By Karen Bishop, RN, ADON
The Heights at Birchaven
Maybe you or a family member have been asked by a health care professional, “What is your code status?” Most people respond by saying they have a living will. Let us discuss the difference between a living will and a code status.
A living will is in effect when you can no longer make any decisions on your own. While you are still able to make your own end-of-life decisions, you may want to put in writing some of your wishes. Do you wish to be put on life-support, such as a breathing machine (ventilator)? Do you wish to have fluids given to you such as a tube feeding or IV fluids? Do you wish to have pain medications? Those are the kind of questions you answer when you make out a living will. Again, these wishes do not take effect until you can no longer make a decision for yourself.
A code status is a decision you can make today. When you are admitted to a nursing facility, this question will come up. Your code status will inform the medical professionals of your present wishes. If a medical emergency were to happen to you, what would you like the medical professionals to do? Do you want them to start CPR? Do you want them to shock you with the pads/paddles in an attempt to restart your heart? Do you want a tube put down your throat to assist with your breathing if you stop breathing? Or do you have a condition where you would just like to be kept comfortable? Talk with your physician and family about these options.
A code status comes in three types. Full code, DNR-CCA and DNR-CC. (Some institutions may have more options.)
A full code means that medical personal would do everything possible to save your life in a medical emergency. In the event that you stop breathing and your heart stops, everything possible will be done to sustain your life. CPR will begin, oxygen will be given, a breathing tube inserted may be inserted, and an automated external defibrillator (AED) may be used. These are a few of the life-saving measures that will be used.
A DRN-CCA (comfort care arrest) is another option. In the event of a change in your condition like breathing or cardiac problems, you would seek medical treatment. You would go to the emergency department of the nearest hospital and have testing done. You may receive oxygen but not administered with a breathing tube. You may get an IV. You will not receive shocks delivered from the AED or heart compressions as preformed in CPR. You would receive treatment until your heart stops beating.
A DNR-CC (comfort care) is yet another option. In the event of a severe change in your condition or a terminal illness, life-saving measures would not be initiated. A physician would order medications to keep you as comfortable as possible.
Talk with your physician about these options. Take the time to discuss your wishes with your family. It is better to be prepared!
