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Comprehensive Information on Do Not Intubate Orders and Advance Healthcare Planning
In Waldon, California, making informed decisions about Do Not Intubate (DNI) orders is an important part of estate planning and advance healthcare directives. A DNI order indicates a person’s wish to decline intubation or mechanical ventilation if they cannot breathe on their own. Properly documenting that preference reduces uncertainty during emergencies and helps healthcare providers and loved ones follow medical wishes. This introduction explains the role of DNI orders within broader healthcare planning, how they relate to living wills and powers of attorney, and why clear documentation and communication matter for ensuring one’s medical preferences are respected in urgent situations.
This guide outlines practical steps for creating, documenting, and communicating a Do Not Intubate order in Waldon while staying aligned with California health and legal practices. Topics include the differences between DNI and other directives, how a DNI is recorded in medical charts, who can authorize changes, and best practices for sharing directives with family and care teams. Whether you are drafting a new DNI order or reviewing existing documents, the information here aims to help you structure decisions that reflect your values, maintain dignity in care, and reduce the burden on loved ones during crisis moments.
Why a DNI Order Matters for Your Healthcare Choices
A Do Not Intubate order provides a clear medical instruction that intubation and mechanical ventilation should not be used if breathing fails. For many people in Waldon, documenting this preference offers peace of mind by aligning emergency care with personal values about medical treatment, comfort, and quality of life. A DNI also reduces ambiguity for clinicians and family members during high-stress decisions, helping avoid unwanted invasive interventions. When coordinated with other directives, a DNI order becomes part of a broader plan that communicates priorities for life-sustaining treatment, symptom management, and the selection of decision-makers who will represent those wishes when needed.
About Our Firm and Our Support for DNI Orders in Waldon
Serving Waldon and surrounding Contra Costa County communities, LA Estate Plans focuses on assisting clients with estate planning and healthcare decision documents, including Do Not Intubate orders. Our approach centers on clear communication, careful document preparation, and practical guidance about how directives are executed within California medical settings. We work with clients to ensure DNI orders are documented in medical records and coordinated with living wills and healthcare powers of attorney. The goal is to create durable, understandable directives that help families and medical teams follow the client’s wishes during emergencies while complying with state requirements.
Understanding Do Not Intubate Orders and Their Role
A Do Not Intubate order is a focused medical directive that instructs clinicians not to place a breathing tube or initiate mechanical ventilation in circumstances where a patient cannot breathe independently. Unlike broader living wills, a DNI narrowly addresses one life-sustaining intervention, making it a useful option for individuals who have specific preferences about respiratory support but may want other treatments to remain available. In Waldon, a properly recorded DNI order becomes part of the patient’s medical record. Discussing intent with both legal advisors and medical providers ensures the order will be understood and followed by the clinical team during emergencies.
Establishing a DNI order typically involves conversations with a treating physician who documents the instruction in the medical record after confirming the patient’s wishes or those of an authorized decision-maker. The DNI can stand alone or be incorporated into an advance healthcare directive that also names a healthcare agent, specifies broader treatment preferences, and clarifies circumstances when interventions should or should not be used. Regular review and communication with family and providers helps maintain consistency between the DNI and other planning documents as health conditions and personal values evolve over time.
What a Do Not Intubate Order Means in Practice
A Do Not Intubate order is a clear instruction to medical staff that intubation and mechanical ventilation are not to be performed if a patient experiences respiratory failure. The order is typically written and signed by a physician who has discussed the patient’s preferences, and it becomes part of the official medical record so emergency teams can act accordingly. While a DNI deals specifically with airway management, it should be reviewed alongside other directives to confirm consistency across documents. Ensuring the order is accessible to treating providers and communicating its existence to family members increases the likelihood that one’s wishes will be honored.
Key Steps to Establishing a Valid DNI Order
To create a valid Do Not Intubate order in Waldon, start by discussing your preferences with your primary physician and any treating specialists. The physician will document the order in your chart after confirming your decision and, if appropriate, the consent of your healthcare agent. Including your DNI within an advance healthcare directive or living will helps coordinate care decisions and clarifies how the DNI fits into broader treatment goals. Share copies with family, caregivers, and your medical team, and keep an updated copy available at home and with your primary care clinic to ensure the order is readily accessible during emergencies.
