Valid Do Not Resuscitate Order Template for California

California Do Not Resuscitate Order: Usage Steps

Filling out a California Do Not Resuscitate (DNR) Order requires careful attention to ensure that the wishes of the individual are clearly stated and legally acknowledged. A DNR order instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) in the event the patient's breathing or heartbeat stops. The process outlined below is designed to make the completion of the DNR form straightforward and compliant with California law.

1. Begin by obtaining the most recent version of the California DNR form, which is available through the California Department of Public Health's website or from a healthcare provider.
2. Enter the full legal name of the patient for whom the DNR order is intended at the top of the form.
3. Fill out the patient’s date of birth in the designated space to ensure clarity regarding the patient's identity.
4. Read the instructions on the form carefully to understand the implications of a DNR order and ensure that it aligns with the patient’s wishes.
5. The form must be signed by the patient, or if the patient is unable to sign, a legally authorized representative may sign on the patient's behalf. Include the date of signature directly beside or below the signature.
6. A physician’s signature is also required to validate the DNR order. The physician must sign and date the form in the designated area.
7. After completion, make several copies of the signed form. Keep the original in a safe but accessible location, and give copies to family members, the healthcare proxy, and the primary healthcare provider to ensure the order is recognized and followed.
8. Consider providing a copy to any home health agency or nursing facility involved in the patient's care to further ensure the DNR order is respected at all times.

Upon completion, the DNR order becomes an active part of the patient’s medical record. It is a legal document that medical professionals are required to follow. In the event of a medical emergency, it informs first responders and healthcare providers of the patient's wishes regarding CPR. Regular review of the DNR order is advised to ensure that it continues to reflect the patient's current wishes, particularly if the patient’s health status changes.

1. What is a California Do Not Resuscitate (DNR) Order form?

   A California DNR Order is a legal document that communicates a person's wish to not have cardiopulmonary resuscitation (CPR) or advanced cardiac life support if their heart stops or if they stop breathing. This decision is based on personal preferences, medical conditions, and discussions with healthcare providers. It is part of advance healthcare planning and must be signed by a licensed California healthcare provider.

2. Who should consider having a DNR Order?

   Individuals who have a terminal illness, severe chronic health conditions, or wish to die naturally without invasive life-saving attempts may consider a DNR Order. They should discuss it with their family and healthcare provider to make an informed decision that aligns with their healthcare goals and values.

3. How can someone obtain a DNR Order in California?

   To obtain a DNR Order, an individual must have a conversation with their healthcare provider about their health status and wishes regarding CPR. If a DNR Order is desired, the healthcare provider will complete and sign the form. The individual (or their legally authorized representative if the individual is unable to do so) must also sign the form, indicating their informed consent.

4. Is the DNR Order effective in all settings?

   The California DNR Order is effective in various settings, including at home, in hospitals, and in nursing homes. However, it is important to inform all healthcare providers, including emergency medical services (EMS), of the existence of a DNR Order. It is advisable to keep the document in a readily accessible place and consider wearing a DNR bracelet for easy identification by medical personnel.

5. Can a DNR Order be revoked?

   Yes, a California DNR Order can be revoked at any time by the individual for whom it was issued. Revocation can be done in any manner that communicates the intent to revoke, such as verbally expressing the wish to disregard the DNR to a healthcare provider or physically destroying the DNR document. It is crucial to inform all relevant parties, including family members and healthcare providers, of the revocation.

6. What is the difference between a DNR Order and an Advance Healthcare Directive in California?

   A DNR Order specifically instructs healthcare providers not to perform CPR or advanced cardiac life support if a patient's breathing stops or the heart ceases to beat. An Advance Healthcare Directive, on the other hand, is a broader document that outlines a patient's wishes regarding various types of medical treatment and end-of-life care, and may include a DNR Order as part of those instructions. The Advance Healthcare Directive also allows individuals to appoint a healthcare agent to make decisions on their behalf if they become unable to do so.

7. Does having a DNR Order affect other medical treatments?

   Having a DNR Order does not affect the provision of other medical treatments unless specifically stated. It solely instructs healthcare providers on the wishes regarding CPR and does not preclude individuals from receiving other forms of medical intervention, such as pain management, oxygen, or antibiotics, where appropriate. It is important to discuss all treatment preferences with healthcare providers to ensure comprehensive care that respects the individual's wishes.

When filling out the California Do Not Resuscitate (DNR) Order form, people often make mistakes that can impact the effectiveness and enforceability of their wishes. Here are nine common mistakes:

1. Not ensuring the form is the current version approved by California law. Regulations and forms can change, and using an outdated form may result in the DNR order not being honored.

