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Advance Directives: What Kind do I Need?

Thursday , April 11 , 2019

Advance Directives: What Kind do I Need?

Many people, both young and old, worry that their end-of-life wishes may not be carried out the way they want when the time comes. There are two documents your elderly loved one can fill out to ensure they receive the kind of healthcare they desire in the case they become incapacitated: an advanced directive and a DNR (Do Not Resuscitate order).

It’s likely that you’ve already heard those terms but aren’t quite sure what they mean. We’re going to go over both – plus the POLST (Physicians Orders for Life-Sustaining Treatment) – so you can better understand the options and make sure your loved one takes the appropriate measures.

Here’s what you need to know:

What is an advance directive?

An advance directive, also called a living will, is a written document that sets out how individuals should be cared for in the event of an emergency or if they are otherwise incapacitated. It allows them to specify their wishes for end-of-life care while they are still well enough to be in control and make decisions –including treatments they would not want to use. For instance, an individual could spell out whether or not, and under what circumstances, they would want to be on a ventilator or have a feeding tube inserted.

This document is mainly a communication between an individual and their doctor or hospital, and it helps guide the physician and hospital staff in the care they will provide.

What is a DNR?

I find that there is often a lot of confusion about the difference between an advance directive and a DNR. Families frequently think that the Do Not Resuscitate order (DNR) is included in the advance directive, but that is rarely the case.

Each document serves a different purpose: While the advance directive is for doctors and the hospital, a DNR is a form than can quickly be handed to first responders or medical staff if an individual is in cardiac arrest. It is short, sweet and to-the-point – something paramedics can easily scan during an emergency situation. It tells them that the patient does not want CPR performed, and it should be kept in a designated spot in the home.

What is a POLST?

Many states, including NJ, have begun using and promoting a new document called a POLST (Physician Orders for Life-Sustaining Treatment) that combines some elements of the advance directive with the DNR. If you or a loved one stops breathing or goes into cardiac arrest, EMTs and hospitals must follow the instructions on the POLST because it is a legally binding document. As long as you are able to express your wishes, however, you can always change your mind.

Final thoughts

It is never too early to start planning for end-of-life. An advanced directive and a DNR are not just documents for the elderly – everyone should plan for medical emergencies and end-of-life care. While none of us wants to face our mortality, it’s important to take the appropriate measures so your family can understand and carry out your wishes if something does happen.

Helpful resources:

For information about POLST & DNR, click here

For a printable DNR form, click here

For a printable NJ POLST form, click here

Posted in: Aging