Key Terms to Know About DNI Orders and Advance Directives
Understanding the most common terms related to DNI orders helps you make informed choices. Key phrases include advance healthcare directive, healthcare power of attorney, living will, Do Not Resuscitate order, and medical order for life-sustaining treatment. Knowing what each document controls and how they interact makes it easier to structure a coherent plan for medical care. This section provides concise definitions and practical notes on how these documents operate within California law and clinical practice, so you can coordinate your DNI order with other documents in a way that reduces ambiguity and supports your medical preferences.
Do Not Intubate (DNI) Order
A Do Not Intubate order instructs medical personnel not to place a breathing tube or use mechanical ventilation if a patient is unable to breathe independently. The order is commonly documented by a physician in the patient’s medical record after a discussion about treatment preferences. It can be issued as a standalone order or incorporated into broader advance directives. Because it deals with a specific intervention, a DNI is particularly helpful for individuals who want to limit respiratory interventions while leaving other treatments available. Ensuring the order is clearly recorded and shared with caregivers supports compliance in emergency situations.
Do Not Resuscitate (DNR) Order
A Do Not Resuscitate order directs medical staff not to perform cardiopulmonary resuscitation (CPR) if a patient’s heart stops. While distinct from a DNI, both documents address life-sustaining measures and are often considered together during advance care planning. A DNR applies specifically to resuscitation efforts, whereas a DNI focuses on whether to perform intubation and mechanical ventilation. Coordinating both orders within a larger advance healthcare directive helps clarify the overall goals of care and reduces the chance of conflicting instructions during emergency response.
Advance Healthcare Directive
An advance healthcare directive is a legal document that outlines a person’s treatment preferences and appoints a healthcare agent to make decisions if the person becomes unable to speak for themselves. It may include instructions about life-sustaining treatments, pain management, and organ donation, and can incorporate specific orders such as a DNI or DNR. Creating an advance healthcare directive provides a comprehensive way to communicate medical wishes and designates someone to advocate for those choices in consultations with clinicians and hospital staff. Regular reviews ensure the directive reflects current preferences and circumstances.
Living Will
A living will is a written statement that specifies the types of medical treatments a person wishes to accept or refuse if they cannot communicate their decisions. It addresses scenarios such as prolonged unconsciousness, terminal illness, and life-sustaining interventions. A living will can include instructions related to intubation, feeding tubes, and other interventions, and it complements a healthcare power of attorney by documenting values and treatment priorities. Combining a living will with a DNI order and a designated decision-maker helps ensure consistent application of treatment preferences in medical situations.
Comparing DNI Orders and Other Advance Care Documents
When planning medical directives in Waldon, people can choose from options such as DNI orders, DNR orders, living wills, and advance healthcare directives. Each serves a specific purpose: DNI targets intubation decisions, DNR focuses on CPR, a living will records treatment preferences, and an advance healthcare directive typically names an agent and covers broader scenarios. Selecting the right combination depends on how specific you want to be about individual treatments versus establishing a comprehensive plan. Reviewing these options with medical and legal advisors helps align documents with personal values and ensures consistency across healthcare settings.
When a Focused DNI Order May Be Appropriate:
Specific Treatment Preferences Around Intubation
Some individuals prefer to limit documentation to a single, well-defined medical intervention such as intubation because their primary concern relates to respiratory support rather than broader end-of-life choices. A standalone DNI order provides straightforward instructions that emergency clinicians can follow quickly without sifting through extensive documents. This approach suits those who want to retain flexibility for other treatments while ensuring their position on intubation is unmistakable. Clear communication with family and treating clinicians ensures that the DNI is recognized and respected when urgent decisions arise.
Simplicity for Emergency Decision-Making
A limited medical directive like a DNI can reduce confusion during emergencies because it focuses on one action: whether to intubate. This simplicity helps first responders and hospital staff act quickly according to documented wishes without having to interpret more elaborate directives under pressure. For people who want a clear, unambiguous instruction about respiratory interventions while keeping other care options open, a DNI order strikes a balance between specificity and ease of implementation. The key is ensuring the order is properly recorded in medical files and communicated to caregivers.
