Also Known As:
Do Not Resuscitate order, no-code order, resuscitation refusal
Type:
Legal medical directive
Primary Purpose:
A DNR is a legal document indicating that a patient does not want CPR or other emergency resuscitation efforts if their heart or breathing stops. It ensures that a patient’s wishes regarding end-of-life care are respected and followed by medical professionals.
When It Applies:
A DNR applies whenever a patient’s heart stops or they stop breathing. It is not limited to hospice care but is commonly discussed during serious or life-limiting illness to clarify care preferences.
Who Is Involved:
Patient, family members, hospice nurse, physician, and other healthcare providers responsible for the patient’s care
Where It Occurs:
Applicable in all care settings, including home, hospital, assisted living, nursing facilities, or inpatient hospice units
Coverage:
DNR orders are recognized by law and respected across all healthcare settings; no special insurance is required
Key Focus:
Ensuring patient wishes regarding resuscitation are clearly documented and legally honored
Common Misunderstanding:
A DNR does not mean that the patient will not receive care or comfort measures. It only limits emergency CPR or advanced life support; patients continue to receive medical treatment, symptom management, and compassionate care.
Definition
A DNR (Don’t Resuscitate) is essentially a legal form that says a person doesn’t want CPR or any other emergency measures if their heart or breathing stops. Choosing a DNR is a very personal decision that many people make based on their own values, goals, and understanding of their medical situation.
For families in hospice care, a DNR is about respecting the patient’s wishes and preferences while still providing them with all the comfort care, symptom management, and emotional support they need. As such, hospice teams do their best to discuss DNR orders with patients and their families, so everyone’s on the same page.
How a DNR Works in Hospice Care
In hospice care, a DNR helps the care team to make sure medical interventions are aligned with the patient’s wishes. If a patient’s heart or breathing stops, the hospice nurse or attending physician will follow the DNR order, so instead of fighting to revive them, they can focus on keeping the patient as comfortable and pain-free as possible.
Families are supported throughout the process with:
- Guidance on understanding the DNR order
- Clarification on what treatments will continue and what will not
- Emotional support in making and living with these decisions
The DNR does not affect the hospice team’s commitment to care; patients continue to receive regular nursing visits, personal care, medications, and emotional and spiritual support according to their care plan.
Making the Decision
Choosing a DNR is a personal choice. Patients and families are encouraged to:
- Discuss their wishes openly with the hospice nurse or physician
- Consider how a DNR aligns with the patient’s overall goals of care
- Review state-specific legal requirements for DNR documentation
Hospice staff provide education, support, and guidance to help patients and families make informed decisions and ensure that the DNR order is properly documented and communicated to all relevant healthcare providers.