DNR & Other Advance Directives: What Families & Caregivers Need to Know (Part 1)

Many caregivers and other family members are currently struggling with health decisions for their senior loved ones.  If you aren’t yet, it’s likely you will eventually be asked to make these decisions and, actually, the sooner the better for everyone involved.  These documents need to be completed before they are needed when all parties are competent enough to fully understand and make instructions for their medical treatment.

If your loved one is able, you should talk with her about what she wants to happen when a medical emergency arises.  The entire family should talk about this together so everyone hears the same story and will act in unison when the time comes.

There are several advance directives that everyone should execute whether they are young or old.  Talking about it doesn’t mean you will make the need for it happen sooner. As a caregiver of a senior, helping them execute these documents will make your burden lighter.  Being able to openly discuss wishes for healthcare with the entire family will allow everyone to focus their attention on the emergency at hand instead of spending your energies trying to make a quick and uninformed decision – one that you may regret later.

Types of Advance Directives

1. Do Not Resuscitate  — a directive in the form of an order to healthcare personnel, such as physicians, emergency medical personnel, nurses and others, who may need to save your loved one’s life if his heart should stop beating or he stops breathing.
2. Living Will — a document that spells out what medical treatment is desired – and, maybe more importantly, not desired – by your senior loved one.
3. Healthcare Proxy — gives a specific, stated caregiver the power to make decisions for the senior in the case of emergency when the senior is unable to speak for him or herself.
4. Durable Power of Attorney — typically allows a designated caregiver to make both healthcare and financial decisions for a senior loved one.

We will explain each of these further in Part 2 of this post, coming next week.

Advance directives typically can be completed with witnesses, with or without an attorney.  You will want to check with the laws in the state where your senior lives to be sure you have met all laws and regulations of that state as they do vary.  You don’t want to go through everything only to learn your loved one’s wishes haven’t been properly documented and thus are not legally binding on healthcare providers.

There is another document that you and your senior loved one can complete that highlights numerous instructions, entitled “Five Wishes”.  You can hear more about that on our podcast Seniors’ Five Wishes.  These advance directives are not the same as a will that details how your senior would like his possessions dispersed in the case of death and caregivers should not assume because a senior has a will that these healthcare directives have been executed.

Individual “Right” Answers

There is no one right or wrong answer or decision about how your senior loved one wants his medical treatment to occur during an emergency or end of life situation.  It is something that most everyone faces eventually and will be the hardest decision of your life if there are no advance directives written and guidelines to follow so you clearly know and can enforce the wishes of your loved one.  Therefore, it is best if you begin the dialogue with your senior loved one and talk over what they would like to happen.

Get it in writing and keep all advance directives in a place where all caregivers and family members have access in an emergency.  Keeping it handy or even carrying it in your wallet will be helpful if needed quickly.  Give a copy to the primary doctor so he or she will be ready as needed and bring a copy when you have a scheduled hospital procedure.  Always have a copy ready to give to EMS or hospital staff if an emergency occurs.

One thing is sure, when you are in a situation covered by one of the advance directives you want to already know the wishes of your loved one!