In the final two years of her mother’s life, Lisa McAllister started carrying copies of her mother’s do-not-resuscitate and power-of-attorney forms in her purse and her car. Her mother was cycling between the hospital, assisted living and rehab — “a round robin of craziness,” said Ms. McAllister, a retired copy editor — and was clear about not wanting to be kept alive with substantially diminished quality of life.
One night in 2012, after her mother had fallen in a nursing home in Silver Spring, Md., Ms. McAllister looked at her mother’s medical chart and saw that someone had checked the box that said, “No D.N.R.”
“I said, ‘There’s a D.N.R.,’ ” Ms. McAllister recalled. “The floor nurse said, ‘No, there isn’t.’ ” Ms. McAllister got testier. “There is, it’s in the file. I’ve seen it there.”
They went to the director of nursing, who checked the records — and yes, there was the D.N.R. form.
It wasn’t the only time Ms. McAllister had to intervene to stop aggressive treatments. “It was a common occurrence,” she said. “There’s a lot of bodies and a lot of files and people coming and going.”
Health care professionals, ethicists and advocates continually urge older people to document their preferences about end-of-life medical decisions, and a growing proportion do. A recent large national study, tracking more than 6,000 people over age 60 who died between 2000 and 2010, found that the proportion with advance directives climbed to 72 percent from 47 percent.