RE: DNR and Advanced Directives

[Faye Jones]

We are currently revising our Advance Directive policy to require quarterly review and follow up with resident/responsible party if the resident does not have a HCP and/or DNR or the resident has requested life sustaining measure such as CPR/tube feedings on their HCP in order to make sure they haven’t changed their minds.  We have recently had some problems with residents who either declined to complete Advance Directives on admission/readmission or processed HCP’s stating they wanted life support and now it is in some cases 20 years later and circumstances are such that we sincerely wished we had reapproached them.  Of course if they want everything done that is fine but for some aging has not been kind and we wonder what they would say now if we could ask.   -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of genie1953 Sent: Thursday, April 08, 2004 12:35 PM To: [EMAIL PROTECTED] Subject: RE: DNR and Advanced Directives   At our facility our residents are asked at each and every one of their Care Plan meetings whether they would like to make any changes in their DNR status. If the patient is incompetent and/or incapacitated then we discuss it with the family member or guardian if they attend the meeting.  If no family members, guardian, etc ever attend the care plan meetings then they are contacted at least annually to see if they would like to make any changes in their status.  They are also contacted if the resident’s condition declines.  I don’t think it is a state, government, or JCAHO requirement but we have elected to do it anyway.  I believe that our facility policy states that it must be done at least annually.  We also review the Advance Directives with the patient (as long as they are mentally competent) to see if they would like to make any changes. This is also done at each care plan meeting.   -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Courtney Hunter Sent: Thursday, April 08, 2004 8:59 AM To: aanac group Subject:   I have 2 questions- first, is there a reg that you have to have a weekly medicare meeting to discuss your medicare A patients?  Or if you do it in morning stand up is it sufficient to cover it.   Second,  Is there a law or reg that a DNR has to be updated yearly?  Thanks in advance for your help.    Courtney Hunter RN