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If you need Caregivers you probably need a DNR. It should be on the frig. I am with Burnt that a CNA should call 911. When the EMTs get there, the aide gives them the DNR and lets the ETMs determine what can and can't be done according to the DNR.

About 10 yrs ago, NJ redid the DNR. The new one lists what you want and don't want. I had to do one for every facility she was in and their doctor sign it. Also in my state of NJ, and the State of Delaware, require CNAs/HHAs to certify in CPR. But not all aides are certified nurses aids and don't have to be when private. Nursing homes where I live train their CNAs.
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Anyone you hire either privately or through an agency should be aware of what you expect. If they do not feel comfortable following those instructions they you look for someone else.
Someone may not be comfortable NOT calling 911 in an emergency but if the person/patient is on Hospice you do NOT call 911 you call Hospice.
So a detailed discussion should be had with the agency and the caregiver to be sure they understand your instructions and what is good for the patient. And your instructions should be written out.
And if they are to call 911 that should be posted along with the medical directive. If they are to call Hospice that number should be posted as well.
Also..fyi if a person does NOT want CPR or other lifesaving measures and the POLST or DNR is not posted or can not be located and 911 is called the EMS responders are required to preform lifesaving measures until the document is located. I had a POLST posted and I always carried a copy with me just in case.
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BurntCaregiver Jul 12, 2025
@Grandma

If someone is in distress even if they have a DNR in place, they need help. Even if the measures taken are just to medicate them or make them comfortable.

I really think it's just asking too much of a homecare aide who has minimal training and is making minimum wage, to just stand there, do nothing, and watch the client die right there in front of them. That's asking too much of an aide. They need to call 911 and get some help because I'll tell you something. 911 is really the only people who are going to answer. I worked for hospice-at-home and had many client emergencies. Good luck trying to get a nurse or someone to help you on a weekend or at night. It goes straight to voicemail and a fat lot of good that does someone in an emergency. 911 will always answer, day or night.
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If a homecare worker doesn't have enough sense to call 911 in an emergency, they're mentally incompetent themselves and should have a homecare worker.

I own a homecare agency. My caregivers are to call 911 in an emergency (their employee handbook states what is considered an emrgency). They do not do CPR, although they may assist if a client is choking. Always call 911 though.
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Okay, I can accept no CPR but they must immediately call 9II.
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Anyone hiring home care must ASK if the workers are trained and accountable to dial 9II and administer CPR. They may not be and you could lose your loved one.
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BurntCaregiver Jul 12, 2025
@randal

How can someone be trained to call 911? You pick up the phone, dial 911, then tell the person who answers what your emergency is and the address.

There really isn't any training for this because there's no training in common sense.
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I think even a child knows to call 911 in an emergency situation, honestly. As for CPR, I wouldn't want a caregiver performing such a potentially bone breaking procedure on my elderly loved one. Both of my elderly parents had DNRs in place, first of all, and I'd want paramedics to see to them first, before a basically untrained caregiver did anything. That's my take on things.
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Surprising and amazingly mine from a local otherwise respected company did not. In the instance of stopped breathing and no heart beat, they did not call 9II or start CPR. They justify this by stating in the contract that “they are not a medical service”. Never occurred to me that they were not trained to immediately call 9II and do CPR. Serious consequences. I would always ask and would never hire a home care worker/company that did not assure emergency medical attention while they are staying alone with a patient.
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lealonnie1 Jul 12, 2025
The CPR I understand, the not calling 911 is unimaginable to me. I'm so sorry!
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