DNR Codes and Levels of Care - Understand Before They're Needed

Many family caregivers of seniors will, at some point, have to answer the question “does your loved one have a DNR?”

Too often that question will come at a stressful time, during a medical emergency.

“What does that mean?” you may ask.

You won’t have to ask that, though, after you read this article.

DNR (Do Not Resuscitate), often referred to as “no code,” is an advance directive document that guides medical personnel to NOT perform CPR or otherwise try to revive your loved one if their heart is stopped.

If your senior loved one does not have a DNR in place, they are considered to be a full code and will receive all aggressive measures if their heart or breathing stops.

As a family caregiver you might be asked about their code status during an emergency — either full or no code or some level in-between.

A DNR advance directive is used only when the person is unable to communicate their own wishes and someone else needs to step in to direct their care, otherwise they will be asked to direct their care themselves.

CPR, cardiopulmonary resuscitation, is a technique that is used to reestablish a person’s heart rhythm and breathing, shocking the heart back to a normal beating rhythm. It can involve chest compressions, rescue breathing, defibrillation, medicine to stimulate the heart function, mask ventilation and intubation for mechanical breathing (also known as life support).
Details About DNR Orders

A doctor is required to sign a DNR advance directive to be placed in your senior loved ones medical record, unlike a living will which requires a signature of the person involved and possibly a witness. A new DNR is required upon each hospital admission, including transfers between facilities.

It is important to know that many EMS (emergency medical personnel) are not allowed to honor a DNR order unless specific to that state and properly executed. For example, some states have a DNR document for use by EMS and then another one for the hospital.

A physician order for life-sustaining treatment (POLST), which covers out of hospital DNR orders, may be available in your state. There are also bracelets or documents kept on the refrigerator to alert first responders or your senior’s wishes.

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DNR Codes and Levels of Care - Understand Before They're Needed