Do Not Resuscitate Order Form for the State of California

What is a Do Not Resuscitate (DNR) Order?

A Do Not Resuscitate Order (DNR) is a legal document that allows a person to refuse life-saving measures like CPR in case of cardiac arrest or respiratory failure. This order helps ensure that medical providers respect individual wishes during critical health situations.

How do I create a DNR Order in California?

In California, creating a DNR Order involves several steps:

1. Consult with your healthcare provider about your wishes regarding resuscitation.
2. Complete a DNR form, which can usually be obtained from healthcare facilities or online.
3. Have the form signed by you and your physician.
4. Keep copies of the form in accessible places, such as with your medical records and with family members.

Who can request a DNR Order?

Any competent adult can request a DNR Order for themselves. In circumstances where an individual cannot speak for themselves, a legal representative, such as a power of attorney or a family member, may make the request on their behalf.

What if I change my mind about my DNR Order?

If you decide to change your mind about your DNR Order, you may revoke it at any time. Notify your healthcare provider and any family members or caregivers about your decision. It’s also important to destroy any copies of the previous DNR form to avoid confusion.

Will a DNR Order affect my overall medical care?

A DNR Order specifically pertains to resuscitation efforts. It does not impact other medical treatments. Your healthcare team will still provide appropriate care for your condition, including pain management and comfort measures, regardless of your DNR status.

Is a DNR Order the same as an Advance Directive?

No, while they are related documents, a DNR Order only addresses resuscitation efforts. An Advance Directive is a broader document that outlines your preferences for medical treatment and healthcare decisions in various situations, including end-of-life care.

Where should I keep my DNR Order?

It is advisable to keep your DNR Order in a visibly accessible place. You may file it with your medical records, store a copy in your wallet, or provide copies to family members and caregivers. Inform your healthcare provider where the form is located.

Do I need a lawyer to fill out a DNR Order?

Typically, you do not need a lawyer to complete a DNR Order. However, it is important to ensure that the form is filled out correctly and complies with state laws. Consulting with your healthcare provider is often sufficient to clarify any questions you may have during the process.

How can I ensure my DNR Order is honored?

To help ensure that your DNR Order is respected, you should ensure it is properly signed and that copies are distributed to relevant parties including your healthcare provider and family members. Discuss your wishes openly with your medical team and loved ones.

What do I do if my DNR Order is not being respected?

If you believe that your DNR Order is not being honored, you should promptly address the issue with your healthcare team. Discuss your concerns directly with your doctor or hospital staff. If necessary, you may also consider seeking advice from a legal professional or patient advocate.

Filling out the California Do Not Resuscitate (DNR) Order form is an important step in ensuring that your medical wishes are clearly understood. However, mistakes can easily happen during this process. One common error is failing to sign the form. A DNR order is not valid unless it has been properly signed by the patient or the authorized representative. Without a signature, it cannot be acted upon by healthcare providers.

Another mistake people often make is not having the form witnessed as required. In California, the DNR form must be signed by either two witnesses or a notary public. Skipping this step can render the document invalid. Remember, both witnesses must be adults and cannot be relatives or healthcare providers who might benefit from the patient's passing.

Many individuals also misinterpret the information required about medical conditions. It’s crucial to provide an accurate account of the patient's health status on the form. A vague or incomplete description can lead to confusion and may disrupt the intended medical intentions.

Also, confusion often arises around the terminology used in the DNR order. Some people misread or misunderstand what "Do Not Resuscitate" truly means. Clarifying that this order specifically pertains to the refusal of CPR and other resuscitative measures can prevent unwanted treatments in critical moments.

The location of the form is also an important consideration. Many individuals do not keep a copy of their DNR order in an easily accessible location. It should be available to family members and healthcare providers to ensure it can be acted upon without delay in an emergency situation.

In some cases, people think that once they fill out a DNR form, it is permanent and cannot be changed. This is not true. Situations and preferences can change, so it’s essential to update the DNR order as circumstances evolve. If a patient's wishes change, a new form should be completed and all previous versions destroyed.

Lastly, some overlook the need for discussing the DNR order with family members or designated healthcare proxies. Effective communication can significantly ease the burden on loved ones during challenging times. It ensures everyone understands the patient’s wishes and helps prevent conflict or confusion regarding care decisions.

When planning for medical care, individuals often consider several documents alongside the California Do Not Resuscitate (DNR) Order form. Each of these documents serves a specific purpose in guiding healthcare decisions and ensuring that an individual's wishes are respected. Here is a list of commonly used forms and documents that can complement a DNR order:

• Advanced Healthcare Directive: This document allows individuals to outline their preferences for medical treatment and appoint someone to make decisions on their behalf if they become unable to do so.
• Physician Orders for Life-Sustaining Treatment (POLST): This is a medical order for individuals with serious illnesses. It translates their treatment preferences into actionable medical orders for healthcare providers.
• Living Will: A living will specifies the types of medical treatments an individual wants or does not want in case of severe illness or injury, focusing particularly on end-of-life care.
• Healthcare Proxy: This document designates a trusted person to make medical decisions if the patient is incapacitated. It is essential for ensuring that someone knows and honors your wishes.
• Durable Power of Attorney for Healthcare: This legal document grants authority to an agent to make healthcare decisions on behalf of someone else, ensuring their wishes are followed even when they cannot express them.
• Do Not Intubate (DNI) Order: Similar to a DNR, a DNI specifies that a patient should not be placed on mechanical ventilation, outlining preferences regarding breathing assistance.
• Organ Donation Consent: This document indicates an individual's wishes regarding organ donation after death, making it clear what should happen to their organs.
• Medication Protocols: These provide guidelines on the administration of specific medications, particularly palliative care options, ensuring comfort in line with the patient's wishes.
• Emergency Medical Information Card: This card contains vital health information and should be carried at all times. It can guide responders in emergencies about DNR status and other medical preferences.

