Homepage / Fillable Do Not Resuscitate Order Document / Attorney-Approved Illinois Do Not Resuscitate Order Document

Misconceptions

Understanding the Illinois Do Not Resuscitate (DNR) Order form is crucial for patients and their families. However, several misconceptions can lead to confusion. Here are five common misunderstandings:

  1. A DNR order means no medical care will be provided. Many believe that having a DNR order in place means that all medical treatment will cease. In reality, a DNR only applies to resuscitation efforts in the event of cardiac arrest. Other medical treatments will continue as needed.
  2. A DNR order is only for terminally ill patients. This is a common myth. Anyone can request a DNR order, regardless of their health status. It is a personal choice based on individual preferences about end-of-life care.
  3. A DNR order must be signed by a lawyer. While legal advice can be helpful, it is not a requirement for a DNR order. The form needs to be completed and signed by a physician and the patient or their representative.
  4. A DNR order is permanent and cannot be changed. This misconception is incorrect. A DNR order can be revoked or modified at any time by the patient or their healthcare proxy, as long as they are capable of making that decision.
  5. Healthcare providers will not respect a DNR order. Healthcare professionals are trained to honor DNR orders as long as they are valid and properly executed. It is important for patients and families to ensure that the order is communicated clearly to all members of the healthcare team.

Addressing these misconceptions can help ensure that individuals make informed decisions regarding their medical care preferences.

Detailed Steps for Filling Out Illinois Do Not Resuscitate Order

Completing the Illinois Do Not Resuscitate Order form is an important step in making your healthcare preferences known. After filling out the form, it is advisable to keep a copy for your records and share it with your healthcare providers and family members to ensure your wishes are understood and respected.

  1. Obtain a copy of the Illinois Do Not Resuscitate Order form. This can be found online or through healthcare facilities.
  2. Fill in your full name, date of birth, and address at the top of the form.
  3. Indicate the date on which you are completing the form.
  4. Designate a healthcare representative by providing their name and contact information, if applicable.
  5. Sign the form in the designated area to validate your request.
  6. Have the form witnessed by two individuals who are not related to you and who will not benefit from your estate.
  7. Ensure that the witnesses sign and date the form in the appropriate sections.
  8. Make copies of the completed form for your records, your healthcare provider, and any family members involved in your care.

Document Preview

Illinois Do Not Resuscitate (DNR) Order Template

This Do Not Resuscitate (DNR) Order is in accordance with Illinois state laws concerning medical decision-making and end-of-life care.

Patient Information:

  • Name: ________________________________________
  • Date of Birth: ________________________________
  • Address: ______________________________________
  • City: ______________ State: ____ Zip Code: ______

Patient's Medical Provider:

  • Name: ________________________________________
  • Phone Number: ________________________________

DNR Order Statement:

This order, issued by the undersigned, indicates that in the event of a medical emergency where the patient undergoes cardiac arrest or respiratory failure, resuscitation efforts should be withheld. Please respect the wishes of the patient as outlined in this order.

Signature:

Patient’s Signature: ______________________________

Date: __________________________________________

Witness Information:

  • Name: ________________________________________
  • Signature: ____________________________________
  • Date: ________________________________________

Healthcare Provider's Confirmation:

I, the undersigned healthcare provider, confirm that this document is complete and reflects the patient’s wishes regarding resuscitation.

Provider's Name: _________________________________

Provider's Signature: ______________________________

Date: __________________________________________

Remember to keep this DNR Order in a visible location or with other important medical documents.

Dos and Don'ts

When filling out the Illinois Do Not Resuscitate (DNR) Order form, it is essential to follow specific guidelines to ensure that your wishes are accurately documented and respected. Here are five things you should and shouldn't do:

  • Do ensure that the form is signed by both the patient and their physician.
  • Do clearly state your wishes regarding resuscitation to avoid any confusion.
  • Do keep copies of the completed form in accessible locations, such as with your medical records or at home.
  • Don't use a DNR form if you have not discussed your wishes with your healthcare provider.
  • Don't forget to review and update the form as necessary, especially after significant health changes.

Key takeaways

When considering the Illinois Do Not Resuscitate Order (DNR) form, it is essential to understand its purpose and the implications of filling it out. Here are key takeaways to keep in mind:

  1. Purpose of the DNR: The DNR form allows individuals to express their wishes regarding resuscitation efforts in case of a medical emergency.
  2. Eligibility: Any adult can complete a DNR order, but it is particularly relevant for those with terminal illnesses or severe health conditions.
  3. Completion: The form must be filled out clearly and accurately to ensure that medical personnel understand the individual's wishes.
  4. Signature Requirements: The DNR form must be signed by the individual or their legally authorized representative, along with a physician's signature.
  5. Distribution: Once completed, copies of the DNR order should be provided to healthcare providers, family members, and kept in a visible location at home.
  6. Revocation: An individual can revoke the DNR order at any time, and it is important to inform all relevant parties of this change.
  7. Legal Protection: Medical personnel are legally obligated to honor a valid DNR order, ensuring that the individual's wishes are respected during emergencies.