Why Broad Advance Planning Often Provides Stronger Protection:
Coordinated Care Across Documents
A comprehensive advance healthcare plan coordinates a DNI with other directives such as a living will and a healthcare power of attorney to avoid conflicting instructions. When documents are aligned, medical teams and family members have a cohesive picture of the patient’s overall treatment goals, including preferences for pain management, comfort care, and decision-making authority. Coordinated documents reduce the risk of misunderstandings in critical moments and make it easier for clinicians to honor the patient’s priorities, which benefits both medical staff and loved ones tasked with making difficult choices.
Addressing a Range of Medical Scenarios
Comprehensive planning covers multiple potential situations rather than a single intervention, helping ensure preferences are applied consistently across different medical contexts. This breadth is useful for people whose wishes extend beyond intubation to include decisions about feeding tubes, long-term life support, organ donation, and comfort measures. A full set of directives, paired with a designated healthcare agent, provides clearer guidance to clinicians and reduces the emotional burden on family members who might otherwise have to make complex decisions without clear instructions.
Benefits of Integrating DNI Orders into a Full Healthcare Plan
Incorporating a DNI order into a broader advance healthcare plan ensures that one’s medical choices are reflected across all relevant documents, supporting consistent interpretation by medical staff and loved ones. A comprehensive approach documents not only whether to intubate but also the values that guide other treatment decisions, names a trusted decision-maker, and specifies preferences for comfort care and symptom management. This reduces the chance of conflicting directives and promotes more predictable application of a person’s wishes in a range of medical settings.
Another important benefit of a full healthcare plan is legal clarity and coordination with California procedures, which minimizes delays or disputes during urgent care. When directives are clearly written, witnessed or notarized as appropriate, and communicated to healthcare providers, the likelihood that the documents will be honored increases. A comprehensive plan also provides family members with guidance and reassurance about how to support the patient’s wishes, which can ease emotional strain during difficult medical episodes and lead to care that better reflects the patient’s goals.
Clear Communication of Medical Wishes
A complete set of advance directives clarifies medical priorities for healthcare teams and family members, helping ensure that the patient’s preferences are followed when they cannot speak for themselves. By documenting specific instructions for interventions like intubation alongside broader guidance about desired outcomes and comfort measures, a comprehensive plan reduces ambiguity and potential conflict. Clear communication supports smoother transitions between care settings and reduces the likelihood that critical decisions will be made without adequate reference to the patient’s documented wishes.
Legal Protection and Reduced Family Burden
When a DNI order is integrated with a living will and a healthcare power of attorney, legal protections are stronger and decision-making responsibilities are more clearly assigned. This structure helps avoid disputes among family members and clarifies who should speak with medical teams. The result is less emotional strain on loved ones who might otherwise have to guess the patient’s preferences. Properly executed documents that comply with California practices increase the chance that medical teams will follow the patient’s instructions and that family members will feel supported in honoring those wishes.
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Practical Tips for Managing Your DNI Order
Discuss Your Wishes with Family and Providers
Open communication is essential when creating a Do Not Intubate order. Talk through your values and treatment goals with close family members and the clinicians who know your medical history. Clear conversations reduce misunderstandings and help ensure that those who may be called upon to make decisions are aligned with your wishes. Sharing why you have chosen a DNI helps family members feel more confident supporting the directive in urgent moments. Regularly revisiting these discussions keeps everyone informed as circumstances and preferences change over time.
Keep Documentation Accessible and Updated
Coordinate DNI with Other Advance Documents
Integrate a DNI order with a living will and a healthcare power of attorney to prevent conflicting instructions and to name someone authorized to implement your wishes. Coordinated documents provide a fuller picture of what you want, covering scenarios beyond intubation and ensuring that the person making decisions understands the values guiding treatment choices. When documents are consistent and easily available to clinicians, the likelihood that your care preferences will be followed increases during critical health events.
Why You Might Choose a DNI Order in Waldon
Choosing a Do Not Intubate order addresses a specific concern about respiratory support, allowing you to express a clear preference about intubation while preserving other potential treatments. People who prioritize comfort care or want to avoid aggressive respiratory interventions often find a DNI aligns with their values. Additionally, documenting the choice legally and clinically reduces the chance of unwanted procedures during an emergency, supports caregivers in implementing those wishes, and contributes to a sense of control over medical decisions at times when the patient may not be able to speak for themselves.
A DNI order can also ease the burden on family members by removing uncertainty about whether to consent to intubation in critical moments. For those with progressive illness, advanced age, or preferences for less invasive treatment, a DNI provides a specific instruction that guides clinicians and supports consistent application of care goals. When combined with other advance planning documents, a DNI helps form a complete strategy to manage future healthcare decisions and aligns medical interventions with personal values and comfort priorities.
