Fillable Illinois Do Not Resuscitate Order Template

Illinois Do Not Resuscitate Order - Usage Guidelines

When the time comes to make important decisions about end-of-life care, some people choose to establish a Do Not Resuscitate (DNR) order. In Illinois, filling out the DNR order form is a way to communicate a person's wishes not to have cardiopulmonary resuscitation (CPR) in the event their breathing stops or if their heart stops beating. This document is crucial for ensuring that a person's preferences are known and respected by healthcare providers. To complete the Illinois Do Not Resuscitate Order form correctly, follow these steps.

1. Gather necessary information, including the patient's full name, date of birth, and address.
2. Read the form carefully to understand the implications and conditions under which the DNR order will apply.
3. The patient or their legally authorized representative must sign and date the form in the designated section. This acknowledges their understanding and consent to the DNR order.
4. A witness, who can be anyone over the age of 18 and who is not the patient or the surrogate, must also sign and date the form. The role of the witness is to verify the identity of the patient or the surrogate who is signing the form.
5. The attending physician must complete their section of the form, which includes verifying the patient's decision, signing, and dating the form. The physician’s signature confirms that the patient or the surrogate's decision has been discussed and is medically appropriate.
6. After the form is fully completed, keep the original document in a location where it can be easily accessed by family members or caregivers. It's also advisable to inform close family members or friends of the existence of the form and its location.
7. Consider giving copies of the completed form to the patient's primary care physician, any specialists they see regularly, and any healthcare facilities where they receive care. It's also a good idea to have a copy readily available at home in case emergency medical professionals need to be consulted.

Once the Illinois Do Not Resuscitate Order form is filled out, it becomes an important part of a person's medical record. It's essential for ensuring that their wishes regarding CPR are honored in emergency situations. If circumstances or preferences change, it's possible to revoke or update the DNR order by completing a new form and informing all relevant parties of the change.

1. What is a Do Not Resuscitate (DNR) Order form in Illinois?

   A Do Not Resuscitate (DNR) Order form in Illinois is a legal document that communicates a person's wish not to have cardiopulmonary resuscitation (CPR) if their heart stops or if they stop breathing. It's used by individuals who want to decline life-sustaining treatments in certain medical situations. This form is part of advance healthcare directives in Illinois, allowing people to make informed decisions about their end-of-life care.

2. Who can complete an Illinois DNR Order form?

   The Illinois DNR Order form can be completed by:

   • An adult with the capacity to make their own healthcare decisions.
   • A legally authorized representative, in the case that the individual is unable to make their own healthcare decisions.
   • The guardian of a minor or of an adult who lacks decision-making capabilities, subject to Illinois law.
   This ensures that all individuals, regardless of their ability to make decisions at a later point, can have their wishes respected regarding CPR.

3. How can one obtain an Illinois DNR Order form?

   To obtain an Illinois DNR Order form, individuals can visit their healthcare provider, who will provide the form and assist in filling it out. The form is also available through many hospitals and healthcare systems in Illinois, as well as from legal advisors specializing in healthcare directives. Additionally, the Illinois Department of Public Health website may offer resources and downloadable versions of the form.

4. Is a physician's signature required on an Illinois DNR Order form?

   Yes, a physician's signature is required on an Illinois DNR Order form. This ensures the document is medically and legally valid. The physician's signature indicates that the doctor has discussed the implications of a DNR order with the patient or their legal representative, ensuring the decision is informed and voluntary. Once signed, the DNR order becomes a part of the individual’s medical record.

5. What should be done with the completed Illinois DNR Order form?

   Once completed and signed, the Illinois DNR Order form should be:

   • Kept in a place where it can be easily found in an emergency, such as with other important documents or in a wallet.
   • Shared with family members or other loved ones who are likely to be present in an emergency situation.
   • Provided to the individual’s healthcare provider to be included in their medical records.
   • Shown to paramedics or other emergency personnel who respond to a medical emergency involving the individual.
   Ensuring the DNR Order is accessible and known to those who need to be aware of it is crucial for it to be followed in an emergency situation.

When filling out the Illinois Do Not Resuscitate (DNR) Order form, individuals often make several common mistakes. It is crucial to avoid these errors to ensure that the form accurately reflects the person's wishes regarding life-saving measures. Here are four mistakes often made:

1. Not having the form signed by a healthcare provider. The DNR order must be signed by a qualified healthcare provider to be valid. This signature confirms the healthcare provider's discussion with the patient or their legal representative about the DNR order and its implications.

2. Filling out the form without adequate understanding. Individuals sometimes complete the form without fully understanding the consequences of a DNR order. This can lead to choices that don't align with their values or wishes. It's important to have a comprehensive discussion with a healthcare provider about what a DNR order means before filling out the form.

3. Forgetting to update the form. A person's preferences for end-of-life care can change, but they often forget to update their DNR order to reflect these changes. Regular reviews and updates of the form ensure that it always matches the person's current wishes.

4. Incomplete information. The form requires specific information to be filled out accurately. Sometimes, crucial details are missed, such as patient identification information or specific medical conditions that warrant the DNR order. This lack of detail can lead to confusion or challenges in implementing the order when it is needed.

