The short answer is no, they are not the same. A DNR stands
for a DO NOT RESUSCITATE order. A Living Will is a completely different
document that is used during a very different time.
A DNR should be entered into at your doctor’s office or in
the hospital, not at your local estate planning and elder law attorney’s
office.
Typical estate planning documents that an attorney will
assist you with would include a financial and medical power of attorney as well
as a Last Will and Testament and maybe a Trust of some type. The confusion
often lies in the fact that in a medical power of attorney, you will often see
a Living Will as a part of the document.
This is collectively known as an Advance Healthcare Directive
if medical power of attorney and living will are together in one document. The
Living Will does not kick in until the individual is “end-stage medical.” While
there is a very long medical definition for this term, I simply like to state
it as when two qualified physicians put in writing that there is no realistic
hope of recovery and that you will always remain vegetative, comatose,
permanently unconscious, and terminally ill. A medical power of attorney, living
will, or advanced health care directive are often documents that are obtained
from your estate planning and elder law attorney and not from your health care
provider.
On the other hand, a DNR or DO NOT RESUSCITATE order is
intended to let emergency and other medical professionals know whether or not
they should resuscitate you. Methods often used for resuscitation would be
things such as defibrillators, breathing tubes, ventilators, CPR, and other
invasive techniques.
The DO NOT RESUSCITATE order comes into play when the heart
has stopped beating or the person has stopped breathing. The medical power of
attorney, on the other hand, comes into play when the person simply cannot
answer questions for themselves. That could be for numerous other reasons, such
as being under sedation or incapacitated, unconscious due to an accident, or
unable to speak.
Certainly, it does not necessarily mean that the heart has
stopped beating or that you have stopped breathing. The Living Will does not
kick in until the end of life, but the heart is often beating, sometimes due to
heroic and lifesaving measures, but the DNR will prevent those “heroics” if
that is your wish.
We truly believe that it is imperative for you to talk to
your estate planning and elder law attorney about the estate planning documents
as outlined above as well as discuss with your doctor about a DNR order. While
you are discussing the DNR order, we would also recommend that you have a
conversation with your healthcare professional about a POLST (Physician’s
Order of Life-Sustaining Treatment). These are documents that will be obtained
directly from your doctor and they will be able to assist you with the nuances
of how they work.
We hope this article provided insight into the definition of a
DO NOT RESUSCITATE order and the difference between a medical power of
attorney and a Living Will. If you would like further information about these
items, contact our office. We’d be more than happy to assist you. Call us at (717) 845-5390.
Why Hire an Elder Law Attorney? Elder law attorneys specialize in estate planning, incapacity planning, and end-of-life care for seniors, helping them remain in their homes and protect against abuse. They are essential in planning for the future and addressing the needs of a vulnerable population. How Can an Elder Law Attorney Help? Long-Term Care Planning: As the number of Americans over 65 is projected to exceed 80 million by 2040, planning for long-term care is increasingly important. Elder law attorneys assist seniors in creating financial plans to cover essential needs like food, rent, and medical care. They also guide clients in applying for public benefits such as Medicaid and Medicare. Housing: Many seniors wish to age in place. Attorneys can represent clients in landlord-tenant disputes, helping them navigate issues like city ordinance violations. They also protect seniors against housing discrimination under the Fair Housing Act. Estate Planning Document Preparation: Elder law attorneys draft critical documents such as wills, health care directives, and powers of attorney, ensuring that seniors rights are protected regarding retirement benefits and medical decisions. A solid estate plan reduces family stress and potential inheritance disputes. Incapacity Planning: Attorneys can help document care wishes for seniors facing disabilities or conditions like dementia. With the rising number of Alzheimers cases, having a plan for incapacity is vital for protecting financial and physical well-being. Guardianship: In cases where an older adult cant make decisions due to conditions like dementia, attorneys assist family members in securing guardianship, which involves legal proceedings and court hearings. They can also advocate for the seniors autonomy by exploring alternatives to full guardianship. Combating Elder Abuse: Elder abuse is a significant public health issue, affecting one in six adults aged 60 and older. Elder law attorneys are well-versed in the rights of seniors and can provide legal recourse against abusers while implementing safeguards like advance directives to protect against financial exploitation. By addressing these diverse needs, elder law attorneys play a critical role in supporting the aging population and ensuring their rights and well-being are protected. Editors Note: This article is for informational purposes only and is not intended to be legal advice.This article was submitted by Ashley Day, Esq. Reach her at 251-277-3377.
