Indiana Do Not Resuscitate Order Template

What is a Do Not Resuscitate Order (DNRO) in Indiana?

A Do Not Resuscitate Order (DNRO) in Indiana is a legal document. It tells health professionals not to perform CPR (cardiopulmonary resuscitation) if a person's breathing stops or if their heart stops beating. This order is used by people who do not want lifesaving treatments in these situations.

Who can request a DNRO in Indiana?

In Indiana, an adult with the capacity to make their own health care decisions, a legally appointed health care representative, a guardian, or a surrogate decision-maker for a minor can request a DNRO. This ensures that people who can't make decisions for themselves still have their wishes respected.

How can someone obtain a DNRO in Indiana?

To obtain a DNRO in Indiana, one must discuss their wishes with a healthcare provider. The healthcare provider will provide the necessary paperwork and guidance on how to properly complete and execute the order. This ensures the document is filled out accurately and reflects the person's wishes.

Is a DNRO permanent?

No, a DNRO is not permanent. It can be revoked at any time by the person it concerns if they change their mind. This can be done verbally or by destroying the document. A new DNRO can also be issued if the person wishes to reinstate it later.

Does a DNRO need to be notarized or witnessed in Indiana?

In Indiana, a DNRO does not have to be notarized. However, it must be signed in the presence of a witness. The witness must be an adult and cannot be someone who is directly involved in providing healthcare to the person requesting the DNRO.

Where should a DNRO be kept?

A DNRO should be kept in a place where it can be easily found in an emergency. Places such as on the refrigerator, in a personal health record, or with a medical alert bracelet are common. It's also important to inform family members or caregivers of its location and discuss the decision with them ahead of time.

Can a DNRO be used in settings other than a hospital, like at home or in nursing homes?

Yes, a DNRO is effective in any setting, including at home or in a nursing home, in Indiana. It informs emergency medical services (EMS) and healthcare providers about a person's wishes not to have CPR performed, no matter where they are.

What happens if medical staff are not aware of a DNRO during an emergency?

If medical staff are not aware of a person's DNRO during an emergency, they may perform lifesaving measures, including CPR. This underlines the importance of making the DNRO easily accessible and communicating its existence to all healthcare providers and family members.

Is there a cost to create a DNRO in Indiana?

There is typically no cost involved in creating a DNRO itself. However, there might be costs associated with the consultation with healthcare providers when discussing and obtaining the DNRO. It's best to discuss any potential costs upfront with your healthcare provider.

Can a DNRO be overridden by family members or healthcare providers?

In Indiana, a DNRO reflects the wishes of the individual and should be followed by healthcare providers. Family members cannot override it if it accurately reflects the individual’s current wishes. However, if there is confusion or disagreement about the person's true wishes, healthcare providers may consult with family members or the court to clarify.

When preparing an Indiana Do Not Resuscitate (DNR) Order, many people find themselves navigating through a critical document with little guidance. It's essential to complete it accurately to ensure that one's health care wishes are respected. Unfortunately, common mistakes often occur, which can lead to significant consequences. Here's a breakdown of some of the most frequent issues:

1. Not consulting with a healthcare provider: Completing a DNR without the guidance of a healthcare professional can lead to misunderstandings about what the order implies and whether it's appropriate for the individual's health status.
2. Incomplete information: Often, crucial details are missed, such as the patient's full name, date of birth, or specific medical conditions that warrant a DNR. Accurate and complete information is vital for the order to be recognized and acted upon in critical situations.
3. Improper signatures: The DNR requires signatures from the individual (or their legal representative) and their physician. Missing or incorrect signatures can invalidate the document.
4. Failure to update the form: Health circumstances and decisions about end-of-life care can change. Not updating the DNR to reflect current wishes can lead to unwanted interventions.
5. Lack of witnesses or notary: Although not always required, having the document witnessed or notarized can add an extra layer of validity, especially in contentious situations.
6. Failure to communicate with family: Not discussing the decision to complete a DNR with family members can lead to confusion and distress during an emergency, as loved ones may not understand the individual's wishes.
7. Errors in distribution: A DNR should be readily accessible to first responders. Failing to inform family members of its location or not providing a copy to the person's primary healthcare provider can result in the DNR not being followed.
8. Misunderstanding the scope: Some individuals might not fully comprehend what a DNR order does and does not cover. It's crucial to understand that it only applies in situations where resuscitation would be the response to a cardiac or respiratory arrest.
9. Confusion with other advance directives: Mixing up a DNR with other forms of advance directives, such as a living will or healthcare power of attorney, can complicate medical decisions. Each document has a distinct purpose and should be completed accordingly.
10. Forgetting to revise after major life changes: After significant life events, such as a new diagnosis or a change in marital status, revisiting and potentially revising a DNR is advisable. These changes might influence one's wishes regarding resuscitation.