Understanding these key points can help individuals make informed decisions regarding their healthcare preferences. It is advisable to discuss these matters with family members and healthcare providers to ensure clarity and support.

Similar forms

The Illinois Do Not Resuscitate Order (DNR) form shares similarities with the Advance Directive. Both documents serve to communicate an individual’s healthcare preferences in the event they become unable to make decisions. An Advance Directive encompasses a broader range of instructions, including preferences for medical treatment and appointing a healthcare proxy. While the DNR specifically addresses resuscitation efforts, the Advance Directive allows for a more comprehensive approach to end-of-life care, ensuring that a person’s wishes are honored across various medical scenarios.

Another document akin to the DNR is the Physician Orders for Life-Sustaining Treatment (POLST). This form provides specific medical orders based on a patient’s preferences regarding life-sustaining treatments. Like the DNR, the POLST is designed for individuals with serious health conditions. However, the POLST goes further by detailing a range of treatments beyond resuscitation, such as the use of feeding tubes or antibiotics. Both documents aim to facilitate conversations between patients and healthcare providers about end-of-life care, ensuring that medical interventions align with the patient's values.

The Living Will is also comparable to the DNR form. A Living Will allows individuals to specify their wishes regarding medical treatment in situations where they are terminally ill or permanently unconscious. While the DNR focuses specifically on resuscitation efforts, a Living Will covers a wider array of treatment options. Both documents empower individuals to make choices about their healthcare, ensuring that their preferences are respected even when they cannot communicate them directly.

The Medical Power of Attorney (MPOA) is another document that bears resemblance to the DNR. An MPOA designates a trusted person to make healthcare decisions on behalf of an individual if they become incapacitated. While the DNR provides specific instructions about resuscitation, the MPOA allows for broader decision-making authority. Both documents emphasize the importance of patient autonomy and the need for clear communication regarding healthcare preferences.

Similar to the DNR, the Do Not Intubate (DNI) order addresses specific medical interventions. A DNI order indicates that a patient does not wish to be placed on a ventilator, which is often used when a patient is unable to breathe independently. Like the DNR, the DNI is intended for situations where patients have expressed a desire to limit aggressive medical interventions. Both documents reflect a patient’s wishes regarding life-sustaining measures, ensuring that healthcare providers respect these choices.

The Comfort Care Order is another document that aligns with the principles of the DNR. This order emphasizes the provision of comfort and palliative care rather than aggressive treatment. While the DNR focuses on avoiding resuscitation, the Comfort Care Order prioritizes symptom management and quality of life for patients nearing the end of life. Both documents underscore the importance of compassionate care and the need to honor patient preferences in challenging medical situations.

Lastly, the Healthcare Proxy is similar to the DNR in that it designates an individual to make healthcare decisions on behalf of someone else. While the DNR specifically addresses resuscitation preferences, the Healthcare Proxy empowers the appointed person to make a wide range of medical decisions based on the patient’s wishes. Both documents are essential tools for ensuring that a person’s healthcare preferences are respected, particularly in critical situations where they cannot express their desires directly.

Documents used along the form

The Illinois Do Not Resuscitate (DNR) Order form is a critical document for individuals who wish to express their preferences regarding resuscitation in medical emergencies. Along with the DNR, several other forms and documents can help clarify a person's healthcare wishes. Below is a list of these documents, each serving a unique purpose in the realm of advance healthcare planning.

  • Advance Directive: This document outlines a person's healthcare preferences, including decisions about medical treatments and interventions if they become unable to communicate their wishes.
  • Healthcare Power of Attorney: This form allows an individual to designate someone to make healthcare decisions on their behalf when they are incapacitated.
  • Living Will: A living will specifies the types of medical treatment a person wishes to receive or avoid in situations where they cannot express their wishes, particularly at the end of life.
  • Physician Orders for Life-Sustaining Treatment (POLST): This form translates a patient's treatment preferences into medical orders that healthcare providers must follow in emergency situations.
  • Do Not Intubate (DNI) Order: Similar to a DNR, this order specifically indicates that a patient does not wish to be intubated or placed on a ventilator if they experience respiratory failure.
  • Organ Donation Form: This document expresses a person's wishes regarding organ and tissue donation after death, ensuring that their intentions are honored.
  • Patient Advocate Designation: This form allows individuals to appoint someone to advocate for their healthcare needs and preferences, ensuring their wishes are communicated effectively.

These documents work together to create a comprehensive plan that respects an individual's healthcare choices. It is essential to keep these forms accessible and communicate their existence to family members and healthcare providers to ensure that wishes are honored during critical times.