When I ask our younger clients if they would like to complete a Health Care Directive, they often say no, stating that they are too young to need such a thing. My response is always, What does age have to do with end-of-life decisions? I can think of at least fifty examples of a young person ending up in the end stage of life and a family member having to make difficult decisions on their behalf. Please, do not get lulled into complacency by thinking that age is protection. I was in my doctors office recently when I noticed a large collage talking about the importance of having a Living Will or Health care Directive. It emphasized the importance of having such a document, regardless of how old you are, reinforcing to me what our office always stresses to our clients and the community. A Health care Directive is a document in which each of us tells our loved ones how we want the end of our life to be handled. When we are in a permanent vegetative state, a permanent state of unconsciousness, or in the end-stage of a medical condition, all with no reasonable likelihood of any significant recovery, it provides answers such as Do you or do you not want to be resuscitated, to you want tube feeding, and appoints an agent that can serve to make decisions for you once you are unable to do so yourself. One of the quotes on the doctors display said, End-of-life decisions should not be made at the end of life. Another said, For human beings, life is meaningful because it is a story, and in stories, endings matter. Another said, I have an Advanced Directive, not because I have a serious illness, but because I have a family. Most of us know what medical decisions we want at the end of our lives, but have we communicated that to our family and loved ones? When we meet with clients to help them create estate planning documents, we always point out to them that they have the option in their Health Care Directive of deciding what, if any, extraordinary measures they want to be taken at the end of their lives. Once they select those options, we then come to perhaps the most difficult question of all: Should these instructions be binding on their families and providers, or do they want their loved ones to be able to override their decisions? Many opt for binding instructions so their loved ones do not have to make any of those difficult decisions in the heat of a devastating crisis. Either way, they have expressed their desire to guide their loved ones. Age is not a factor in creating a Health Care Directive; tragedy can strike unexpectedly at any age. The expense is low, but the peace of mind comes from knowing that when our time comes, we have already made those decisions for ourselves and our loved ones. So, start the conversation with your family. Communicate your wishes to them and urge them to communicate theirs to you. Then, go to a qualified estate attorney and put those wishes on paper so that when your time comes, all involved, including your medical providers, know how you want the end of your life to be managed. We offer FREE Workshops each week. You can also call our office at (717) 208-2899.
Durable Power of Attorney Documents: Why They Are IMPORTANT Adults make decisions every day in life. You make financial choices regarding banking, paying bills and managing assets. You decide with whom to socialize and also where to live. You make health care decisions such as consenting to or refusing treatment, obtaining medical records and choose a course of treatment when ill. But what happens if you are too sick or disabled to manage these decisions? Before it is too late, have you prepared for someone to act on your behalf in the event of a crisis or if you are unable to manage decisions on your own? Adding a person to your bank accounts is not the answer because, among other reasons, it is dangerous and places your accounts at risk. Thankfully, there is a key legal tool for substitute decision making called a Durable Power of Attorney. A Durable Power of Attorney means one person (the principal) gives legal authority to another (the agent or attorney-in-fact) to act on behalf of the principal. Durable means the agent can act when the principal loses capacity. A General Durable Power of Attorney permits your agent to manage any part or all of your financial affairs and property. A Health Care Durable Power of Attorney enables your agent to make any or all health care decisions if you become incapacitated. A Living Will allows you to spell out your desired medical treatment regarding life-saving procedures, artificial nutrition and artificial hydration if you become unable to speak for yourself and have a terminal illness, or are in a persistent vegetative state. Choosing the right person as an agent is a very important decision and should be given careful consideration. It should be someone who is trustworthy, honest, knows how to handle money and accepts the responsibility as an agent. This agent owes a duty to the principal called a fiduciary duty, which means the agent has to act in the principals best interest, in good faith and with care, and keep good records. Abuse by an agent or a breach of fiduciary duty can be punishable civilly and criminally. A principal has the control to revoke a Power of Attorney at any time. If you become incapacitated and have not executed Power of Attorney documents, court proceedings called Guardianship and Conservatorship may be needed for someone to obtain decision making authority, which is both time consuming and costly. However, this may be avoided by planning in advance the execution of Durable Power of Attorney documents, which give you greater control and freedom of choice in an affordable manner. This article was written by Donna A. Schuyler, Attorney, who practices in the areas of estate planning, elder law, guardianship and probate. Donna Schuyler Law, PLLC; elderlawboise.com; Phone 208-344-1947