Health care proxy, MOLST and DNR: what do they mean in a New York nursing home?

The documents

• Health care proxy. Signed by the resident while able, naming a health care agent. The agent's authority begins when the resident is determined to lack capacity. The agent is entitled to the medical information needed to make decisions.
• MOLST. A bright pink New York form that records decisions about CPR, intubation, hospital transfer, artificial nutrition and other treatment as medical orders. It should be reviewed periodically and when the resident's condition changes.
• DNR (do not resuscitate). An order not to attempt CPR. In nursing homes it usually appears on the MOLST. A DNR does not mean "do not treat"; the resident is still entitled to all other care.
• Living will. A written statement of the resident's wishes, which guides the agent and the team.
• Surrogate. If there is no proxy and no guardian, the Family Health Care Decisions Act sets an order of priority (generally a guardian, then a spouse or domestic partner, an adult child, a parent, a sibling and a close friend).

What families should check

• Is a copy of the health care proxy in the chart, and does the facility have the agent's correct phone number?
• Does the MOLST reflect what the resident actually wanted, and was it discussed with the resident or agent?
• Was the MOLST reviewed after a hospital stay or major decline?

A power of attorney is different. It covers finances, not medical decisions. See does a power of attorney help.