In summary, completing a Do Not Resuscitate Order calls for careful consideration and clear communication, both with healthcare providers and loved ones. Avoiding these common mistakes can help ensure that individual healthcare preferences are respected during critical moments. Taking the time to carefully prepare this document can provide peace of mind for everyone involved, knowing that decisions about end-of-life care are thoughtfully made and clearly documented.

In the complex and often emotionally fraught landscape of healthcare decision-making, the Indiana Do Not Resuscitate (DNR) Order form represents just one of several critical documents individuals may use to communicate their wishes regarding end-of-life care. By electing not to receive CPR in the event that breathing or heartbeat stops, the signer of a DNR order exercises profound agency over their medical treatment. However, this document does not stand alone. Several other forms frequently accompany or complement the DNR, each serving a unique purpose in ensuring a person's healthcare preferences are fully understood and respected.

• Living Will Declaration: This document allows individuals to state their wishes concerning medical treatments, including life-prolonging measures, if they are unable to communicate these preferences due to a terminal condition or permanent unconsciousness. It is broader than a DNR order, covering more potential scenarios and interventions.
• Healthcare Representative Appointment: Through this form, a person can designate a healthcare representative – a trusted individual who will make healthcare decisions on their behalf, should they become unable to do so. This representative is empowered to interpret the patient’s wishes as circumstances change and decisions not previously contemplated need to be made.
• Five Wishes: Considered a comprehensive living will, Five Wishes goes beyond traditional medical instructions. It touches on personal, emotional, and spiritual wishes in addition to medical preferences, thereby offering a holistic approach to end-of-life planning. This document can serve as a guide for discussing and documenting care preferences with family and healthcare providers.
• POST (Physician Orders for Scope of Treatment): This medical order is designed for those in an advanced stage of illness and specifies the types of medical treatment an individual wishes to receive toward the end of life. Unlike a DNR order, which is limited to cardiopulmonary resuscitation, a POST covers a broader range of treatments, such as hospitalization, intubation, and antibiotics, and must be signed by both the patient (or their representative) and the physician.

Together, these documents form a network of directives that safeguard patient autonomy, ensuring that healthcare decisions reflect the individual's values, preferences, and specific medical conditions. Importantly, the process of creating these documents encourages discussions among individuals, their families, and healthcare providers about wishes for end-of-life care, laying a foundation for decision-making that honors the person’s dignity and desires. As laws and forms can vary significantly by jurisdiction, always verify that the correct documentation is used and completed in accordance with state requirements.

The Indiana Do Not Resuscitate Order form is similar to several other documents used in healthcare and end-of-life planning. These documents, including the Living Will, Medical Power of Attorney, and POLST (Physician Orders for Life-Sustaining Treatment), share common goals. They aim to respect the wishes of individuals regarding medical treatment, yet they differ in specific functions and circumstances under which they are used.

The Living Will is a document that shares similarities with the Do Not Resuscitate (DNR) order in its purpose to direct medical care. Where a DNR specifically addresses the refusal of CPR (cardiopulmonary resuscitation) in the event that an individual’s heart stops or they stop breathing, a Living Will is broader. It outlines a person's preferences for various life-sustaining treatments, such as mechanical ventilation or tube feeding, in the event they are unable to communicate their wishes. Both documents serve to guide healthcare providers and loved ones during critical moments, ensuring that an individual’s medical treatment aligns with their preferences.

Medical Power of Attorney is another document related to the DNR, but with a distinct role. While a DNR directly indicates a person's wish not to have CPR performed, a Medical Power of Attorney designates an individual (an agent) to make healthcare decisions on one’s behalf if they're unable to do so. This appointed agent can make decisions about a range of treatments, not just CPR, according to the patient's wishes, values, and instructions, possibly outlined in other documents like a Living Will. Essentially, having a Medical Power of Attorney allows for a broader scope of decision-making power in medical situations beyond those specifically addressed by a DNR.

The POLST (Physician Orders for Life-Sustaining Treatment) form also shares similarities with the DNR order, but it is a more comprehensive medical order. The POLST is intended for seriously ill or frail individuals for whom healthcare professionals believe CPR or other life-sustaining treatments might be used in the near future. It addresses a wider range of treatments than a DNR, including preferences regarding intubation, antibiotics, artificial nutrition, and hydration methods. While a DNR is strictly focused on CPR, the POLST translates a patient's wishes into medical orders to be followed by all healthcare workers, not only in a hospital but in any setting, such as at home or in a nursing facility.

When filling out the Indiana Do Not Resuscitate (DNR) Order form, there are crucial steps to follow and mistakes to avoid. This guidance ensures the document reflects your wishes accurately and is considered valid under Indiana law.

