The importance of the Do Not Resuscitate (DNR) form

Not long ago, I met someone admitted to the ICU after a stroke. It was her second major stroke within a short period of time. Her son said his mother was ready to die.

“Do you have a hard copy of the DNR (short for "Do Not Resuscitate”)? I asked.

“At home,” he said. He looked drained and exhausted.

It was late at night. The son lived close by. He said he could run home and bring it back. His mom was sleeping. The nurse told him he could go home to rest and that she would call if anything changed. Unfortunately, a few hours later, when the nurse on the third shift called, it was to say that mom was in cardiac arrest. He rushed to the hospital, only to find someone trying to resuscitate his mother. She couldn’t speak. She looked terrified. And she passed away with this look.

Judy Lowd, a nurse with Heartland Hospice, said in a recent presentation to the local chapter of National Aging in Place Council, that medical personnel are required to do everything possible during a “Code Blue” if they do not see a hard copy of the patient’s DNR. It should be taped on the wall next to them.

Every year in the United States, about 100,000 hospital patients age 65 and older experience a "Code Blue," which calls a medical team to administer cardiopulmonary resuscitation.

CPR (short for "Cardiopulminary resuscitation") means pushing down into the chest at least 2 inches deep and at least 100 times per minute.

In addition to broken ribs, the frail elderly often also experience lung bruising, damage to the airway and internal organs, and internal bleeding.

The DNR is a one-page form completed with one’s physician and typically on a golden rod colored sheet of paper that is critical for the frail elderly and those on hospice to keep on their person or by their bed in the event of cardiac arrest so that their wishes are known and honored in situations like the one I describe above.

If you or a loved one falls in this category, a DNR is a critical topic to discuss with your physician.

In a future blog post, we will discuss another critical form, the MOST, short for Medical Orders on Scope of Treatment.