Once you have decided against trying resuscitation, how can you prevent people from trying anyway? You need to have a clear discussion with your doctor and those near you to be sure that everyone understands your wishes. Resuscitation is rarely effective in those who are very sick, and life after resuscitation is often short and uncomfortable. However, since resuscitation has to be started right away, there is a presumption in favor of using it whenever the situation is unclear. It is up to you and your doctor to see to it that your plans are clear!
|At home, you will have less risk that resuscitation will be tried, unless someone panics and calls the emergency medical system. There are usually ways to ensure that the emergency crew will follow your wishes, but you have to find out what the process is in your area and follow it.|
|In a hospital, you should ask for a "do not attempt resuscitation" (DNR) order. If possible, ask your doctor to phone this order ahead of your admission. When you arrive at the emergency room or the admissions desk, ask to be sure that an order is in place as early as possible. When you get to a hospital room, ask your nurse and any doctors who see you to be sure that your order is in place. Most hospitals have some way to identify patients who have requested "do not attempt resuscitation orders," such as a bracelet or a bright sheet in the front of the medical chart. Ask about the process and be sure it is followed.|
|In a nursing home, the situation may be parallel to a hospital or may be more entrusted to your primary nurse. Ask how you can be sure that no one will misunderstand what you want. In a nursing home, you need to be clear about whether you should be sent to a hospital if you become quite ill. If you are at the point that you would want to go to a hospital only to relieve symptoms, or not at all, be sure to make that clear as well as your intentions about resuscitation|
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