Here are things you should do:

• Read the form thoroughly to understand all the sections and what they entail.
• Ensure all required information is filled in accurately, including full legal names and addresses.
• Discuss your wishes with your family, healthcare provider, and if applicable, your healthcare proxy or power of attorney, to ensure they understand your decisions.
• Sign the form in the presence of a witness. The witness must be a competent adult who understands the intent of the document and can attest to the voluntariness of your decision.
• Have the form signed by a physician, advanced practice registered nurse, or physician assistant to validate the DNR Order.
• Keep the completed form in a readily accessible place and inform family members and caregivers of its location.
• Provide copies to your primary healthcare provider and consider registering the form with the Indiana Department of Health if such an option is available.

Here are things you should not do:

• Do not fill out the form without fully understanding the implications of a DNR order. If necessary, seek clarification from a healthcare professional.
• Do not leave any required fields incomplete, as this could lead to questions about the validity of the form.
• Do not use the DNR order to convey other medical wishes or advanced directives. These should be documented separately in the appropriate forms.

Properly completing the Indiana DNR Order form is a critical step in ensuring that your healthcare wishes are known and respected. Always consult with healthcare professionals or legal advisors if you have questions about the form or the process.

When it comes to the Do Not Resuscitate (DNR) Order form in Indiana, several misconceptions can cloud understanding and decision-making. Discussing these can help clear up confusion and ensure that people's wishes regarding emergency medical care are understood and respected.

• Misconception 1: A DNR order means no medical treatment will be provided. This is incorrect. A DNR order specifically addresses the avoidance of CPR (cardiopulmonary resuscitation) in the event that breathing stops or the heart stops beating. It does not mean that other forms of medical care, especially measures to provide comfort or address pain, will be withheld.

• Misconception 2: Anyone can sign a DNR order on behalf of a patient. In Indiana, only the patient or their legally authorized representative has the authority to consent to a DNR order. This ensures that the patient's own wishes are respected or are being accurately represented by someone with legal authority to make such decisions on their behalf.

• Misconception 3: A DNR order is permanent and cannot be changed. This isn't true. A DNR order can be revoked or altered at any time by the patient or their authorized representative. It's important for individuals to communicate with their healthcare providers if they change their mind about their DNR status.

• Misconception 4: DNR orders are universally recognized across all settings. While DNR orders are legally binding in healthcare settings, there can be variations in recognition and implementation procedures depending on whether the patient is in a hospital, at home, or in another care setting. Always check with the specific healthcare facility or provider to understand how they recognize and act on DNR orders.

• Misconception 5: A DNR order is needed to stop all life-sustaining treatments. This is not accurate. A DNR order specifically refers to not starting CPR if a person's breathing or heart stops. Decisions about other life-sustaining treatments, such as mechanical ventilation or artificial nutrition, are addressed through other documents, such as advance directives or living wills.

• Misconception 6: DNR orders only apply to elderly patients. Age is not a factor in whether a DNR order can be issued. People of any age with serious illnesses or at a certain stage in their disease progression may consider a DNR order appropriate, based on their values and medical advice.

• Misconception 7: Discussing or signing a DNR order means giving up hope. Choosing a DNR order can be part of a thoughtful discussion about goals of care, reflecting personal values and medical reality. It doesn’t necessarily signal giving up; rather, it's about making informed choices that align with the patient's wishes and quality-of-life considerations.

Addressing these misconceptions can help ensure that individuals are making informed decisions about DNR orders based on accurate information and clear understanding. It’s crucial for patients, families, and healthcare providers to engage in open, honest conversations about these important decisions.

In Indiana, understanding and utilizing the Do Not Resuscitate (DNR) Order form is crucial for those wishing to make informed decisions about their end-of-life care. Here are six key takeaways to guide individuals and their families through this process:

• The DNR Order form must be completed by both the patient (or their legally authorized representative) and a licensed physician, advanced practice registered nurse, or physician assistant. This collaboration ensures that the wishes of the patient regarding resuscitation are clearly documented and medically reviewed.
• A valid DNR Order indicates that the patient has decided against the use of cardiopulmonary resuscitation (CPR) in the event their breathing stops or their heart ceases to beat. This decision is highly personal and should be made after thorough discussion with healthcare providers and loved ones.
• It is important for patients to communicate their decision to have a DNR Order with family members and caregivers to prevent confusion or conflict in emergency situations. Clear communication can help ensure that a patient’s wishes are respected.
• The DNR Order should be kept in a readily accessible location. In a medical emergency, healthcare providers need to be able to verify the existence of a DNR Order quickly to comply with the patient's wishes.
• Patients have the right to change their mind about having a DNR Order at any time. If they decide to revoke their DNR Order, it is crucial to inform their healthcare provider immediately to update their medical records and remove the DNR from their medical plan.
• Having a DNR Order does not mean that the patient will be denied other forms of medical care. Patients with a DNR Order will still receive comprehensive medical care aimed at providing comfort and addressing other health issues. The order specifically relates to the use of CPR in the event of cardiac or respiratory arrest.

Individuals considering a DNR Order in Indiana should consult with their healthcare provider to ensure they fully understand the implications of this important medical directive. Making an informed decision helps protect a patient's right to have their end-of-life care wishes honored.