I have Durable Power Of Attorney for my mother for both financial and medical. She does not have a DNR or Healthcare Directive for end of life care. She has told me of her wishes and will make every attempt to carry them out. Do I need to have those other two documents or can I, as her DPOA, make those end of life choices for her.
"A do not resuscitate order, or DNR, is a medical order written by a doctor. It instructs health care providers not to do cardiopulmonary resuscitation (CPR) if breathing stops or if the heart stops breathing.
"A DNR order allows you to choose before an emergency occurs whether you want CPR. It is a decision only about CPR. It does not affect other treatments, such as pain medicine, medicines, or nutrition.
"The doctor writes the order only after talking about it with the patient (if possible), the proxy, or family."
also "If you have a DNR order, you always have the right to change your mind and request CPR."
And " Make sure to:
"Include your wishes in a living will or health care power of attorney. Inform your health care proxy and family of your decision."
further "If your doctor has written a DNR order already at your request, your family cannot override it."
in addition "You may have named someone to speak for you, such as a health care agent. If so, this person or a legal guardian can agree to a DNR order for
you."
and finally "Your doctor can tell you how to get a wallet card, bracelet, or other DNR documents to have at home or in a non- hospital setting.
"Standard forms may be available from your state’s Department of Health."
THE FULL TEXT IS AVAILABLE HERE:
http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000473.htm
As far as "enhancing", in California for example, a DNR can be established (form filled out) upon admission to a hospital or a nursing home, it does not HAVE TO be done ONLY by a doctor. It's just that the patient's wishes, stated to a doctor or written in the healthcare POA, either one when the patients are competent to either say or sign, are less likely to be subject to challenging by family members who disagree with the concept of DNR. As usual, and especially important with dementia patients, competency to choose is an issue.
If mom IS competent, make sure your wishes are documented in her health POA as well as having her tell her doctor so it in her medical chart should a question arise at a later date. If she isn't competent, the responsibility to choose falls on you as her health agent. If her wishes are not already documented, you COULD be subject to challenge. This would you really be by disagreeing family members, but a hospital or doctor would probably challenge if you'd try to initiate a DNR and your mom's health care POA clearly states that she wanted ALL life saving measures.
EVERYONE should learn from these questions and the applicable laws how important it is to put one's wishes in writing EARLY, before impairment, before questioning, before arguments.
DPOA does not cover end-of-life decisions.