Valid Do Not Resuscitate Order Template for Illinois

Illinois Do Not Resuscitate Order: Usage Steps

Filling out an Illinois Do Not Resuscitate (DNR) Order form is an important step for individuals who wish to make their healthcare preferences known, particularly regarding CPR (cardiopulmonary resuscitation) in the event their heart stops or they stop breathing. This document communicates a person's request not to have CPR performed by healthcare professionals. Completing this form requires careful attention to detail to ensure that the individual’s wishes are clearly stated and legally recognized. Follow these steps to correctly fill out the form:

1. Start by entering the full name of the individual the DNR order is for. This ensures the DNR order is correctly associated with the right person.
2. Next, provide the person's date of birth. This is crucial for identifying the individual accurately in medical records.
3. Specify the address of the individual. This information helps healthcare providers locate and verify the person’s identity.
4. Fill in the date that the DNR order is being completed. This date is important for healthcare providers to know when the directive became effective.
5. The individual or their legally authorized representative must sign the form. This signature is essential for validating the DNR order.
6. A witness is required to sign the form as well. The witness's signature confirms that the individual or the representative signed the form voluntarily.
7. Finally, the form must be signed by the individual’s physician. The physician’s signature verifies that they have discussed the DNR order with the patient or their representative, ensuring that the decision is informed.

Once the form is fully completed and signed, it is important to keep it in an easily accessible place and inform family members or caregivers of its location. Healthcare providers should also be made aware of the form’s existence and its location to respect the individual's wishes in case of an emergency. Understanding and completing the Illinois Do Not Resuscitate Order form is a proactive step in managing one’s healthcare decisions and ensuring that they are honored.

1. What is an Illinois Do Not Resuscitate (DNR) Order form?

   A Do Not Resuscitate (DNR) Order form in Illinois is a legal document that instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a patient's breathing stops or if the patient's heart stops beating. It is used by individuals who wish to avoid lifesaving measures in certain medical situations.

2. Who can complete a DNR Order in Illinois?

   In Illinois, a DNR Order can be completed by an individual (18 years of age or older), a legally authorized healthcare agent, a guardian, or a parent if the individual is a minor. The decision should be informed and voluntary, often made after discussing with a healthcare provider.

3. How does one obtain a DNR Order form in Illinois?

   To obtain an Illinois DNR Order form, an individual should speak with their healthcare provider. Healthcare providers can provide the form and offer guidance on how to complete it properly. Additionally, the form may be available through some Illinois health departments or online through official state health websites.

4. Is a physician's signature required on the Illinois DNR Order form?

   Yes, a physician's signature is required on the Illinois DNR Order form for it to be valid. The physician must review the patient's medical condition and confirm that the DNR Order is appropriate for the patient's healthcare wishes. The physician's signature indicates their agreement with the DNR order.

5. What should be done with the DNR Order once it is completed?

   Once completed and signed, the DNR Order should be kept in a place where it can be easily accessed in an emergency, such as with the patient or their healthcare proxy, in the patient's medical records, or in a location in the patient's home known to family members or caregivers. A copy should also be provided to the patient’s primary healthcare provider for inclusion in medical records.

6. Can an Illinois DNR Order be revoked?

   Yes, an Illinois DNR Order can be revoked at any time by the individual or their legally authorized healthcare agent. Revocation can be done by destroying the DNR Order form, orally informing healthcare providers of the decision to revoke, or any other act demonstrating a clear intention to revoke the order. It is important to communicate this revocation to all relevant parties, including healthcare providers and family members.

Filling out the Illinois Do Not Resuscitate (DNR) Order form requires attention to detail and an understanding of the document's significance. People often make mistakes during this process, which can lead to unintended consequences. Here are eight common errors:

1. Not consulting with a healthcare provider before completing the form. A healthcare provider can offer valuable insight into the implications of a DNR order and ensure that it reflects the individual's wishes accurately.

2. Failing to use the person's legal name. It's crucial to use the name that appears on legal identification to avoid any confusion about the individual's identity.

3. Leaving signature fields blank. Both the individual and a witness or a healthcare provider must sign the form to make it legally binding. Unsigned forms are not valid.

4. Including incorrect or outdated contact information. This can prevent healthcare providers from reaching the right person for consent or discussions about the DNR order.

5. Not specifying the conditions under which the DNR order should apply. Without clear indications, healthcare providers might be unsure when to implement the order.

6. Misunderstanding what the DNR order covers. Some people mistakenly believe it declines all forms of medical treatment, when it specifically pertains to not performing resuscitation.

7. Forgetting to update the form. As situations and wishes change, it's essential to revise the DNR order to reflect current preferences.

