Medical Orders
Medical orders typically come in (and on) two forms:
- DNR - Do Not Resuscitate (Yellow)
- MOST - Medical Order for Scope of Treatment (Pink)
Both forms require consultation with a physician (MD, DO), physician's assistant (PA) or nurse practitioner (NP) and must be signed by that person. MOST orders also require signing by the patient or the patient's representative; DNR's do not.
Existing DNR orders remain valid for one year after signing or have no expiration date.The MOST order is a more recent option. Choosing which one to implement is made through discussions between the health care provider and the patient or patient representative(s).
DNR orders are simpler; they focus on the desire to have or not have cardiopulmonary resuscitation.
MOST orders provide choices relating to several kinds of treatment; they are more of a 'salad bar.' Being newer than DNR's means that health care providers are less familiar with them.
EMS (Emergency Medical Service) staff are trained to look for and observe the particularities of each form and act accordingly.
The forms are available online (example copies only; the actual form is only available through a health care provider).
A training video about the two forms and their appropriate uses is available from
http://www.emspic.org/MOST/credit.html.
--Source: Tina Como, Training Chief, Eastern Wake EMS http://easternwakeems.com/
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2009/2010 FCAT Price Survey
The 2009/2010 survey of prices for goods and services at more than 130 funeral homes and crematories in and arround the Research Triangle area of North Carolina has been released. It is available for download and use at this web site.
FCAT volunteers have used best efforts to enter data correctly. If errors other than a change of price since the summer of 2009, please let us know by email to
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
and we will make corrections.
"n.d. means no data and was used to keep data aligned in columns."
This survey is available in these forms:
Sortable Survey Pages
1. Pages you can sort by firm name, city, zip code, or any of several prices that were collected in the survey.
Address Data
Price Data
Lookup by Zip
Look up firms that have zip codes close to one that you live in or want to know about.
Using This Form
The form can help you find funeral homes that are relatively close to a zip code you enter, along with a distance radius within which the funeral homes in the FCAT price survey have their own zip codes.
The zip code data cover the entire United States, but the current funeral firm data are only for a portion of North Carolina. So you can enter, for example, a zip code from Virginia along with a distance of 100 or 200 miles and get results showing some North Carolina funeral home. But the intended use is for zip codes in central NC to find firms within 5, 15 or 30 miles, for example.
The columns are sortable: they come arranged by distance, but can be sorted by firm name, town, or zip code, for example
The distances are approximations based on a location that is central to each zip code. But zips vary widely in size from rural to urban areas. This means actual road distance (not a point-to-point straight line) may be longer than the value given. Still, having the approximation will get searchers started in an area with which they are unfamiliar. Use it but check things out on the ground with a map and increase your familiarity with the locality of interest:
Funeral Home Lookup by Zip Code
Report and Tables -- Downloadable
These files are in .pdf format. You can right click and save them. (A free .pdf reader is available from Adobe.com if it is not already installed on your computer.)
On this site is a report about the survey and copies of the tables. You can look at this on the site or download it to your own computer to read, print, and share with others.
Please check Home page, Resources menu, Download item to download price survey reports.
If you find these materials useful, please consider making a donation to FCAT for its continued work providing information, education, and advocacy relating to end-of-life issues.
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Caring Connections...... is a program of the National Hospice and Palliative Care Organization (NHPCO), is a national consumer and community engagement initiative to improve care at the end of life. FCAT is a member organization and we highly recommend their web site for information about planning ahead your end-of-life decision-making. Their website is: www.caringinfo.org. Under the heading “Planning Ahead” you will find detailed information on the following topics: • Advance Care Planning o How to Talk with Your Loved Ones
o What to do if Family Members Disagree
o How to Talk with Your Healthcare Providers
o Talking with Others about Their End-of-Life Wishes • Advance Directives o What are Advance Directives?
o Healthcare Agents: Choosing One and Being One
o Preparing Your Advance Directives • Financial Information o Information for Family and Friends of People at the End of Life
o Identify Sources of Financial Help
o Financial Advice
o Financial Information for People Facing the End of Life
o Plan a Funeral/Memorial Service
o Find a Financial Planner
In addition, Caring Connections provides state-specific advance directives and information on finding a hospice in your community.
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Sunday, 15 June 2008 10:12 |
Planning
Planning for death is the title of a series of talks on Marketplace Money, a part of American Public Media. Much of the focus is on the estate planning side, with needs for wills (only about half of us have them).
This is the link to the first article in the series. It aired before 0800 hours on Sunday morning, 15 June, but you can listen to a podcast of it and the sequels, which will follow, a couple each Sunday, I believe.
Grief
Death is hard and painful for survivors --- each in his or her own way. Grieving is natural process not one event; ordinarily it is not a mental illness or weakness. There is no standard way of grieving that fits everyone; each of us creates a unique way. Nor is there a standard time line.
Hospices and other health care institutions, funeral homes, religious and social services institutions may offer grief or bereavement services local to you. These may include series of group sessions, single events, and individual counseling. Hospice of Wake, among others, offers helpful programs in Wake County. Check the web and your local organizations when you or those you know might be ready for such aid.
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The July 2008 issue of Consumer Reports (pp 40-44) reports on a study of health care in the last two years of life for Medicare patients. It contrasts the outcomes at medical centers with practice models that vary from conservative to aggressive for serious illnesses. It finds major differences in the costs, tests, physician visits and hospital stays, all of which are larger at the aggressive end of the spectrum. But this extra effort does not lead to longer or better quality of life or to higher satisfaction with care received. There is much more in the article but it raises serious concerns about when a shift should be made by each patient from seeking a cure to accepting palliative care aimed at providing the best quality of life knowing that death is coming. You can find ratings of hospitals, cities and states and other materials from the study at Dartmouth Atlas.
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