To avoid these mistakes, individuals should ensure the form is completed accurately and reviewed by a healthcare provider. Understanding the implications of a DNR order, regularly reviewing and updating preferences, and providing complete information are key steps in the process. By paying attention to these details, the individual’s wishes regarding resuscitation will be clearly and effectively communicated.

When considering end-of-life decisions, such as a Do Not Resuscitate (DNR) order in Illinois, understanding and preparing additional legal and medical documents can provide comprehensive care plans and ensure that an individual's wishes are respected and followed. These documents complement a DNR order by addressing various aspects of care and personal preferences. While a DNR specifically instructs healthcare professionals not to perform CPR in the event of cardiac or respiratory arrest, the following documents offer broader directives or detailed preferences regarding an individual's care.

• Living Will: This document allows an individual to outline specific medical treatments they do or do not want if they are unable to communicate their wishes, especially in the case of terminal illness.
• Health Care Power of Attorney (HCPOA): It permits an individual to appoint someone they trust to make health care decisions on their behalf if they are incapable of making decisions for themselves.
• Physician Orders for Life-Sustaining Treatment (POLST): Similar to a DNR, a POLST provides detailed instructions about specific types of life-sustaining treatments an individual wants or does not want, including intubation, mechanical ventilation, and feeding tubes, based on their current health condition.
• Medical Information Card: Carried by the individual, this card contains critical health information, such as blood type, allergies, and medications, along with their DNR status, to alert emergency personnel during a crisis.
• Advance Directive: An overarching term that includes living wills and HCPOAs, advance directives guide choices for doctors and caregivers if one is unable to make decisions for themselves.
• Organ and Tissue Donation Form: Allows individuals to specify their wishes regarding organ and tissue donation at the time of their death.
• Advance Mental Health Care Directive: This document specifies preferences regarding mental health treatment, including medications, hospitalization, and ECT (electroconvulsive therapy), in case the individual is unable to make decisions due to a mental health condition.
• Do Not Intubate (DNI) Order: Specifically prohibits the use of intubation and mechanical ventilation but does not restrict other forms of CPR.
• Hospital Discharge Planning Documents: Help to ensure a smooth transition from hospital to home or another facility, detailing the care and support an individual will need after leaving the hospital.
• Financial Power of Attorney: Authorizes someone to manage financial affairs and make financial decisions on behalf of the individual, which can be crucial when serious health issues prevent managing one's own finances.

Incorporating these documents into one's healthcare planning can offer peace of mind, knowing that all aspects of care and personal wishes are documented and can be legally upheld. Consulting with healthcare providers and legal professionals can ensure that these documents are correctly completed and adequately reflect an individual's preferences. It's crucial to periodically review and update these documents to ensure they continue to accurately represent an individual's wishes as circumstances change.

The Illinois Do Not Resuscitate Order form is similar to other important healthcare directives, yet distinct in its purpose and application. Documents it is akin to include the Living Will and the Healthcare Power of Attorney. While all these documents address aspects of a person’s wishes regarding their healthcare, there are noteworthy differences in their focus and the situations they apply to.

Living Will: Like the Illinois Do Not Resuscitate (DNR) Order, a Living Will speaks to a person’s healthcare preferences, particularly about life-sustaining treatment. However, while a DNR specifically instructs healthcare professionals not to perform CPR (cardiopulmonary resuscitation) if a person’s breathing or heartbeat stops, a Living Will encompasses a broader array of interventions. It might include wishes regarding the use of ventilators, feeding tubes, and other life-sustaining measures in cases of terminal illness or permanent unconsciousness. The main similarity lies in their proactive nature – both documents serve to convey the individual’s healthcare wishes in advance. The crucial difference is the scope of medical interventions each addresses.

Healthcare Power of Attorney: This document is another crucial component of a person's healthcare planning, like a DNR order. However, instead of detailing specific medical treatments one wishes to accept or refuse, a Healthcare Power of Attorney designates another person to make healthcare decisions on one’s behalf when they are unable to do so. This appointed individual, often referred to as an agent, can make a broad range of decisions, not limited to life-sustaining measures. The similarity with a DNR order lies in their mutual goal to ensure that healthcare decisions align with the individual’s values and wishes. The difference, however, is in execution: the DNR order gives direct medical instructions, while the Healthcare Power of Attorney entrusts someone to make those decisions, potentially including whether to follow a DNR order, when the individual cannot.

When completing the Illinois Do Not Resuscitate (DNR) Order form, it's crucial to ensure the document accurately represents the wishes of the individual it concerns. To facilitate this process, here's a guide of dos and don'ts:

Do's:

• Ensure the patient or their authorized representative has a clear understanding of what a DNR order entails before filling out the form.
• Verify all information is accurate and legible, including the patient’s full name, date of birth, and other personal details.
• Have the form signed by the authorized medical provider to ensure the order is valid and legally binding.
• Discuss the decision with family members or other loved ones to ensure they understand the patient's wishes.
• Keep the completed DNR form in an easily accessible location, and inform family members or caregivers of its location.
• Provide copies of the completed form to relevant healthcare providers to ensure the patient's wishes are honored in all settings.

