Does Hospice Require You to Sign a DNR?

Transitioning a loved one to hospice is no easy task. While Agape Hospice & Palliative Care makes every effort to streamline the process, you’re still likely to deal with strong emotions and lots of questions. One of the most common concerns families have surrounds Do Not Resuscitate (DNR) orders. Some people believe that a DNR order is necessary to qualify for hospice. However, this topic is complex and deeply personal—it should always be handled with care and compassion. Here’s what you should know about DNR orders and hospice care in Los Angeles and Orange Counties.

What Is a DNR?

A Do Not Resuscitate, or DNR, is a medical order written by a doctor that instructs healthcare providers not to perform CPR if a patient’s heart stops or if they stop breathing. Without a DNR in place, healthcare teams are required to perform all lifesaving measures, including chest compressions, defibrillation, and intubation, regardless of the patient’s prognosis or quality of life.

Is DNR Required for Hospice?

Signing a DNR is not a requirement to receive hospice care. Hospice is meant to provide comfort-focused care that prioritizes quality of life over aggressive, life-prolonging treatments. While many patients in hospice choose to sign a DNR in alignment with their goals of care, they are not obligated to do so.

Why Do Some Patients in Hospice Choose to Sign a DNR?

Many hospice patients decide to sign a DNR as part of their end-of-life care planning. Everyone has their own reasons for requesting a DNR order, but here are some reasons why this decision may be made:

• Low Success Rate of CPR in Hospice—The chances of successfully resuscitating terminally ill patients are generally very low. For those who do survive, recovery can involve prolonged hospitalization, more invasive procedures, and reduced quality of life.
• Focus on Comfort—While patients may have differing views on what comfort and dignity mean, many don’t feel that physically aggressive CPR fits within those categories. CPR often leads to broken ribs and internal injuries, leading many to believe it conflicts with their desire for peaceful end-of-life care.
• Peace for Loved Ones—Families often find comfort knowing their loved one’s wishes are documented and will be respected. A DNR order removes pressure from loved ones to make emergency decisions during emotionally challenging moments.

What Happens If You Choose Not to Sign a DNR?

Although many people sign a Do Not Resuscitate order, hospice patients are never required to do so. If your loved one chooses not to sign a DNR order in hospice care, their decision will be fully respected. This means that in an emergency, hospice staff will initiate lifesaving measures such as CPR and contact emergency medical services. If you have further questions about how CPR aligns with the philosophy of hospice care, our team is here to discuss these issues with you openly and compassionately.

How Do You Get a DNR Order?

If a loved one is considering a DNR order, the first step is to talk to their healthcare provider. They’ll discuss the patient’s specific medical condition, treatment options, and preferences for care. If your loved one decides to proceed, their healthcare provider can ensure it’s added to their medical record. Here are some factors to consider when deciding whether to sign a DNR order:

• Health Status and Prognosis—Overall health and the anticipated progression of an illness are the biggest factors in determining whether a DNR is right for a loved one.
• Quality of Life—Reflect on how CPR or further treatments could impact your loved one’s quality of life. Would it lead to prolonged suffering or reduced independence? If treatment could actually diminish quality of life, a DNR order might be the solution.
• Values and Goals—What matters most to your loved one? Are they most interested in peaceful care or exploring all available medical interventions?
• Professional Guidance—Always speak with your loved one’s hospice care team or physician if they’re considering a DNR order. These professionals can provide insights based on their experience and answer your questions.

Here for You and Your Loved One, DNR or Not

Whether or not your loved one has signed a DNR order, Agape Hospice & Palliative Care is here for you. We understand that hospice is not about limiting your choices, but empowering patients to receive care that aligns with their priorities. While a DNR can complement the hospice philosophy of comfort and dignity, it’s entirely your loved one’s decision to sign one. If you’re looking for guidance during this challenging emotional time, don’t hesitate to reach out to our Los Angeles and Orange County team for support.