Answer: Patients do not need to have a DNR (Do Not Resuscitate) order signed at the time of their enrollment into hospice. Often, physicians rely on hospice to get a DNR order because they are reluctant to hold the discussion with patients themselves. If DNR were a legal requirement, referrals to hospice would be postponed and length of hospital stay would be even more dismal than it already is. However, hospice staff will work with the family to determine the best time to have a DNR order signed after enrollment.

Hospices should make it clear to patients that hospice election means giving up aggressive treatments and accepting that death is approaching. But, there is no legal requirement to force this choice by signing a DNR before admission. In practice, many hospices choose not to be so blunt, and give patients and families time to adjust to the terminal illness and prognosis, even paying in some cases for life-extending treatment such as chemotherapy and radiation.

Additional information about advance directives and an emergency profile form that may be helpful to you and your family are available from Hospice Foundation of America. Your local hospice, hospital or physician should also be able to provide you with more information on completing these important documents

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