This checklist helps Alzheimer's caregivers set up a DNR order, match it to related care forms, and keep it ready for every care team. A DNR order is a medical order written by a health care provider that tells providers not to perform CPR if breathing stops or the heart stops, as MedlinePlus explains in its DNR patient instructions. Use the order before a crisis, not during one. Talk with the person with dementia when possible, plus the proxy and family, then file the signed form where responders can find it.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- What a DNR covers
- When to start after diagnosis
- How DNR, advance directives, and POLST differ
- What to weigh before choosing DNR
- Checklist to keep the order valid across settings
What a DNR covers
A DNR applies only to CPR. It does not stop pain medicine, other medicines, or nutrition. That limit matters because families sometimes expect broader comfort-only care.
Ideally create the order before an emergency after discussion with the patient when possible, proxy, or family. The doctor then writes and signs the medical order. Keep that signed copy as the active record.
When to start after diagnosis
Start advance planning as soon as possible after a dementia diagnosis, while the person still has capacity. The Alzheimer's Association gives this timing advice in its end-of-life planning guide.
Early talks record care wishes and name a decision-maker. Late-stage care can then follow expressed wishes. Waiting risks leaving choices to others under pressure.
How DNR, advance directives, and POLST differ
A DNR bars CPR when heart or breathing stops. Alzheimers.gov also lists POLST or MOLST medical orders for broader life-sustaining and life-supporting treatment choices. A POLST form is an optional, portable medical order for people who are seriously ill or frail.
The National POLST Collaborative states in its about the POLST form that it tells providers what to do if the patient becomes unresponsive, while healthy adults should use an advance directive instead. In short, an advance directive is a legal document for all adults. A POLST is a provider-signed order for limited critical decisions in serious illness or frailty.
What to weigh before choosing DNR
Consider likely benefit and burden in advanced Alzheimer's. The National Institute on Aging warns in its end-of-life care decisions guide that CPR often does not succeed in older adults with multiple chronic illnesses or frailty.
Ask the doctor how CPR, hospital transfer, and ventilation fit the person's goals. Ask what comfort care continues with or without CPR. Record the answers in plain words for family caregivers.
Checklist to keep the order valid across settings
Tell the doctor in charge about the DNR choice. Inform family and paid caregivers. Keep signed DNR and POLST copies accessible at home, in hospital, and in long-term care.
- Confirm the correct state-specific form and signatures are complete
- Give copies to the primary doctor, home caregiver, facility nurse, and proxy
- Place one copy by the bed, with medicines, and in a hospital go-bag
- Review the order after hospitalization, a move, or a major decline
- Replace void forms the same day and collect outdated copies
