What Is a Do Not Intubate Order?

Discover the Meaning of a Do Not Intubate Order

Making medical decisions can be challenging, especially when planning end-of-life care. One such decision is establishing a Do Not Intubate (DNI) order. This critical document can ensure that your care aligns with your wishes and values. As you read below, we will explain the meaning of a DNI order, how it differs from a Do Not Resuscitate (DNR) order, and key considerations to help you make an informed decision. We’ll also address a common question regarding hospice and DNI orders.

What Is a Do Not Intubate Order

A Do Not Intubate (DNI) order is a legal medical directive that lets healthcare providers know you do not wish to be intubated. Intubation involves inserting a tube into the airway to help a person breathe, typically with the assistance of a mechanical ventilator. A DNI order specifically applies to situations where a person cannot breathe adequately, such as severe respiratory failure. By creating this order, you indicate that while other forms of medical care can be provided, intubation should not be performed. For many, this decision is tied to personal beliefs, the desire to avoid prolonged suffering, or maintaining dignity during the final stages of life.

DNI vs DNR: How They Differ

While the Do Not Intubate (DNI) and Do Not Resuscitate (DNR) orders are medical directives, they serve different purposes. Understanding these differences is crucial when deciding your preferences for care.

• Do Not Intubate Order
  • Addresses only intubation and mechanical ventilation.
  • Does not exclude other forms of advanced care, such as chest compressions or defibrillation.
• Do Not Resuscitate Order
  • Applies in cases of cardiac or pulmonary arrest.
  • Indicates that chest compressions, defibrillation, and other resuscitation efforts should not be performed.
  • Often broader in scope than a DNI order.
• DNI and DNR Together
  • You can have both a DNI and DNR in your medical records, allowing for more specific instructions regarding your care. These directives help ensure your healthcare team respects your wishes during critical moments.

Does Hospice Require You to Sign a DNI?

A common misconception is that enrolling in hospice or palliative care requires signing a Do Not Intubate (DNI) order. Hospice programs like Agape Hospice & Palliative Care focus on patient-centric care, meaning your care plan is tailored to your personal preferences. Hospice does not require patients to sign a DNI or DNR. However, hospice care typically prioritizes comfort over curative treatments, so having clear directives in place can help align medical interventions with your end-of-life goals. Discussing your priorities with your hospice team, caregivers, and loved ones can help ensure everyone is on the same page about your care.

Consider These Thoughts Before Signing a DNI

Implementing a Do Not Intubate (DNI) order is a deeply personal decision. Here are a few factors to consider before making your choice:

• Personal Values: Reflect on your beliefs about life-sustaining treatments and their impact on your quality of life.
• Your Condition: Discuss your medical condition and prognosis with your healthcare provider to understand when intubation might be necessary and what outcomes to expect.
• Alternatives to Intubation: Consider whether you are open to non-invasive forms of intervention, such as oxygen therapy or other supportive treatments.
• Family and Loved Ones: Communicate openly with those closest to you about your wishes to avoid confusion or distress during medical emergencies.
• Legal and Medical Guidance: Work with your healthcare team or legal advisor to ensure your intentions are documented in a way that is easily accessible and enforceable in a healthcare setting.

Plan for Peace With Agape Hospice & Palliative Care

Deciding on a Do Not Intubate (DNI) order is both personal and important. Understanding your options and rights can empower you to make decisions that align with your goals for care. At Agape Hospice & Palliative Care, we are here to guide and support you every step of the way. Our compassionate team proudly serves patients in Los Angeles and Orange Counties, helping individuals and their families create care plans that honor their wishes. Contact us today to begin your journey toward comfort and dignity.