What Is a DNR and Advance Directive? A Guide for Seniors and Families

What Is a DNR and Advance Directive? A Guide for Seniors and Families

Planning ahead for serious illness is one of the most compassionate steps you can take for yourself or a loved one. Two key documents in this planning are the DNR (Do Not Resuscitate order) and the Advance Directive (or Living Will). At Preferred Providers, we guide patients and families in Colorado through these choices—helping ensure care aligns with values and wishes.

What Does DNR Mean? Understanding “Do Not Resuscitate”

A DNR (Do Not Resuscitate) order is a medical directive addressed to healthcare professionals: it states that if a person’s heart stops or breathing ceases, CPR and advanced life support should not be initiated. It is most often considered by patients with serious or terminal illness who wish to avoid aggressive life-saving measures that might prolong suffering.

Key points about DNR:

• It applies only if the heart or breathing stops—not for other treatments

• It must be documented in medical records or in a state-recognized form

• It can be revoked at any time by the patient (if they have capacity)

• Being “DNR” does not mean no care—it means comfort-focused care continues

• Emergency medical personnel, hospitals, and in-home providers respect DNR orders when properly documented

What Is an Advance Directive (Living Will) and Why It Matters

An Advance Directive is a broader legal document where you outline your healthcare preferences in case you cannot communicate later. Typical contents may include:

• Wishes about resuscitation (DNR)

• Decisions about mechanical ventilation, dialysis, artificial nutrition/hydration

• Pain management and comfort care preferences

• Selection of a healthcare proxy or decision-maker, who can make choices on your behalf

When properly executed, it gives guidance to family, clinicians, and hospice or palliative teams about your values.

Colorado Laws and Requirements for DNRs and Advance Directives

In Colorado:

• Advance directives are legal and recognized under Colorado Revised Statutes Title 15, article 18.7 (Health Care Advance Directives).

• A DNR order must follow state forms (often called Colorado Medical Orders for Scope of Treatment or CMOST) for in-home, hospital, or EMS settings.

• To be valid, the directive usually needs your signature (or mark) and a witness or notary depending on state rules.

• You can amend or revoke the documents at any time if you retain decision-making capacity.

It’s important to review these documents periodically—especially as health status changes.

The Role of In-Home Primary Care and Palliative Care in Advance Planning

Preferred Providers integrates discussions about DNRs and Advance Directives into our routine home visits for medically complex seniors. Here’s how:

• We introduce the topic early—while patients have capacity to express wishes

• Our clinicians explain in plain language what DNRs and advance directives mean, and how they impact care

• We help patients complete the proper Colorado documents and ensure they’re filed in medical records

• We revisit decisions regularly, especially if health status changes

• We coordinate with other medical providers and ensure all parts of the care team understand and honor documented wishes

These conversations reduce confusion, avoid conflict, and help ensure care aligns with preferences.

Common Questions and Misconceptions

Does having a DNR mean you stop all medical care?No. A DNR refers only to resuscitation efforts. You may still receive all other treatments—medications, comfort care, symptom control, etc.

If I sign an Advance Directive, am I refusing everything?Not necessarily. You can selectively refuse certain treatments you don’t want (e.g. mechanical ventilation) while accepting others (e.g. antibiotics, pain management).

What if I change my mind later?You can revise or revoke your documents anytime, as long as you have capacity. Your clinician will help you document changes.

Call to Action

Having a DNR and Advance Directive in place gives peace of mind and clarity when difficult decisions arise. If you or your loved one is over 65 and homebound in Colorado, request a screening call with Preferred Providers. Our team will guide you through creating or updating these documents and ensure your in-home care team respects your wishes.