Common Situations Where a DNI Order Is Considered
Individuals often consider a DNI order in situations such as advanced chronic illness, terminal diagnoses, significant frailty related to aging, or when comfort-focused care is the priority. The directive is also relevant for anyone who prefers to avoid invasive respiratory support in favor of symptom management and quality of life. Discussing these circumstances with medical providers and family helps clarify whether a DNI is the right fit, how it interacts with other treatments, and how to record and communicate the decision effectively to ensure that clinical teams honor the directive when needed.
Advanced Chronic or Terminal Illness
For people facing progressive or terminal medical conditions, a DNI order can prevent interventions that may prolong life without improving quality. Focusing care on comfort and symptom relief rather than invasive respiratory support aligns treatment with priorities of dignity and personal values. Conversations with treating clinicians help ensure the DNI is appropriate for the clinical context and that it is documented in a way that emergency teams will find and follow. Including the DNI within an overall care plan makes intentions clear across care settings.
Prioritizing Comfort Over Aggressive Measures
Individuals who place high value on comfort-focused care often opt for a DNI order to avoid intubation, which can involve sedation, prolonged hospitalization, and invasive procedures. A DNI clarifies that the focus should be on symptom control and quality of life rather than life-prolonging respiratory interventions. This choice should be discussed with loved ones and medical providers so that the care team understands the preference and can coordinate appropriate palliative or hospice-oriented care when the DNI is in effect.
Concern About Burden on Family or Medical Interventions
Some people choose a DNI order to lessen the emotional and decision-making burden on family members during emergencies. When directives are clear, family members are not forced to make sudden, high-stakes choices without guidance. A DNI also sets expectations about medical interventions that might otherwise lead to prolonged hospital stays or intensive care treatments that do not align with the patient’s values. Clear documentation enables family and clinicians to act in a way that respects the patient’s intentions and reduces conflict at stressful times.
We Are Here to Assist with DNI Orders in Waldon
Why Choose Our Firm for Your DNI and Advance Planning Needs
Clients in Waldon rely on our practice for practical assistance in drafting DNI orders and related documents because we focus on clear communication and document clarity. We help clients document their preferences in language that is readily understood in clinical settings and coordinate those choices with other advance directives. The goal is to make instructions easy for medical personnel to find and follow while also providing family members with confidence about how to act in urgent circumstances.
We guide clients through the procedural aspects of recording a DNI, such as discussing the order with the treating physician, making sure it is entered into the medical record, and advising on witnessing or notarization where appropriate. We also assist in distributing copies to relevant parties and explain steps for updating directives as health or personal circumstances change. This hands-on approach helps ensure directives remain current and accessible when they are needed most.
Beyond document preparation, we emphasize strategies for communicating wishes effectively to family and clinicians, reviewing existing healthcare directives for consistency, and advising on how to maintain and update records. Our aim is to reduce confusion during emergencies by helping clients establish well-structured directives and practical plans for document access, which contributes to honoring patients’ preferences in clinical settings throughout Waldon and California.
Contact Our Waldon Office to Discuss Your DNI Options
How We Prepare DNI Orders and Advance Directives
Our process for preparing a DNI order and related advance directives begins with listening to your medical preferences and treatment goals, then reviewing any existing documents you may have. We advise on the most effective way to record a DNI alongside a living will and healthcare power of attorney and ensure documentation aligns with California practices. The process emphasizes clarity, accessibility, and proper coordination with treating clinicians to increase the likelihood that your wishes will be followed in urgent situations.
Step One: Initial Consultation and Information Gathering
During the initial consultation, we discuss your health circumstances, values, and objectives for care. This conversation helps identify whether a standalone DNI, an integrated advance healthcare directive, or another combination of documents best reflects your preferences. We also review any existing paperwork to determine necessary updates and collect information needed to draft clear, legally appropriate language for the DNI and associated documents.
Discussing Medical Preferences and Goals
We spend time understanding your priorities for medical care, including specific views on intubation, artificial respiration, and other life-support measures. Clarifying the circumstances under which you would accept or refuse certain interventions helps us craft a DNI that accurately reflects your intentions. We also talk about who you trust to make decisions when you cannot and how best to document those preferences so clinicians can follow them in emergencies.
