Seems like, for the rest of my days, I’ll be clarifying CPR (cardio-pulmonary-resuscitation). Fortunately, there is a one-page explanation in my book, The Blueprint to Age Your Way.

Preference for CPR is not as clear-cut as it appears. People who have thoughtfully considered and documented their preferences in legal documents are often are lulled into a false sense of security. If an ambulance shows up at your door, do you think your carefully worded legal documents will protect your end-of-life wishes? Ninety percent of my patients and families think so. But they’re wrong.

Your “Directive to Physician” is a valuable legal document, helpful in making decisions with all facts considered. But its value flies out the window once EMS (emergency medical services) is involved. For these situations, you need a different form, the DNR (do not resuscitate) document. This directs EMS to not perform CPR, if that is your wish, allowing a natural death instead.

In an emergency, EMS will never stop to read legal documents. When a patient has no heartbeat and isn’t breathing, every second counts. Paramedics go straight to CPR. That’s their job. They’ll stop for just one thing: If someone hands them the out-of-hospital DNR form as they enter the house. Whatever your legal documents say about your wishes makes no difference to EMS.

When the DNR instruction is in place and presented, then EMS workers will treat all other emergency conditions and transport you to the hospital when indicated. The only thing they will not do is to perform CPR if you have already died.

Therefore, if you or your loved one wishes to allow a natural death and not be revived if death occurs in the home, it’s essential to complete the EMS document that clarifies this wish in advance. Search the Internet for the Out-of-Hospital DNR form in your specific state. You may want to meet with your physician and discuss wishes, then complete the document. Most states require a physician’s signature for the form to be valid. Your doctor also knows your medical conditions and can offer advice.

It’s important to note, this document is specifically designed to be effective when out of the hospital setting. This can be in the home, nursing home, assisted living, ambulance, or anywhere apart from the hospital. Once you pass through the hospital doors, the Out-of-Hospital DNR form is no longer effective. However, your advocate may find it useful as evidence to argue your wishes, should you become nonverbal or incapacitated while in the hospital. The more extensive, specific and accessible your advance documentation, the greater the chance your wishes will prevail.

If you can speak for yourself when admitted to the hospital, you can and should direct your “code status.” In hospital lingo, “coding” refers to the moment when a patient experiences cardiac or respiratory arrest. “Code status” is the hospital’s own term. Unless clarified otherwise, everyone is a “full code” when entering the hospital, which means CPR will be performed. Should this not be your wish or not be the wish of your loved one, a talk with the attending hospital doctor will be needed to initiate a DNR order for that hospital stay.

For this and a treasure trove of additional information, visit my website

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