“Do you want to be resuscitated if your heart stops—meaning if it happened at this moment, would you?”

Depending on the stage of a person’s life, many reply, “No, I don’t want to be resuscitated and those wishes are documented in my Living Will (aka Advance Directives).”

The difference between a Living Will and a Do Not Resuscitate (DNR) order and how they are used is a common misunderstanding among older adults and their adult children.

The Problem

If your heart stops and you are unconscious (aka cardiac arrest), someone will call 911.

Paramedics will arrive and attempt to resuscitate you by default. They will not ask to see a copy of your Living Will or Advance Directives while fighting to save your life.

How will you communicate your wishes outside of your legal advance directives?

Unlike most Americans, you have been conscientious about legally preparing for the future. You have been thoughtful and diligent about getting your ducks in a row.

Our Observation

We estimate at least 90% of older adults and families we serve do not recognize the difference between the legal documents designed to carry out your end-of-life wishes and a Physician-signed Do Not Resuscitate (DNR) order.

The reason may be that when we are younger, our Advance Directive may indicate the desire to prohibit life-sustaining interventions in the event of a lengthy coma with no reasonable expectation to survive. (Do you recall the case of Terri Schiavo?) When medical professionals have determined your body cannot function without artificial means (i.e. a ventilator) our Living Will reveals our wishes to family.  However, outside of traumatic permanent injuries, most of us want to be resuscitated when we are young.

Older adults often feel differently. By their advanced years, many adults have dealt with cancers, several chronic conditions such as COPD, diabetes, heart disease, arthritis, dementia, etc. By the time they reach a certain age, they may feel fulfilled and are comfortable with letting nature take its course.

The Solution

If you do not want to be resuscitated, then it is time to talk to your doctor. Debbie Aggen RN, CMC, CDP tells her clients, “A DNR is not a document written up by an attorney. It is a medical order from the doctor. Medical professionals have to follow a doctor’s order, that includes Paramedics, EMT, hospitals, nurses and home care aides or others who may be in your home.“

Ask your doctor if it is time to consider a DNR.

Questions to Ask

Discuss medical interventions and how they may affect you with your doctor. Medicare will cover the doctor conversation.

Here are questions to start the dialogue:

• What are the chances that CPR will save your life?
• What happens to my body when CPR is administered?
• When would artificial nutrition be appropriate?
• What if I just want to be kept comfortable? When would respiratory therapy be considered?
• DNR: Where should the DNR go and who should have it?

The two most important places a DNR should be kept:

• The Refrigerator
• In Your Wallet.

Make several copies and make sure your family and doctor also have a copy.

Consider how a Living Will and a DNR affects your life.

Your life is your choice.

Still Have Questions?

Do you need additional information about a DNR? Contact Us. We look forward to answering your questions.

For some of us, what we hear on the news about the pandemic occurring in nursing homes, and other congregate living communities can be frightening.  Is now the best time to move? For independent living retirement communities (aka CCRC’s) much is the same.  Here are two communities in Northern VA sharing what has changed, if anything.

Goodwin House (Bailey’s Crossroads and Alexandria 703.820.1488) has seen very few changes.  Due to their geographic location, move-ins remain strong during the pandemic.  By proactively sharing how infection control is managed, older adults are feeling comfortable to continue their transition plans to enter a robust retirement community.  However, according to Sue Dolton in Sales and Marketing, Goodwin House has seen about a 47% drop in new inquiries.  Tours are not being done and some older adults are postponing decision to become a priority club member (aka waitlist). Potential residents indicate they feel the world is uncertain.  Others find the prospect of putting their home on the market and having buyers walk through their homes feels unsafe at this time.  What older adults do not appear concerned about is the current real estate market and the strength of their finances according to Sue.

Resident life in Goodwin house has changed to some degree.  There is no congregate dining currently. Three meals a day are being delivered to residents in their apartments.  Activities and events are occurring, but differently.  Many opportunities to be active are happening outside in the warmer weather.  Masks, 6 ft. social distancing, etc. is the standard practice during gatherings.

Non-essential, non-emergency visitors are discouraged. Visitors are screened. Testing of residents and staff is ongoing at Goodwin House to ensure a safe and healthy community.

In Loudoun County, Ashby Ponds, (703.723.1999) a continuing care retirement community developed and managed by Erickson Living, has seen a modest decline in new inquiries.  According to Holly Henderson, Director of Sales, the community and its marketing partners quickly recognized reductions in advertising (direct mail, digital) would be wise for the time being.  What has remained strong are the number of inquiries and engagement levels for Priority List members.  These members are still learning about the campus by speaking with residents and employees about how Ashby Ponds is responding to the COVID-19 crisis.  Like other senior living communities, Ashby Ponds is taking all necessary precautions to protect everyone’s health.  Families of current residents share grateful messages to the staff for keeping their loved ones safe during the pandemic.

