In Home Supportive Services Advise: How to Save Advanced Directives, DNR's & Health Care Surrogates

Learn the proper ways to document and save DNRs, Advanced Directives and more from in home supportive services

Q) In your last column you discussed types of advance directives. Who should have a copy and also can you address Do Not Resuscitate Orders? Beth Clements - Sarasota

A) Beth you bring up an important issue. People often written documents and file them away in the bedroom drawer and don’t recall what they have or what it says.

Some suggestions from our in home supportive services would be:

• Make sure that your health care provider, attorney, and the significant persons in your life know that you have an advance directive and where it is located. You should also give them a copy and can give your in home supportive services provider one as well.
• Some people keep original papers in a bank safety deposit box. If you do, you may want to keep copies at your house or information concerning the location of your safety deposit box. My clients use a service that can fax any or all of your legal documents to a doctor or hospital day or night within minutes. They best part is that you can authorize your family members so they can have access to your condition from afar. There are services that will also keep your medical records online. This is especially handy if you travel a lot.
• Keep a card or note in your purse or wallet that states that you have an advance directive and where it is located or the number to call to get this info.
• It is very important to let your loved ones and/or your in home care providers know your intentions and where the documents are.

The Advanced directives we discussed usually name a Health Care Surrogate, but as an alternative to a health care surrogate, or in addition to, you might want to designate a durable power of attorney. Through a written document you can name another person to act on your behalf. It is similar to a health care surrogate, but the person can be designated to perform a variety of activities (financial, legal, medical, etc.) at the time you say or when you become incapacitated. You should consult an attorney for further information.

As far as Do Not Resuscitate Orders—

A do not resuscitate (DNR) order is another kind of advance directive. A DNR is a request not to have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing. (Unless given other instructions, hospital staff or EMS will try to help all patients whose heart has stopped or who have stopped breathing.) You can use an advance directive form or tell your doctor that you don't want to be resuscitated. In this case, your doctor puts a DNR order in your medical chart. Doctors and hospitals in all states accept DNR orders.

If you are terminally ill (or if you have a loved one who is in a persistent vegetative state) you may want to consider having a pre-hospital Do Not Resuscitate Order (DNRO).

The pre-hospital DNRO is a specific yellow form available from the Florida Department of Health (DOH). It must be on this yellow form and should be hanging on your refrigerator or it will not be honored.

Your attorney, health care provider, or ambulance service may also have copies available for your use. You, or your legal representative, and your physician sign the DNRO form. More information is available on the DOH website, www.doh.state.fl.us or www.MyFlorida.com (type DNRO in these website search engines) or calls (850) 245-4440. You can also give additional copies of these documents to your in home supportive services team for safekeeping.

For more information from your in home supportive services please email us at Bradenton@comfortkeepers.com or call us at (941) 932-8887.