2. Failing to properly identify the person the DNR applies to with complete and accurate personal information. This mistake can lead to confusion in emergency situations.

3. Omitting the signature of the patient, or if the patient is unable to sign, not following the correct procedure for having a legal representative sign on their behalf.

4. Not having the DNR order signed by a California-licensed physician. The physician's signature, license number, and date are crucial for the document's validity.

5. Ignoring the need for witness signatures when required. In some cases, witness verification is necessary to attest to the authenticity of the patient or legal representative's signature.

6. Leaving out crucial information, such as specific medical conditions or allergies, that could be relevant in a medical emergency.

7. Misunderstanding the scope of the DNR, leading to the belief that it covers situations beyond resuscitation efforts, such as declining all forms of medical treatment or palliative care.

8. Forgetting to discuss and share the DNR order with family members, caregivers, and healthcare providers who need to be aware of the patient's end-of-life wishes.

9. Neglecting to keep the DNR order in an easily accessible and visible location. In an emergency, healthcare professionals need to locate and verify the DNR order swiftly to follow its directives.

Understanding and avoiding these mistakes can ensure that the individual's wishes are clearly communicated and respected in critical situations.

In California, the Do Not Resuscitate (DNR) Order form is an essential document for individuals seeking to express their wishes regarding the use of resuscitation methods in critical health situations. Accompanying this document, there are several other forms and documents that are often used to ensure a person's medical and end-of-life preferences are clearly stated and respected. These documents play a crucial role in guiding healthcare providers and loved ones in making informed decisions that align with the individual’s wishes.

• Advance Health Care Directive - This document allows individuals to specify their preferences for medical treatment in various situations when they are not capable of communicating their wishes. It also enables them to appoint a healthcare agent to make decisions on their behalf.
• Physician Orders for Life-Sustaining Treatment (POLST) - The POLST form complements a DNR order by providing more comprehensive instructions regarding other types of life-sustaining treatments, such as the use of ventilators or feeding tubes, in addition to resuscitation preferences.
• Medical Power of Attorney - This legal document appoints someone to make healthcare decisions for the individual in case they become unable to make these decisions themselves. It's crucial for situations not covered by the Advance Health Care Directive.
• Living Will - A living will outlines a person's desires regarding medical treatments at the end of life. While similar to an Advance Health Care Directive, it focuses more exclusively on end-of-life care and not on appointing a healthcare agent.
• HIPAA Release Form - This form allows healthcare providers to share an individual's medical information with specified persons. It ensures that a patient's health information can be accessed by loved ones or a healthcare agent, aiding in informed decision-making.

Together, these documents provide a comprehensive framework for communicating and enforcing an individual's healthcare preferences. It's essential for individuals, especially those with strong feelings about their end-of-life care, to consider preparing these documents in addition to a DNR order. This not only grants peace of mind to the individual but also guides families and healthcare providers through difficult decisions during critical times.

• A Living Will is a document that shares similarities with a Do Not Resuscitate (DNR) Order. It allows individuals to express their preferences regarding end-of-life medical care, including whether they want life-sustaining treatments. Like a DNR, it communicates crucial decisions ahead of time, reducing the burden on family members and ensuring the patient's wishes are respected.

• The Health Care Power of Attorney (HCPOA) is another document similar to a DNR order. It designates an agent to make medical decisions on behalf of the individual if they are unable to do so themselves. While a DNR specifically addresses resuscitation, an HCPOA covers a broader range of medical decisions, aligning closely in purpose by ensuring a person's medical treatment preferences are honored.

• A Physician Orders for Life-Sustaining Treatment (POLST) form also shares similarities with a DNR order. It goes a step further by transforming an individual’s treatment preferences into medical orders. Designed for patients with serious illnesses, a POLST covers a range of life-sustaining treatments beyond resuscitation, including mechanical ventilation and artificial nutrition, ensuring comprehensive communication of a patient's wishes regarding end-of-life care.

• The Medical Orders for Scope of Treatment (MOST) is similar to a DNR in that it is a doctor's order that outlines a plan for end-of-life care based on the patient's wishes. It is more comprehensive than a DNR, covering various treatments and interventions, not just resuscitation. MOST forms ensure that patients receive only the types of medical intervention they desire, honoring their preferences across different scenarios.

• Emergency Medical Services (EMS) DNR forms are directly related to DNR orders but are specifically designed for emergency medical professionals. They inform EMS personnel not to perform CPR or advanced cardiac life support if the patient's heart stops or if they stop breathing. This type of DNR is crucial for individuals who want their DNR wishes to be honored not only in hospital settings but also in the event of an emergency at home or in public places.

