Many older people have had discussions with their doctor about end-of-life decisions, including a do not resuscitate order, or DNR.

And they've talked with their children about their wishes, what kind of life-sustaining procedures they want or don't want. 

But if a medical emergency occurs at home, the paramedics responding need to know those wishes, too.

The local Emergency Medical Services Oversight Authority has developed a standard DNR form that people can sign, have their doctor sign and then hang on their refrigerator, said Pam Randall, director of emergency services for St. Elizabeth Regional Medical Center and a board member of the oversight group.  

The DNR form, folded, will fit in a magnetized "File of Life" folder that can hang on a refrigerator and is available at senior centers and fire stations across Lincoln.

The File of Life comes with a card where you can record all necessary medical information, including prescriptions and dosages.

Accurate medication lists also can help the emergency responder and emergency department personnel, Randall said.

She suggests also putting a copy of medications and dosages in your wallet or purse, just in case.

Volunteers have been providing File of Life folders to seniors for more than a decade.

People put them on their refrigerator where emergency responders know to look. They also can take the packets with them when they go to the doctor or hospital, said Lily Hans, a volunteer who coordinates the File of Life program.

The card has a line indicating whether a person has a DNR and space to put where it is located. 

But the signed DNR form needs to be readily available for emergency responders, Randall said.

Lincoln Fire & Rescue personnel have to do CPR, unless they have the signed DNR paperwork, she said.

The single-page form on the refrigerator is easy to grab and hand to them, she said.

DNR forms are different from living wills, Randall said. A living will lists the people who can take over health care decisions if someone is incapacitated.  

The DNR specifically says the person does not want a tube placed in their airway nor do they want to be given CPR if their heart stops beating, she said.

This standard DNR form says the person has been diagnosed with a medical illness and has discussed treatment options with a physician.

The form also requires a physician's signature, indicating that professional believes a DNR order is appropriate.

The standardized DNR forms are being distributed to nursing facilities and physicians, she said.  

Having a standard form makes it easy to recognize so paramedics and other local medical professionals know at once what it is, Randall said.

The Emergency Medical Services Oversight Authority is a collaborative governing board that includes representatives from the two Lincoln hospitals and mayoral appointees.

Reach Nancy Hicks at 402-473-7250 or