Reviewing Existing Documents and Medical Context
If you already have a living will, advance directive, or healthcare power of attorney, we review those documents to identify gaps or inconsistencies. We also consider relevant medical information and consult with your care providers where appropriate to ensure the DNI fits the clinical context. This step helps align legal language with medical realities so the resulting DNI will be practical and understandable to treating teams.
Step Two: Document Preparation and Customization
After gathering necessary information, we draft or update the DNI order and any supporting advance directives to reflect your expressed preferences. The documents are written in clear, actionable language designed to be recognized and implemented by healthcare professionals. We tailor the documents to align with California practices and advise on appropriate methods for signing, witnessing, and distributing copies so the directives are accessible when needed.
Drafting a Clear DNI Order
The DNI order is drafted to make the intent regarding intubation unmistakable, while also noting how it interacts with other care directives. We ensure the language is straightforward so that emergency and hospital staff can quickly identify the instruction in the medical record. The order may be created as a standalone medical order or integrated into an advance directive, depending on your preferences and the advice we provide during the planning process.
Coordinating with Living Wills and Healthcare Agents
To avoid conflicting instructions, we coordinate the DNI with a living will and appointment of a healthcare agent. This ensures that named decision-makers understand the patient’s values and how to apply the DNI in context. Clear coordination among documents provides a consistent framework for clinical decision-making and offers family members direction about how to support the patient’s wishes throughout different stages of care.
Step Three: Final Review, Signing, and Implementation
In the final phase we review all documents with you in detail, answer questions, and advise on the required steps for signing, witnessing, or notarization as appropriate. We provide guidance on distributing copies to your medical providers, family, and any care facilities where you receive treatment. We also explain practical steps to ensure the DNI appears in the medical record and discuss ways to carry or display proof of your directives for emergency responders.
Signing, Witnessing, and Document Storage
We walk you through the signing process to help ensure the DNI and associated directives meet procedural expectations in California. This may include witness signatures or notarization where useful, though requirements can vary by document and setting. We also advise on secure storage options, practical methods for sharing copies with medical teams, and ways to make the documents discoverable for first responders and clinical staff in urgent situations.
Communicating Directives to Care Teams and Loved Ones
After documents are finalized, we emphasize communicating their contents to primary care physicians, specialists, and the family member or healthcare agent named in your directives. Providing copies and discussing the circumstances that trigger the DNI helps ensure clinicians and loved ones understand the intent behind the order. These conversations reduce the risk of misinterpretation in emergencies and support consistent application of your documented medical preferences.
The Proof is in Our Performance
Frequently Asked Questions About DNI Orders in Waldon
What is the difference between a DNI and a DNR?
A Do Not Intubate (DNI) order instructs medical personnel not to perform intubation or initiate mechanical ventilation if a person cannot breathe independently. A Do Not Resuscitate (DNR) order, by contrast, directs clinicians not to perform cardiopulmonary resuscitation (CPR) if the heart stops. While both relate to life-sustaining treatments, they cover different interventions and may be applied separately or together depending on the individual’s preferences and medical circumstances. When forming either order, it is helpful to discuss the clinical differences and likely outcomes with treating physicians so you understand how each order would be applied during emergencies. Coordinating DNI and DNR decisions with a living will and a designated healthcare agent helps ensure consistent application of your values across multiple medical scenarios.
Can I change or revoke my DNI order?
Yes. You can change or revoke a DNI order at any time while you have capacity to make healthcare decisions. The revocation should be communicated to your treating physicians and the healthcare facilities where your records are kept so the medical record reflects current wishes. Informing your designated healthcare agent and family members about any changes ensures that others understand and can support the updated preference in urgent situations. To make a revocation effective, follow the clinical facility’s procedures for removing or updating orders, and consider documenting the change in a revised advance healthcare directive or through a signed statement. Keeping copies of updated documents with your care team and family reduces the risk of confusion during emergencies.
How is a DNI order recorded and who signs it?
In California a DNI order is generally documented by a treating physician in the patient’s medical record after a conversation confirming the patient’s wishes or those of an authorized decision-maker. The order becomes part of the official health record so that emergency responders and hospital staff can act in accordance with the instruction. The exact process may vary by facility, but physician documentation in the chart is the most recognizable method for ensuring the DNI is accessible to clinical teams. If you prefer, a DNI can be included in an advance healthcare directive or living will and accompanied by a physician’s notation in the medical record. Working with your doctor to place the order in the chart and distributing copies to relevant providers increases the chance that the directive will be observed in urgent situations.