Don'ts:

• Do not fill out the form without the consent of the patient or their legally recognized healthcare proxy.
• Do not leave any required fields blank, as missing information can render the order invalid.
• Do not use unclear language or abbreviations that may be misinterpreted by healthcare providers.
• Do not forget to renew or update the form as needed, in accordance with Illinois state laws and regulations.
• Do not fail to communicate the existence of a DNR order to all healthcare personnel involved in the patient's care.
• Do not disregard the importance of reviewing the form regularly to ensure it still reflects the patient's current wishes.

When it comes to the Illinois Do Not Resuscitate (DNR) Order form, there are several misconceptions that can lead to confusion about what it is, who it's for, and how it works. Understanding the truth behind these misconceptions is crucial for making informed decisions about your health care or that of a loved one. Here are eight common misconceptions and the facts to correct them:

• Misconception 1: A DNR order is only for the elderly.

  Truth: DNR orders are not specific to age. People of any age with serious health conditions who wish to avoid CPR in the event their breathing or heartbeat stops may consider a DNR order.

• Misconception 2: Signing a DNR means you’ll receive no medical treatment.

  Truth: A DNR order specifically addresses CPR and does not affect other treatments. Patients with DNR orders still receive medical care, pain relief, and other interventions unless specified otherwise in an advance directive.

• Misconception 3: Only a patient can request a DNR order.

  Truth: If a patient is unable to make their own healthcare decisions, a health care proxy or power of attorney can request a DNR on their behalf, based on previously expressed wishes of the patient or, in some cases, what is believed to be in the patient's best interest.

• Misconception 4: DNR orders are permanent and can't be changed.

  Truth: DNR orders can be revoked or modified at any time by the patient or their designated proxy. Changes should be discussed with a healthcare provider and documented appropriately.

• Misconception 5: DNR orders are mandatory for certain conditions.

  Truth: DNR orders are completely voluntary and are made at the discretion of the patient or their proxy in consultation with healthcare professionals, based on personal wishes, beliefs, and medical advisement.

• Misconception 6: A DNR order means you are giving up on life.

  Truth: Choosing a DNR order is a personal decision that some make to avoid aggressive medical interventions. It does not signify giving up but rather a choice about the nature of end-of-life care based on personal values and medical advice.

• Misconception 7: DNR orders apply to all medical situations.

  Truth: DNR orders apply specifically to CPR and do not preclude treatment for other medical issues. Patients with a DNR can still receive antibiotics, surgery, and other forms of care unless indicated otherwise in an advance healthcare directive.

• Misconception 8: Emergency medical personnel won't honor a DNR order.

  Truth: In Illinois, as in all states, emergency personnel are legally required to honor valid DNR orders. However, it’s important that the DNR order is readily accessible and presented upon request to ensure it is followed.

Clearing up these misconceptions is essential for anyone considering a DNR order in Illinois. It ensures that decisions are based on accurate information and reflects the individual's wishes regarding their care. Always consult with healthcare providers to understand how a DNR order fits into broader healthcare planning.

Understanding the Illinois Do Not Resuscitate (DNR) Order form is crucial for making informed decisions about end-of-life care. This document plays a vital role in ensuring that an individual's wishes regarding resuscitation are respected by healthcare providers. Here are key takeaways regarding the filling out and using of the Illinois DNR Order form:

• The Illinois DNR Order form requires complete and accurate information about the patient. This includes the patient's full name, date of birth, and other pertinent details that verify the patient’s identity.
• A licensed healthcare provider must discuss the DNR order with the patient or their legally authorized representative to ensure that the decision is informed and voluntary.
• The form must be signed by both the patient (or their representative) and the healthcare provider. This dual signature requirement affirms that both parties agree to the DNR order.
• It's important for the patient or their representative to understand the implications of a DNR order. The form specifies that no attempts will be made to resuscitate the individual in the event of cardiac or respiratory arrest.
• Once completed, the DNR Order should be kept in a place where it can be easily accessed by emergency responders or healthcare providers, such as with the patient’s medical records or in a visible location in the patient’s home.
• Patients have the right to revoke the DNR Order at any time. This revocation must be communicated verbally or in writing to the healthcare provider.
• Emergency Medical Services (EMS) personnel are trained to look for DNR Orders in specific locations, such as on the refrigerator or in the patient’s wallet. It is advisable for patients to inform family members or caregivers about the existence and location of their DNR Order.
• There may be instances where a healthcare facility or provider has policies that affect the implementation of DNR Orders. Patients should discuss how their DNR Order will be handled in different settings, such as in a hospital, nursing home, or during transport by EMS.

Comprehending these key points ensures that individuals and their loved ones can make thoughtful decisions about DNR Orders, respecting the patient’s wishes for their end-of-life care. Always consult with a healthcare provider or legal advisor to understand all implications of completing and maintaining a DNR Order in Illinois.