When filling out the California Do Not Resuscitate (DNR) Order form, understanding the do's and don'ts can guide you through this important decision, ensuring the document reflects your wishes correctly. Below are the key considerations to keep in mind.

Things You Should Do

1. Review the form with a healthcare provider to ensure you fully understand the implications of a DNR order and how it operates within California law.
2. Ensure that all the required information is filled out accurately, including complete patient information and the necessary signatures.
3. Discuss your decision with close family members or loved ones to make your wishes known and provide them with a copy of the form.
4. Keep the original DNR order in a visible and accessible place in your home where emergency personnel can easily find it.
5. Carry a wallet card indicating you have a DNR order, or wear a medical alert bracelet, to inform healthcare providers of your DNR status when outside your home.

Things You Shouldn't Do

• Don't fill out the DNR form without fully understanding the consequences of your decision, and don't hesitate to ask for clarification or assistance.
• Don't use the DNR form to express other medical wishes, like the desire for or refusal of specific treatments; a separate Advanced Healthcare Directive should be used for these purposes.
• Don't leave parts of the form blank or assume that partially completing the form will convey your wishes.
• Don't fail to communicate your decision with your primary care physician and ensure they have a copy of the completed form.
• Don't keep your DNR order hidden or in an undisclosed location where it cannot be found immediately during an emergency.

Many people have heard of a Do Not Resuscitate (DNR) Order, especially in the context of medical care in California. However, there are several misconceptions about what this form is and what it entails. Clarifying these misunderstandings can help individuals make informed decisions about their healthcare preferences.

• It applies in all medical situations: Some believe that a DNR Order is applicable in all medical scenarios. However, it specifically applies to situations where a person is unable to breathe or their heart has stopped. It does not apply to other medical interventions or treatments unless clearly specified.
• A DNR Order is permanent: This misconception could deter someone from opting for a DNR Order. It's important to know that a person or their legally authorized representative can revoke a DNR Order at any time according to their changing wishes or medical situation.
• Only the elderly or terminally ill can have a DNR: A common belief is that DNR Orders are only for the elderly or those with terminal illnesses. In reality, any individual, regardless of age or health condition, can have a DNR Order based on their personal preferences for emergency care.
• Doctors can override a DNR: People often think that in a critical situation, a doctor can override a DNR Order. The truth is that healthcare providers are legally bound to respect these orders as long as they are valid and current, irrespective of the circumstances.
• Hospitalization nullifies a DNR Order: Another misconception is that once a person with a DNR Order is hospitalized, the order becomes null and void. In reality, the DNR Order remains in effect across different care settings, including hospitals, unless a patient or their representative chooses otherwise.
• A DNR means no aggressive treatments: There's a false belief that having a DNR Order means a patient will not receive aggressive treatment for their conditions. DNR Orders specifically address not performing CPR; they do not limit other forms of medical treatment or care unless the patient has specified otherwise in an advance directive.
• You need a lawyer to complete a DNR Order: While legal advice might be helpful in understanding the implications of a DNR Order, it is not necessary to have a lawyer to complete the form. A DNR Order can be completed with the guidance of a healthcare provider to ensure it accurately reflects the patient’s wishes.

Addressing these misconceptions can empower individuals to make informed healthcare decisions that align with their values and desires. Understanding what a DNR Order does and does not do is a critical step in this process.

Understanding the California Do Not Resuscitate (DNR) Order form is critical for individuals who want to ensure their healthcare wishes are respected. Here are six key takeaways to consider:

• The California DNR Order form must be completed by a licensed physician, indicating a patient's wish not to receive cardiopulmonary resuscitation (CPR) in the event of a cardiac or respiratory arrest.
• For the DNR Order to be considered valid, it needs to be signed by the patient or their legally recognized healthcare decision-maker and the attending physician.
• This form should be kept in an easily accessible location at all times; many individuals choose to place it on or near their refrigerator or carry a copy with them.
• The DNR Order is applicable in all settings: at home, in a hospital, or while in hospice care, ensuring that the patient's wishes are honored across different care scenarios.
• It’s critical to communicate the existence and location of the DNR Order to family, caregivers, and healthcare providers to avoid any confusion or delays in an emergency situation.
• A DNR Order can be revoked at any time by the patient or their designated healthcare decision-maker, necessitating immediate communication of this change to all involved parties.

Properly filling out and sharing one's California DNR Order form is a step towards ensuring that an individual's end-of-life wishes are respected, providing peace of mind to both the individual and their loved ones.