Importance of Having a Living Will and Health Care Directive in the Dying Process

When Hospice Has Been Chosen a Power of Attorney, Living Will and Healthcare Directive is a Must!

A hospice patient should insist that their family agree to honor their wish to die at home (if feasible), without artificial attempts at extending the patient’s life.

Many New Jersey hospice patients (particularly patients still living at home and diagnosed with heart disease or weak hearts) complete a form called an “Out of Hospital DNR Order.” This form is available from your hospice agency, if you ask. This form will be useful if a hospice patient suffers a heart attack and someone not knowing the patient’s wishes calls 911. (For example, a visiting friend, a neighbor, or a newly arrived family member — or simply a family member who panics.) This form should be honored by emergency medical technicians (EMTs) if the form is shown to the EMT crew immediately upon their arrival to the house. It is therefore important that the Out of Hospital DNR Order be posted in an obvious place easy to reach (many families post them on the refrigerator door).

What is a DNR?

A DNR (Do Not Resuscitate) Order is a legal document, signed by a physician, which informs caregivers and medical personnel that the patient does not want cardiopulmonary resuscitation (CPR) if the heart stops.

Cardiopulmonary resuscitation (CPR) is an artificial means of extending life. It is useful and often successful in restoring the heartbeat of a patient who has suffered accidental, sudden or traumatic cessation of heart function. CPR, however, hardly ever works with patients who have severe heart disease or weak hearts — for them, the rushed and aggressive administration of CPR by strangers will be the last thing they experience in life.

Can I get hospice care without a DNR Order?

Absolutely you can.  Current law says a patient without a DNR Order can receive hospice care. Hospice patients are encouraged, however, to get a DNR Order from their physician or the hospice agency they select. Having a DNR Order makes clear to the family and professional caregivers that the patient does not seek to extend life through artificial means.

Attempting CPR (cardiopulmonary resuscitation) on a terminally ill patient with heart disease or a weak heart is quite likely to be unsuccessful. Such action will often upset and confuse the family and deprive the patient of peace during their final moments of life.

What is an advance medical directive?

An advance directive is a written instruction, in a form recognized by New Jersey law, that speaks to the level(s) of health care desired (or refused) should a patient be incapacitated.

Will I need an advance medical directive to enroll in hospice?

No. There are only two qualifications to enroll in hospice care: (1) a patient must wish to forego further curative treatment and instead seek comfort; and (2) two physicians must certify that the patient suffers from a terminal illness and has a life expectancy of six months or less.

An advance directive helps inform your family, physician and the hospice team of the kind of care you would want if you were no longer able to decide for yourself. In the absence of an advance directive, the hospice staff will continue to provide comfort care through the end-stage of your disease.

What is a living will?

Fredrick P. Niemann Esq.

A living will is a document that specifies what lifesaving and life-sustaining care a person wants and does not want to receive if the person becomes both incapacitated and terminally ill.  Basically, it is a document that states a person’s wishes about the dying process and level of medical effort that should be used to either keep the person alive or be allowed to die.

If you would like to speak to a NJ hospice attorney, contact Fredrick P. Niemann, Esq. toll-free at (855) 376-5291 or email him at to schedule a consultation about your particular needs. He welcomes your calls and inquiries and you’ll find him very approachable and easy to talk to.



Written by Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a New Jersey Hospice Care Attorney

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