How can I make sure my DNI order is followed in an emergency?
To increase the likelihood a DNI is followed, make sure the order is part of your medical record, provide copies to your primary care provider and specialists, and give copies to your healthcare agent and close family members. Carrying a card or wearing a medical alert that notes the existence and location of a DNI document can also help first responders identify the directive quickly. Regular communication with the care team ensures they are aware of and understand your preferences. Additionally, ask your physician to place the DNI as a clearly labeled order in your chart, and confirm facility protocols for documenting such orders. When documents are easy to find and those around you understand your wishes, clinicians are better equipped to honor the instruction in emergencies.
Should a DNI be included in a living will or advance directive?
A DNI can be a standalone medical order or incorporated into a living will or advance healthcare directive. Including it within a comprehensive document can reduce the chance of conflicting instructions and helps provide context about overall treatment goals. When a DNI is coordinated with a living will and a designated healthcare agent, medical teams and family members have a clearer understanding of the patient’s broader values and preferences. Whether standalone or integrated, the most important considerations are clarity and accessibility. If you include a DNI in a larger advance directive, ensure the language is consistent and that physicians enter the instruction into the medical chart so emergency personnel can apply it promptly.
Who can speak for me if I can’t communicate my DNI wishes?
If you cannot communicate and have already designated a healthcare agent through a power of attorney for healthcare, that agent can speak for you and make decisions consistent with your documented wishes. When a DNI is part of an advance directive, the agent’s role is to ensure the directives are communicated and followed, working with medical staff to interpret the patient’s goals of care. If no agent is designated, California law has procedures for surrogate decision-makers, which typically follow a priority order among family members. In either case, having clear written instructions such as a DNI reduces the burden on decision-makers and increases the likelihood that care aligns with your preferences.
Will a DNI order affect other treatment decisions?
A DNI affects decisions about intubation specifically, but it should be viewed within the broader context of overall medical care. It does not automatically prohibit other treatments such as medication for pain or antibiotics, unless those restrictions are included in a living will or other directives. Coordination between documents ensures clinicians understand the boundaries of medical interventions you accept or refuse and how a DNI fits into those choices. When drafting a DNI alongside other directives, consider explicitly stating which treatments you do or do not want and the circumstances that matter most to you. Clear language prevents unintended limitations or conflicts with other aspects of the care plan.
How often should I review my DNI and related documents?
Review your DNI, living will, and related documents periodically, especially after major health changes, major life events, or changes in personal preferences. Regular review ensures the directives continue to reflect your current values and medical goals. If your health condition advances or your outlook on invasive treatments changes, updating your documents prevents confusion and keeps instructions aligned with your wishes. When you revise directives, notify your healthcare providers and family, and replace older copies in medical charts and personal records. Consistent communication and updated documentation help medical teams follow your most recent instructions in urgent situations.
Can a DNI order be used for someone in hospice or palliative care?
Yes. A DNI order can be appropriate for people receiving hospice or palliative care who prefer comfort-focused management over invasive respiratory interventions. In hospice settings, the emphasis is often on symptom control and quality of life, and a DNI can formalize the preference to avoid intubation. Discussing goals of care with hospice clinicians helps align the DNI with palliative treatment plans and ensures the directive integrates smoothly into the care approach. As with other settings, document the DNI in the patient’s records, and ensure family members and the hospice team understand the directive. Clear documentation and communication support consistent application of care that prioritizes comfort and dignity.
What steps should family members take if they need to present a DNI order to emergency personnel?
Family members should locate the DNI order and any supporting documents promptly and present them to emergency personnel or intake staff at medical facilities. It helps to provide a physician-signed order or a clear copy of an advance directive that references the DNI. Informing staff where the DNI is recorded in the medical chart, and providing contact information for the healthcare agent or physician who signed the order, expedites verification and proper application of the directive. Families should also communicate the existence of the DNI to first responders and to hospital intake staff when transferring a loved one, and ensure that updated copies are placed in the medical record. Advance preparation and easily accessible documentation help emergency teams respect the patient’s wishes without delay.