Understanding these documents can empower individuals to make informed decisions about their healthcare. When used together thoughtfully, they create a comprehensive approach to ensure that one's medical preferences are honored during challenging times.

• Living Will: Like a Do Not Resuscitate Order (DNR), a living will allows individuals to outline their preferences regarding medical treatments. It is a written document that specifically details what types of medical care a person does or does not wish to receive if they become incapacitated.
• Advanced Healthcare Directive: This document combines the elements of a living will and a durable power of attorney for healthcare. It not only states treatment preferences but also designates someone to make healthcare decisions on behalf of the individual if they are unable to do so.
• Medical Power of Attorney: This allows a person to appoint another individual to make healthcare decisions on their behalf. While the DNR focuses on resuscitation efforts, a medical power of attorney encompasses a wider range of medical decisions.
• POLST (Physician Orders for Life-Sustaining Treatment): Similar to a DNR, a POLST is a medical order signed by a physician that specifies what types of medical interventions should be provided or withheld. POLST forms are often used for patients with serious illnesses.
• Do Not Intubate (DNI) Order: A DNI order is more specific than a DNR and clearly states that intubation (the placement of a tube in the airway to assist with breathing) should not be performed. Both documents communicate the patient’s wishes regarding critical medical procedures.

When filling out the California Do Not Resuscitate Order form, it is essential to approach the process with care. Here are some guidelines to help ensure the form is completed correctly.

• Do have a conversation with your healthcare provider. Discuss your wishes and medical condition to ensure you understand the implications of the DNR order.
• Do ensure the form is signed by the appropriate parties. The patient's signature, or that of a legal representative, is necessary.
• Do keep a copy of the form accessible. Providing copies to your medical team and family members ensures everyone is informed.
• Do regularly review your wishes. Ensure your instructions reflect your current health and preferences.

• Don't use vague language. Clearly state your intentions to avoid any confusion regarding your wishes.
• Don't forget to comply with state requirements. Ensure all elements of the form meet California's legal standards.
• Don't assume the form will be automatically honored. Communicate your wishes with your healthcare team and family.
• Don't leave the form unsigned. An unsigned DNR order will not be valid and may not be recognized in an emergency.

The California Do Not Resuscitate (DNR) Order form is often misunderstood. Here are some common misconceptions related to it:

• Only terminally ill patients can have a DNR. Many people believe that DNR orders are only for those who are facing imminent death. However, anyone with a serious health condition can choose to have a DNR in place, regardless of their prognosis.
• All healthcare providers must follow a DNR order. While healthcare providers should respect a valid DNR, there can be exceptions, especially in certain medical settings like hospitals. It’s essential to discuss your wishes with your medical team in advance.
• A DNR order means no medical care at all. A DNR only applies to resuscitation efforts if your heart stops or you stop breathing. You will still receive all other necessary medical treatments and care.
• The DNR form is permanent. Some people think that once a DNR is signed, it cannot be changed. In reality, you can revoke or update your DNR order at any time, according to your changing wishes or health status.
• Patients must be conscious to sign a DNR. It’s a common misconception that a patient must be alert to execute a DNR. A legally appointed decision-maker can sign on behalf of an incapacitated patient.
• Having a DNR is a sign of giving up. Many view a DNR as a choice to stop fighting. In fact, creating a DNR is about respecting personal values regarding the type of medical interventions one wishes to receive.
• A DNR only exists in a hospital setting. A DNR can be effective in various locations, including at home and in nursing facilities. Ensure that it is easily accessible wherever care is being provided.
• You need a lawyer to set up a DNR. Establishing a DNR does not require legal representation. You can fill out the DNR form yourself, as long as it follows state guidelines.
• All DNR forms are the same. DNR orders can vary by state. In California, there is a specific form that must be completed correctly to ensure it is honored. Make sure to use the correct state-specific document.

By debunking these myths, individuals can better understand their rights and options related to end-of-life care in California.

Here are some essential points to consider when filling out and using the California Do Not Resuscitate Order form.

• Understanding the Purpose: The Do Not Resuscitate Order (DNR) is a medical order indicating that you do not wish to receive cardiopulmonary resuscitation (CPR) in the event of cardiac arrest.
• Eligibility: Anyone over 18 years old can complete a DNR form, but it's crucial to discuss your wishes with your healthcare provider first.
• Completion Requirements: To be valid, the DNR form must be signed by both you (the patient) and your healthcare provider.
• Placement: Keep the completed DNR form in a visible location, such as on your refrigerator or in a medical binder, to ensure emergency personnel can find it quickly.
• Informing Others: Make sure to inform your family members and caregivers about your DNR status and where the form is located.
• Regular Review: Revisit your DNR form regularly, especially if your health situation changes, to ensure that it still reflects your medical wishes.

Taking these steps can help ensure your healthcare wishes are honored during critical moments. It’s about peace of mind for you and your loved ones.