatment in advance. The key difference lies in the specificity of instructions; an advance healthcare directive can cover a wide range of medical decisions and conditions, whereas a DNR specifically addresses the desire not to receive cardiopulmonary resuscitation (CPR) in the event of a cardiac or respiratory arrest.

Similar to the DNR, a living will is another document that speaks for you when you cannot speak for yourself due to incapacitation. A living will typically outlines a broad spectrum of wishes concerning end-of-life care, from life support to pain management, and may include a DNR instruction. However, a living will often goes into more detail about various treatments and conditions, while a DNR is focused only on the act of not initiating CPR or advanced cardiac life support.

The POLST (Physician Orders for Life-Sustaining Treatment) form is closely related to a DNR but is more comprehensive in scope. Like a DNR, it's designed to ensure a patient's wishes regarding life-sustaining treatments are followed. Yet, POLST forms go further by covering additional interventions such as antibiotic use, feeding tubes, and more, based on a patient's current health status. It's a physician's order that is highly recommended for seriously ill or frail patients, encompassing more than just the CPR directive found in a DNR.

A healthcare proxy, sometimes called a medical power of attorney, parallels the DNR order in its purpose of preparing for a future where one may not be able to communicate their healthcare desires. This document appoints someone else to make medical decisions on behalf of the individual if they become incapable of making those decisions themselves. While it doesn't contain specific medical instructions, it designates someone who can enforce the individual’s healthcare wishes, such as the enforcement of a DNR order, when necessary.

The Five Wishes document blends elements of a living will and health care proxy, offering a comprehensive approach to documenting one’s care preferences in case of incapacity. It addresses personal, spiritual, and emotional needs alongside medical wishes, such as the wish for a DNR order. By guiding individuals through various scenarios, it emphasizes communication of one's values and desires in both clinical and personal contexts, ensuring a holistic approach to end-of-life planning, much like the focused intent of a DNR, but with broader considerations.

When filling out the California Do Not Resuscitate (DNR) Order form, it's critical to approach this sensitive document with care and precision. Below are lists of what you should and shouldn't do, ensuring the process is handled correctly.

Things You Should Do

1. Read the guidelines provided with the form carefully to understand its purpose and the implications of signing it.
2. Discuss your decision with a healthcare provider to ensure you fully comprehend the medical aspects and consequences of a DNR order.
3. Fill out the form accurately, ensuring all information is current and correctly entered.
4. Sign and date the form in the presence of a witness or notary, as required by California law.
5. Inform your family and close friends about your decision and where the form is stored.

Things You Shouldn't Do

1. Don’t fill out the form without fully understanding its purpose and consequences. Seeking clarification from a healthcare professional is advisable if you are unsure.
2. Don’t leave any sections of the form blank. Incomplete forms might not be legally effective.
3. Don’t sign the form without the appropriate legal witness or notarization, as this could render it invalid.
4. Don’t forget to review and update the form periodically, especially if your medical condition or wishes change.
5. Don’t keep your DNR order a secret from those who need to know, including your healthcare proxy, family members, and primary care physician.

Misunderstandings surround the California Do Not Resuscitate (DNR) Order form, leading to confusion about its purpose and execution. By clarifying these misconceptions, individuals can make more informed decisions regarding end-of-life care.

• It applies in all medical situations: The DNR only applies to cardiopulmonary resuscitation (CPR) attempts. It does not affect other treatments or interventions unless specifically stated in an Advance Healthcare Directive.

• It's only for the elderly or terminally ill: While often associated with these groups, anyone seeking to avoid CPR for personal or medical reasons can request a DNR.

• A verbal wish is sufficient: California requires a formal written order, signed by a physician, to be considered valid. Verbal wishes alone are not legally binding.

• It's irreversible: A DNR order can be revoked by the individual at any time, provided they are competent to make that decision, or by their legally authorized representative.

• It must be included in a living will: While a DNR can be part of an Advance Healthcare Directive, it is a separate document that requires a physician’s signature.

• All family members must agree: Legally, the decision rests with the individual or their appointed healthcare proxy. While family consensus is ideal, it is not a legal requirement.

• EMTs will not assist if they find a DNR: Emergency responders will provide all necessary care except for CPR. The DNR specifically instructs them to refrain from resuscitative efforts only.

• It affects insurance coverage: A DNR order does not impact health insurance benefits or eligibility for treatment of conditions unrelated to the DNR provisions.

• It's only for hospital use: DNR orders are recognized in various settings, including at home, in hospices, and in other care facilities.

• It guarantees no attempts will be made to resuscitate: While it provides clear instructions, the presence of a DNR does not 100% guarantee that CPR attempts will not occur, especially if the document is not immediately available or recognizable by emergency personnel.

Understanding the specifics of the California DNR Order form is vital for making informed healthcare decisions. It is important to discuss wishes with healthcare providers and loved ones to ensure that end-of-life care preferences are respected.

In California, a Do Not Resuscitate (DNR) Order is a crucial document that tells medical staff not to perform CPR (cardiopulmonary resuscitation) if a person's breathing or heartbeat stops. Here are some key takeaways to consider when filling out and using the DNR form:

• The DNR Order must be completed and signed by a California-licensed physician, indicating a patient's wish not to receive CPR in the event of a medical emergency.
• A valid DNR Order form or DNR bracelet is recognized by emergency medical personnel as an indication of the patient's wishes.
• Communication is key. Patients should discuss their wishes with their family, loved ones, and healthcare providers to ensure their wishes are understood and respected.
• The form should be kept in an easily accessible location, preferably in a bright pink color, known as a POLST (Physician Orders for Life-Sustaining Treatment) form in California, so it can be quickly identified by emergency personnel.
• It's important to review and update the DNR Order regularly, especially if the patient’s health status or wishes change.
• Carrying a DNR identification, such as a bracelet, can also help alert emergency personnel to the patient's wishes if they are found unconscious or unable to communicate.
• A DNR Order does not affect receiving other types of emergency care besides CPR. Patients can still receive medications, oxygen, and other treatments to relieve pain and suffer.
• If a patient changes their mind, the DNR Order can be cancelled by physically destroying the document and notifying all relevant parties, including their physician and family.
• It's beneficial to inform family and healthcare providers where the DNR Order is stored, to ensure it is respected in case of an emergency.
• Understanding the legal and ethical considerations of a DNR Order is vital. Patients or their legal representatives should feel comfortable discussing any concerns or questions with healthcare professionals.