Not every thing in our lives is planned. Little surprises like unexpected traffic can be frustrating, but in the long run we get where we’re going, albeit a little later than we thought. In many aspects of life, planning can be minimal and that’s ok. But there are a few exceptions.
End-of-life decisions are the sorts of plans that people tend to avoid. But even healthy people should consider the factors now, so that if one of life’s surprises catches you off guard, you and your loved ones won’t be stuck making less informed decisions regarding your comfort. To explain do-not-resuscitate orders (DNR), we spoke with Sarah Payne, DO, a medical director specializing in hospice and palliative care at Banner Heath Center.
What Is a DNR?
If a person’s heart stops or if they stop breathing, efforts are typically made to revive them. In most cases this means using CPR and other methods to keep oxygenated blood flowing. What we see in action movies can paint a picture of easy revival and immediate recovery. Of course, any outcome is possible, but for old, ill or injured patients, resuscitation can be especially traumatic and in cases of terminal illness, it is rarely successful. A do-not-resuscitate order instructs your health care workers that you do not want to be revived.
When Is It Time to Consider a DNR?
Dr. Payne explained that many people wait too long to make their decision regarding DNR. “Many times, the DNR is not considered until risk factors become reality,” she said. “If you are at risk for heart attacks or other life-threatening issues, don’t wait until the moment of emergency to consider your options.” Although elderly or ill individuals may feel more urgency, Dr. Payne added that everyone is at risk for accidental injuries like car crashes. Even for healthy people, it’s beneficial to learn how a DNR works.
How to Make the Decision
Your primary care physician is a great resource when weighing your options. They will be familiar with your health and can walk you through scenarios so that you understand the factors that go into your decision. Ask your physician to help you fill out a do-not-resuscitate order with the details that make you feel most comfortable.
Spouses and children may have strong opinions regarding your decision. Even if you want to make this decision on your own, consider bringing them into the discussion so that everyone can understand the end-of-life approach you choose.
Dr. Payne mentioned an important step in finalizing your decision. She said, “Ask your physician for an ‘orange form.’ This can be filled out and attached to your refrigerator in case something happens while you are at home and you are not able to communicate your wishes to the emergency response team.”
Who Can Make This Decision?
If you are capable, the responsibility of the DNR rests on your shoulders. In cases of emergency, if the patient is incapacitated, the choice falls to the medical power of attorney (MPOA), which is typically your spouse unless otherwise indicated. Check the laws in your state to verify who your default surrogate decision maker would be.
Can I Change My Mind?
Of course! If you have a change of heart at any point, you are entitled to change your decision to file as DNR or vice versa. Keep an open dialogue with your physician and let them know if you would like to change anything.
Schedule a visit with your primary care physician to begin making goals and decisions for your Advanced Care.
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