8. Not distributing copies of the completed form to relevant parties. Family members, healthcare providers, and in some cases, legal representatives should have access to the DNR order to ensure it is honored.

These mistakes can often be avoided with careful review and consultation with healthcare and legal professionals. Ensuring that the DNR order is correctly filled out and understood is crucial for it to serve its intended purpose effectively.

When discussing end-of-life planning, a document often mentioned is the Illinois Do Not Resuscitate (DNR) Order form. This form is crucial for those who wish to decline resuscitation attempts in the event their heart stops or they stop breathing. However, the DNR is just one piece of a comprehensive approach to planning for medical and personal care preferences near the end of life. Various other forms and documents can play vital supporting roles, ensuring a person's wishes are clearly outlined and respected. Let's explore some of these important documents that are commonly used alongside an Illinois DNR Order form.

• Advance Health Care Directive - This document allows individuals to provide instructions about their healthcare preferences, including end-of-life care, and to appoint a healthcare proxy. The proxy can make medical decisions on behalf of the individual if they become unable to do so.
• Power of Attorney for Health Care - Similar to an advance directive, this legal document designates a person (agent) to make healthcare decisions for someone else (the principal) in the event they become incapacitated.
• Living Will - A living will is a written statement detailing a person’s desires regarding their medical treatment in circumstances where they are no longer able to express informed consent, especially concerning life-sustaining treatment.
• Medical Orders for Life-Sustaining Treatment (MOLST) - This form is used to document a person's preferences for life-sustaining treatments, including resuscitation, intubation, and artificial nutrition and hydration.
• Physician Orders for Scope of Treatment (POST) - Similar to a MOLST, this document is intended to communicate a patient's treatment preferences, including wishes about CPR, to health care providers.
• Power of Attorney for Property - A legal document that names someone to handle financial matters for another person. While it doesn’t deal directly with medical decisions, it’s important for comprehensive planning, covering situations where medical bills and care-related expenses need to be managed.
• Five Wishes - An advance directive that addresses personal, spiritual, and medical concerns. It goes beyond the traditional medical care plan to include what the person values most in their life and care treatment.

While the Illinois DNR Order form is specifically about resuscitation preferences, the journey of end-of-life planning encompasses much more. By combining the DNR with other legal and medical forms, individuals can create a well-rounded plan that covers a wide range of scenarios and preferences. These documents ensure that a person's healthcare wishes are understood and respected by family members and healthcare providers, providing peace of mind to all involved. Understanding and preparing these documents in advance can be a profound act of care for oneself and for one's loved ones.

• Living Will: Similar to a Do Not Resuscitate (DNR) Order, a living will is a document that outlines an individual's desires regarding their medical treatment in scenarios where they are unable to communicate their wishes. Just as a DNR specifically addresses the wish not to have cardiopulmonary resuscitation (CPR) in the event of a cardiac or respiratory arrest, a living will can cover a broader range of medical interventions, including life support, mechanical ventilation, and artificial nutrition and hydration.

• Healthcare Power of Attorney: This legal document is akin to a DNR Order in that it empowers another individual to make healthcare decisions on one’s behalf under certain conditions. While a DNR is a direct directive against resuscitation, a Healthcare Power of Attorney allows the designated person, often called an agent, to make a wide range of medical decisions, including but not limited to enforcing or refusing a DNR, when the individual is incapacitated and unable to express their wishes.

• Physician Orders for Life-Sustaining Treatment (POLST): Much like a DNR order, a POLST is designed to ensure that a patient's wishes regarding life-sustaining treatments are respected by healthcare professionals. However, a POLST goes beyond the scope of a DNR by specifying preferences for other types of life-sustaining interventions such as intubation, mechanical ventilation, and antibiotics, making it a more comprehensive guide for emergency and other healthcare workers.

• Advance Directive: An advance directive is a broader term that encompasses documents like DNR orders and living wills. It’s designed to outline a person’s healthcare preferences ahead of unforeseen medical incapacitation. DNR orders form part of this proactive planning, focusing specifically on the refusal of CPR in critical situations. Thus, an advance directive can include detailed wishes beyond resuscitation preferences, enabling a more granular control over one's future healthcare.

Filling out the Illinois Do Not Resuscitate (DNR) Order form is a critical step for those deciding on their emergency medical treatments. To ensure this process is done accurately and reflects your wishes, here are six dos and don'ts to guide you:

Do:

1. Consult with a healthcare professional. Before completing the form, it's essential to discuss the implications of a DNR order with your doctor or a healthcare provider. They can explain what the DNR order means and how it will affect emergency medical care.

2. Ensure the form is signed and dated. A valid Illinois DNR order must be signed and dated by the individual (or their legal guardian, if applicable) and their physician. This verifies that both parties have agreed to the DNR order.

