Three Things Needed for a Guardian to Petition for a Do Not Resuscitate Order (DNR)

 

Legal Documents

Image Credit: peggydavis66

For certain clients, the Guardian may determine it is best to establish a Do Not Resuscitate (DNR) for their client. Typically, a DNR is sought because the potential lifesaving measures taken by emergency medical staff to resuscitate the client will end up doing more harm, often breaking bones without successful resuscitation.

 

In order to obtain a DNR within a Guardianship, a court order is usually needed, so it is a good idea to consult with your attorney about the matter if you think a particular client may need a DNR, preferably in advance of a crisis.

 

There are generally three things that should be gathered in order to initiate a petition for a DNR. They are:

 

Medical Condition Information: Request a letter (maybe even more than one letter) from the client’s doctors, such as a primary care physician, cardiologist, neurologist, infectious disease, or other relevant doctors. If none of those are available, you can also get a letter from the hospice director, or the attending physician at the hospital, if needed.

 

The letter should provide a glimpse of the individual’s medical condition in laymen’s terms, not in medical terms, explaining the entirety of their condition, the likelihood of success in resuscitation efforts, the potential quality of life after resuscitation, and the doctor’s opinion of the inappropriateness of a full code status on this particular patient.

 

Historic Beliefs and End of Life Documents: Of course, we always hope to have fully executed, well drafted Advanced Directives, like a Living Will, for every client making their wishes well known, but we can use almost anything that shows the client’s belief system about the end of life. Items like organ donor cards, hand written notes and signed letters about their wishes, comments in Wills or burial arrangements, or anything else that clearly shows what the client would choose for themselves if they had capacity, work well for proving the client’s wishes.

 

Consent / Support from Family and Close Friends: Many times, clients will have conversations with people in their life about their end of life wishes. When a client has family, friends, clergy, co-workers, or other individuals willing to provide, in writing, the client’s wishes, it can often work as supporting documentation for obtaining the DNR. However, this can also be a problem when two people state very different interpretations of what the client wants with regards to their end of life wishes.

 

 

In a perfect world, a Guardian will provide all three to the court when petitioning for the DNR, however, more often than not we only have two of the three.

 

Regardless, the decision to grant the Order to Initiate a DNR is up to the judge. Some judges will sign these petitions when they are simply sent to the courts. Others will require a hearing every time. Some judges feel that guardians do not even need a court order to make this medical decision.

 

That’s why, as a Professional Guardian, it is important to gather the proper documentation, and speak with your attorney in advance to get a plan in place for the client. That way you’re not stuck when you get that call at 2 am from the ICU, and they need a fast answer as to the client’s code status.

2014 Year End Review – December Newsletter

 

Chronicles of a Professional Guardian

 

Serving as Care Managers, Elderly & Disabled Life Care Plan Assessors, and providing Professional Guardian services in Central Florida for over 20 years, we have discovered unique solutions to many difficult problems.

 

We are continuing our tradition of giving back by sharing our knowledge in the hopes that this information can help others to better serve and care for our elderly and disabled population.

 


2014 Year End Review

 

Another year is quickly coming to an end, and before you know it, it will be January, 2015. But before we turn the calendars forward, we’d like to take a moment to reflect on this past year, with all its wonderful, and crazy, times.

 

Some of the highlights include:

 

The 2014 Annual Client Holiday Party

 

We held our Annual Client Holiday Party on December 5th, at the Maitland Civic Center. We’ve hosted this party every year since the late 1990’s to honor and celebrate our clients, giving them a chance to join in the holiday cheer. We have clients who look forward to it all year long.

 

This year’s highlights included: arts and crafts making ornaments and Christmas decorations, dance entertainment provided by a local, non-profit dance troupe, a soulful serenade sung by one of our clients, and a visit from Santa, who let us borrow his sleigh for pictures.

 

Guardian Care's 2014 Annual Holiday Party Guardian Care's 2014 Annual Holiday Party

Guardian Care's 2014 Annual Holiday Party Guardian Care's 2014 Annual Holiday Party

A Focus on Sharing Information

 

One of our biggest focuses in 2014 was information sharing. We continued to do this through digital means, such as sharing information through this newsletter, the Guardian Care blog, and on Facebook and LinkedIn.

