What a DNR order really means (and what it doesn’t)
The way too many people think about DNR orders, it’s as if the initials stood for “Deny Needed Remedies” instead of “Do Not Resuscitate.”
As one hospital Registered Nurse wrote anonymously, “Do Not Resuscitate does not mean that we will not provide care if you become critical” (emphasis in the original). It does not mean the patient wants no care at all and does not want to prevented from catastrophic decline, she added, noting that most hospitals do not treat DNR patients any differently than patients that are Full Code, with regard to transferring to ICU if necessary and providing aggressive treatment…The code simply means that if one stops breathing or one’s heart stops beating we will go in one of two predetermined directions: either CPR or not.
In other words, a Do Not Resuscitate order is really an Allow Natural Death order, and many in the healthcare profession are pushing to start calling it that instead.
But regardless of terminology, chances of successful resuscitation are very low – between 11 and 30 percent, depending on comorbidities and the hospital itself.
And as the patient’s age goes up, the chances of surviving CPR, living to be discharged and having the same quality of life as before go way down. For example, as you age your bones thin. CPR applies enough force to break ribs and leave bone fragments that can puncture lungs, even in younger, stronger-boned adults.
So while nobody wants to spend time thinking about the scariest of all possible “what if?” scenarios, it’s really important do sit down with a blank Advance Directive form and let it help guide you through the thought process.
In addition to thinking about it, talk it over with your family and your clergy member – and with a good elder law attorney, to go over your options and make sure you’ve taken all the factors and possibilities into consideration. (If you don’t know of one, we’ll gladly refer you.) Even after you complete the form, sign it, and have it notarized, you can always make changes if your priorities change; it’s not permanent.
No two people have the exact same needs, priorities and values. And just as we put every client’s priorities first, you should take this opportunity to spell out yours, so that your family doesn’t have to guess about them. It’s the ultimate way to live better with better care.