3. Make multiple copies. Once the DNR order is completed, make several copies. Keep the original in a safe but easily accessible place, and give copies to your family members, close friends, and healthcare providers.

Don't:

1. Rush the decision-making process. Taking the time to fully understand the consequences and implications of a DNR order is crucial. This decision should be considered carefully, possibly with input from family members and legal advisors, alongside medical professionals.

2. Forget to review and update. Circumstances and perspectives can change. It is important to review and potentially update your DNR order periodically or if your health condition changes significantly.

3. Fill out the form inaccurately. Errors in filling out the form can lead to misunderstandings about your wishes. Pay close attention when completing the form to ensure all information is accurate and reflects your intentions clearly.

Misconceptions about the Illinois Do Not Resuscitate (DNR) Order form are not uncommon. Understanding what a DNR is and isn't can help individuals and their families make informed decisions about their healthcare. Here's a list of common misconceptions and the facts to clear them up:

• Only the elderly can have a DNR order. People of all ages can have a DNR order. The decision is based on a person’s healthcare preferences and medical condition, not their age.
• A DNR order means no medical treatment. This isn’t true. A DNR specifically refers to not performing CPR if a person’s breathing or heartbeat stops. It does not mean refusing other types of medical care or treatments.
• Doctors decide if a patient needs a DNR. While doctors provide advice and information, the decision to have a DNR is ultimately up to the patient or their healthcare proxy.
• A DNR can only be issued in a hospital. DNR orders can be prepared in various settings, including at home, in a hospice, or in assisted living facilities. They just need to be properly documented and communicated to healthcare providers.
• Emergency personnel will ignore DNR orders. Emergency personnel will respect a DNR order as long as it is properly presented to them. Illinois has specific formats and sometimes wristbands that signify a DNR order, which helps in such situations.
• DNR orders are permanent and cannot be changed. A DNR order is not permanent. It can be revoked or modified at any time based on the individual’s wishes. This adjustment needs to be communicated clearly to the healthcare team and family.
• Having a DNR means you can't be admitted to the hospital. This is a misconception. Individuals with DNR orders can be hospitalized. The DNR specifically addresses the use of CPR, not other treatments or care that might be necessary.
• A DNR order also means "Do Not Treat." This is not correct. A DNR order relates specifically to CPR and does not affect other treatments, such as hydration, nutrition, medication, or other medical interventions that can provide comfort or treat other conditions.
• You need a lawyer to complete a DNR order. While legal advice may be beneficial in understanding the implications of healthcare decisions, a lawyer is not required to complete a DNR order. It should be discussed with healthcare providers to ensure it aligns with the individual’s wishes and is properly documented.

Understanding and completing a Do Not Resuscitate (DNR) Order in Illinois can be a critical step for individuals who wish to have their end-of-life care wishes formally recognized. A DNR order instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) in the event the patient's breathing stops or the heart ceases to beat. Here are six key takeaways about filling out and using the Illinois DNR Order form:

• Eligibility: The Illinois DNR Order is available to any individual who, in consultation with their healthcare provider, decides that they do not want to receive CPR in the event of a cardiac or respiratory arrest. This can include individuals with a terminal illness, chronic conditions, or those who are at a significant risk of declining into a state where they would not want CPR.
• Consultation with a Healthcare Provider: Before completing the form, the individual should have a thorough discussion with their healthcare provider about the implications of a DNR order. Understanding the medical consequences and ensuring that the decision aligns with the person's values and wishes is essential.
• Documentation Requirements: The DNR form must be completed accurately. Key information includes the patient's name, date of birth, and specific instructions regarding the DNR order. It is crucial that the form is signed by both the patient (or their legally authorized representative) and the physician. This dual signature requirement confirms the mutual agreement on the DNR decision.
• Accessibility: Once completed, the Illinois DNR Order should be kept in a place where it can be easily accessed by family members and healthcare providers. Copies should be given to appropriate family members, healthcare proxies, and primary care providers. Additionally, if the individual resides in a healthcare facility, a copy should be included in their medical records.
• Revocation Process: It's important to note that the individual can revoke the DNR order at any time. This can be done orally or in writing. If the DNR is revoked, it is essential to inform all relevant parties, including healthcare providers and family members, and to remove any DNR identifiers from the person's surroundings.
• Legal Implications: The DNR Order respects the patient's right to make decisions about their own healthcare and ensures that their wishes are followed. However, it does not address other medical treatments and does not serve as a substitute for a Power of Attorney for Health Care or a Living Will. For comprehensive end-of-life planning, individuals may need to consider additional legal documents.