 

GSI at FSGA 2014 Conference Beth

We also shared our knowledge in the real world, as we focused on getting the Geriatric Scene Investigation (GSI) course to as many elder care professionals as possible in 2014. We taught our hands-on, interactive investigative training course at conferences and stand-alone locations such as facilities and senior resource locations throughout the state.

 

We hope to continue this trend in 2015, as we are working towards expanding GSI into a longer three or four hour course hosted at facilities, senior centers, resource locations, corporate settings, and more. This next evolution came at the request of our attendees, as our most frequent feedback was that the course just wasn’t long enough to find all the clues.

 

If you’d like to host or sponsor GSI training, or help in other ways, please contact Guardian Care at (407) 786-6033. Visit www.GSI-Experience.com for general information.

 

(And the Bad / Ugly) Self-Igniting Cars

 

blog.orlandoguardian.com F150 on fire

In February, we had an extra heap of craziness added to the month when Theresa Barton’s beloved 14-year-old F-150 decided it was no longer fit for this world and took itself out of existence by igniting flames one afternoon in the back parking lot of Guardian Care.

 

To this day, Theresa still misses her truck. We hope this serves as a cautionary tale for F-150 owners to do the research and follow up on those pesky vehicle manufacturer post cards.

 

 

 

 


Did You Know?

 

That Guardian Care started a blog? In our profession, we learn so much great information that we want to share with as many people as possible. That’s why we started a weekly blog.

 

You can check out or blog at blog.orlandoguardian.com, or follow us online on Facebook or LinkedIn and never miss a blog post (or newsletter).

 

Here are the articles we shared in November:

Stay tuned, because in 2015 we will be revamping our newsletter layout to feature the articles we post in between newsletters.


Tip of the Month:

 

As a reminder, there will be a monthly Social Security increase in 2015 of 1.7% for recipients.

 

This small increase could be enough to bump some Medicaid Recipients over the income limit for the program(s) they are on. Should this happen, you may wish to consult with an Elder Law Attorney to determine the available options to preserve benefits.

 


Upcoming Guardian Care Events:

 

As active members of the community, we can be found around town speaking, sponsoring, supporting, and educating other professionals and the general public on Guardianship and caring for the elderly and disabled.

 

Want us to speak at your next event? Our topics include Guardianship, Private Care Management, and Elderly & Disabled Life Plan Assessment. Feel free to contact us at 407.786.6033.

 

Upcoming Events:

 

We currently have no upcoming events, but that’s likely to change in 2015, so contact us soon to schedule us at your next event as our calendar fills up quickly.

 

Previous Events:

  • November 20th – Presentation to a Social Work Class at UCF
  • October 9th – Presenting “Wards Gone Wild, Not Just Sex,” at the 2014 Elder Law Conference in Tampa
  • September 24 – Presentation “Help Your Aging Family Members,” at Serenades of Sonata
  • September 13 – Presentation “Wards Gone Wild, Not Just Sex,” at the 2014 Elder Law Conference in Boca Raton

Community Events

 

Click on the event for additional information.

Four Common Types of Guardians for Adults in Florida

 

GSI at FSGA 2014 Conference Beth

Image Credit: Guardian Care

When it comes to adult guardianship in Florida, there are four common types of guardians. Depending on the client’s particular needs, one type of Guardian may be better suited for a specific case than another.

 

Here is a breakdown of each of the common types of Guardians for adults in the State of Florida:

 

Professional Guardian: Most commonly involved when there are no willing, interested, appropriate, or available family or friends able to serve as Guardian. A Professional Guardian is also often appointed when there are multiple feuding family members all wanting to be the guardian, and the courts determine that an independent, Professional Guardian is the better option.

 

Public Guardian: A State recognized entity, usually a non-profit agency, funded through public and grant dollars. Public Guardians serve individuals with little to no assets, usually referred to as Pro-Bono clients.

 

Family Guardian: (In this context as relating to adults only) A family member or friend who is willing, able, and appropriate to serve as the guardian for the individual who is in need of a decision maker for the Person and/or Property.

 

Corporate Guardian – Of the Property: This is usually a trust entity, like a bank or trust department of a financial institution, managing the funds and assets of an individual determined to be unable to handle their own financial affairs.