Author: Tiffany Stockton
Reviewed By: Catherine Braxton

Yes, assisted living facilities are allowed to have DNRs (do not resuscitate orders), but it depends on state and facility policies. Residents in assisted living often have more autonomy in making health care decisions, and facilities must respect individual preferences regarding life-sustaining measures, such as DNRs. However, you should ensure the facility has access to these forms for these preferences and communicates them effectively.

Legal and ethical considerations of DNRs

The ability of assisted living facilities to implement and respect DNRs  depends on state laws. Some states permit DNRs within assisted living facilities and outline clear guidelines for their execution. Others leave space for individual facility policies to determine the acceptance of DNRs and the protocol for implementing them. Always check with the facility and consult legal professionals versed in elder law to ensure your loved one’s wishes are adequately documented and respected.

Residents retain the right to make informed decisions about their medical care, including having a DNR order. Facilities must ensure residents have access to relevant information and support to make these choices freely. Only clear and informed consent by residents or their legal representatives validates a DNR order, and it also requires a physician’s signature. Health care professionals then uphold medical ethics and honor valid DNR orders while providing quality care and advocating for residents’ well-being. Without a DNR, health care providers assume “full code” status and take every action necessary to revive a resident.

How to establish a DNR

The process begins with open and honest communication between the resident, their family members and health care professionals. Everyone involved should approach discussions about end-of-life preferences with sensitivity and empathy. These conversations can take place during routine care planning meetings or whenever the resident wishes to address their health care directives. Written documentation according to state law and facility policy occurs once the resident has made a decision regarding resuscitation.

Sometimes, this decision changes over time based on the resident’s health status or personal beliefs. Regular reviews of the resident’s care plan ensure the documentation accurately reflects the current wishes. The DNR order and code status on the door or nameplate of a resident’s room communicate these preferences to all relevant health care providers within the assisted living facility. Residents can also consider wearing a bracelet or other piece of jewelry to alert others in the event they receive emergency care outside the facility.