Free Do Not Resuscitate Order Form for California State

1. Not Signing the Form: It's crucial to sign the Do Not Resuscitate Order (DNR) form. Without your signature, the document is not valid. Ensure that you and your physician both sign it.

2. Forgetting to Date the Form: Always include the date when you fill out the DNR form. This helps clarify when the order was made and ensures it is current.

3. Not Discussing with Family: Failing to talk to family members about your decision can lead to confusion. It’s important they understand your wishes regarding resuscitation.

4. Using Incorrect Terminology: Be careful with the terms you use. Misunderstandings can arise if the language is unclear. Stick to the terminology used in the form.

5. Not Keeping Copies: After completing the form, make copies for your records and share them with your healthcare provider. This ensures everyone involved knows your wishes.

When considering end-of-life care options in California, the Do Not Resuscitate (DNR) Order form is an essential document. However, several other forms and documents can complement the DNR to ensure that an individual’s healthcare preferences are clearly communicated and respected. Below is a list of these important documents.

• Advance Healthcare Directive: This document allows individuals to specify their healthcare preferences in advance. It can designate a healthcare agent and outline treatment choices if the person becomes unable to communicate.
• Physician Orders for Life-Sustaining Treatment (POLST): A POLST form translates a patient's wishes about life-sustaining treatment into actionable medical orders. It is intended for individuals with serious illnesses and complements the DNR by detailing specific treatment preferences.
• Living Will: A living will is a type of advance directive that outlines what medical treatments a person does or does not want if they are terminally ill or in a persistent vegetative state.
• Healthcare Proxy: This document appoints someone to make medical decisions on behalf of an individual if they are unable to do so. It ensures that a trusted person advocates for the individual’s wishes.
• Durable Power of Attorney for Healthcare: Similar to a healthcare proxy, this document grants authority to someone to make healthcare decisions. It remains in effect even if the individual becomes incapacitated.
• Do Not Intubate (DNI) Order: This order specifies that a patient should not be intubated if they experience respiratory failure. It is often used alongside a DNR order to clarify treatment preferences.
• Organ Donation Consent: This document expresses an individual's wishes regarding organ donation after death. It can be included as part of an advance directive or completed separately.

Having these documents in place helps ensure that an individual's healthcare preferences are honored. It is advisable to discuss these options with family members and healthcare providers to facilitate clear communication and understanding of one's wishes.

When filling out and using the California Do Not Resuscitate Order form, keep the following key takeaways in mind:

1. Understand the Purpose: The form allows individuals to refuse resuscitation efforts in case of a medical emergency.
2. Eligibility: Only patients who are adults or legally emancipated minors can complete the form.
3. Consult Your Physician: Discuss your wishes with a healthcare provider to ensure your decisions are understood and respected.
4. Signature Requirements: The form must be signed by the patient or their legal representative, along with a witness signature.
5. Distribution: Keep copies of the completed form in accessible locations, such as with your healthcare provider and family members.
6. Review Regularly: Revisit your Do Not Resuscitate Order periodically, especially after significant health changes.

These steps are essential for ensuring your wishes are honored during critical medical situations.

The Advance Healthcare Directive is a crucial document that allows individuals to outline their healthcare preferences in advance. Similar to the California Do Not Resuscitate Order (DNR), it empowers patients to make decisions about their medical treatment in the event they become unable to communicate their wishes. This directive can include preferences about resuscitation, organ donation, and the appointment of a healthcare agent, ensuring that a person’s values and choices are respected even when they cannot speak for themselves.

A Physician Orders for Life-Sustaining Treatment (POLST) form serves a similar purpose by translating a patient’s wishes into actionable medical orders. Like the DNR, the POLST is designed for individuals with serious health conditions. It provides clear instructions to healthcare providers about the types of medical interventions a patient desires, including resuscitation efforts. The POLST is particularly useful in emergency situations, as it is a portable document that travels with the patient, ensuring their preferences are honored across different care settings.

When filling out the California Do Not Resuscitate Order form, there are some important things to keep in mind. Here’s a straightforward list of dos and don’ts to guide you through the process.

• Do ensure you understand the implications of the DNR order before signing.
• Do discuss your wishes with your healthcare provider and family members.
• Do fill out the form completely and accurately to avoid any confusion.
• Do keep a copy of the signed form in an accessible place.
• Do review and update the form as needed, especially if your health status changes.

• Don’t rush through the form; take your time to ensure everything is correct.
• Don’t sign the form without discussing it with your loved ones.
• Don’t forget to date the form when you sign it.
• Don’t assume medical staff will know your wishes without the form.
• Don’t ignore the need for witnesses or notarization if required.