Move-ins at Ashby Ponds are occurring due to a continued hot real estate market, according to Holly. “…Some new residents literally had no place to go” because their homes sold quickly. Other potential residents are waiting to move until a vaccine can provide a higher level of comfort or, at the very least, lightening of government restrictions.  However, Holly noted an uptick of cross country moves so residents can be nearer to family in Northern Virginia, providing a better support system during the pandemic.

There’s no doubt that making the decision to move without being able to visit does present a challenge in really getting the feel of the community lifestyle in person. Currently, Ashby Ponds is using technology like never before, such as for virtual tours of apartment homes.  The anticipation is for Virginia to be lifting restrictions soon and the summer and fall will be an even busier move-in season than normal.

As many of us are on ‘hold’ to make changes in our lives, it’s good to know older adults are moving along to make their dreams and plans of living in a retirement community a reality no matter what the circumstances may be.

For further information or help with selecting the best senior living community for you, call 571.437.9396 Caring Considerations Email: [email protected]

I often find our local, northern Virginia government confusing and overwhelming.  We hope that if you need mental health resources that you will contact our Aging Life Care Professionals at 571-488-9396 or reach out to the entities below:

Local Resources:

• Fairfax-Falls Church Community Services Board offers help for mental health, substance abuse, and developmental disabilities. Click here for a flyer on getting help during COVID-19, or call 703-383-8500 for more information and to apply for services.

• Prince William County Community Services Board provides mental health, developmental disability, substance abuse, emergency services and early intervention programs for residents of Prince William County. You can visit their website for more information, or call 703-792-7373 (Woodbridge) or 703-792-5241 (Manassas) if you need assistance.

• PRS provides skills training and supports to individuals living with mental illness, substance use disorders, mild intellectual disabilities, autism spectrum disorders  throughout Northern Virginia and in the District of Columbia. For more information on services offered in Virginia, call 703-536-9000 or click here.

• If you need mental health support, or assistance with other essentials like finding food and paying rent/mortgage, dial 211 to be connected with someone who can help.

For Immediate Help:

• Disaster Distress Helpline. Call 1-800-985-5990 or text TalkWithUs to 66746.The Disaster Distress Helpline (DDH) provides crisis counseling and support for anyone in the U.S. experiencing distress or other behavioral health concerns related to any natural or human-caused disaster, including public health emergencies.

• National Suicide Prevention Lifeline. Call 1-800-273-TALK (8255) or click here to chat online. Offers 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals.

• Caregiver Help Desk. Contact Caregiver Action Network’s Care Support Team by dialing 855-227-3640. Staffed by caregiving experts, the Help Desk helps you find the right information you need to help you navigate your complex caregiving challenges. Caregiving experts are available 8:00 AM – 7:00 PM ET.  
•   If you are in an emergency, call 911.

For LGBTQ+ Individuals:

• LGBT National Help Center. Call 800-246-7743 or visit glbthotline.org. Offers a talkline and weekly chatrooms for youth, providing confidential peer-support, information, local resources and community. 

• The Trevor Project. Call 1-866-488-7386 or text START to 678678. A national 24-hour, toll free confidential suicide hotline for LGBTQ youth.

• Trans Lifeline. Dial 877-565-8860. Trans Lifeline’s Hotline is a peer support service run by trans people, for trans and questioning callers.

For Survivors of Assault and Abuse:

• National Domestic Violence Hotline. For any victims and survivors who need support, call 1-800-799-7233 or 1-800-799-7233 for TTY, or if you’re unable to speak safely, you can log onto thehotline.org or text LOVEIS to 22522.

• The National Sexual Assault Telephone Hotline
  Call 800-656-HOPE (4673) to be connected with a trained staff member from a sexual assault service provider in your area.

For Veterans

• Veteran Crisis Line. Call 1-(800) 273-8255 and press 1, text 838255, or click here to reach a qualified responder with the VA.

• Department of Veterans Affairs. Click here for a resource guide to help veterans manage stress during the pandemic.

Please continue to take care of yourselves and each other, and remember that my office is here to help. Be sure to visit the COVID-19 page on my website for more information and resources. If you have any questions or concerns, or if you need assistance, please don’t hesitate to call us at (703) 256-3071.

Sincerely,

Gerald E. Connolly
Member of Congress