Guidelines For DNR Policies in Nursing Facilities

GOVERNMENT Policies related to older People in the Philippines
1. Republic Act no. 344

Republic Act No. 344 or the Accessibility Law of 1982 provides for the minimum
requirements and standards to make buildings, facilities, and utilities for public use
accessible to persons with disability, including older persons who are confined to
wheelchairs and those who have difficulty in walking or climbing stairs, among others.
Republic Act No. 7876 entitled “An Act Establishing a Senior Citizens Center in all Cities
and Municipalities of the Philippines, and Appropriating Funds Therefore” provides for the
establishment of Senior Citizens Centers to cater to older persons’ socialisation and
interaction needs as well as to serve as a venue for the conduct of other meaningful
activities. The DSWD in coordination with other government agencies, NGOs and people’s
organisations shall provide the necessary technical assistance in the form of social and
recreational services, health and personal care services, spiritual services, livelihood
services and volunteer resource services.
3. Republic Act no 8425
Republic Act No. 8425 provides for the institutionalisation and enhancement of the social
reform agenda by creating the National Anti-Poverty Commission (NAPC). Through its
multi-dimensional and cross-sectoral approach, NAPC provides a mechanism for older
persons to participate in policy formulation and decision-making on matters concerning
poverty alleviation.
4.Republic Act No. 10155
known as “The General Appropriations Act of 2012”, under Section 28 mandates that all
government agencies and instrumentalities should allocate one percent of their total
agency budget to programs and projects for older persons and persons with disabilities.
Republic Act No. 9994, known as “Expanded Seniors Citizen Act of 2010″, an act granting
additional benefits and privileges to senior citizens, further amending Republic Act No.
7432 and otherwise known as “an act to maximise the contribution of senior citizens to
nation building, grant benefits and special privileges and for other purposes”.
6. Presidential Proclamation no. 470 series of 1994
Presidential Proclamation No. 470, Series of 1994, declaring the first week of October of
every year as “Elderly Filipino Week.”
7. Presidential Proclamation no. 1048 series of 1999
Presidential Proclamation No. 1048, Series of 1999, declaring a “Nationwide Observance in
the Philippines of the International Year of Older Persons”.
8. Executive Order no. 105 series of 2003
Executive Order No. 105, Series of 2003, approved and directed the implementation of
the program providing for group homes and foster homes for neglected, abandoned,
abused, detached, and poor older persons and persons with disabilities.
10. Do Not Resuscitate Orders

A “Do not resuscitate” (DNR) order is a specific order from a
physician, entered on the physician order sheet, which instructs
health care providers not to use or order specific methods of
therapy, which are referred to as cardiopulmonary resuscitation
(CPR)
The Health Insurance Portability and Accountability Act of
1996 (HIPAA) may:
1. Increase a person’s ability to get health care coverage when the person begins a new
job;
2. Lower the chance of losing existing health coverage, whether the coverage is through a
job or through individual health insurance;
3. Help maintain continuous health coverage when a change of job occurs; and
4. Help purchase health insurance coverage individually if the coverage is lost under an
employer’s group health plan and no other health coverage is avail able
RESIDENT BILL OF RIGHTS

1. The right to select a personal attending physician and to receive complete
information about one’s care and treatment, including access to all records
pertaining to the resident
2. Freedom from physical or mental abuse, corporal punishment, involuntary
seclusion, and any unwarranted physical or chemical restraints
3. Privacy with regard to accommodations, medical treatment, mail and tele
phone communication, visits, and meetings of family and resident groups
4. Confidentiality regarding personal and clinical records
5. Residing in a facility and receiving services with reasonable accommoda
tion of individual needs and preferences
6. Protesting one’s treatment or care without discrimination or reprisal, in
cluding the refusal to participate in experimental research
7. Participation in resident and family groups
8. Participation in social, religious, and community activities
9. The right to examine the federal or state authorities’ surveys of a nursing
facility
Guidelines for DNR Policies in Nursing Facilities
• That a facility must have competently trained staff available 24 hours a day to provide
CPR (Schreiber, 1990).
• Whether CPR will be performed unless a DNR order exists.
• The conditions under which the facility will issue DNR orders. These factors should be in
compliance with applicable state law; thus, it is necessary to examine the DNR provisions
of the jurisdiction. Considerations include required physician consultations regarding
medical conditions and documented discussions with the patient and family members.
• That competency is established, again with proper documentation or medical
consultation, as may be indicated by applicable state law.
• The origin of consent for the order: via the patient, while competent; by an advance
medical directive (AMD); or by a substitute or surrogate decision maker.
• Provision for renewal of DNR orders at appropriate intervals with ongoing documentation
of the condition to note changes.
• As required by the TJC standards, the roles of various staff members. The policy should
be approved through all appropriate channels.

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GOVERNMENT Policies related to older People in the Philippines

1. Republic Act no. 344

10. Do Not Resuscitate Orders

RESIDENT BILL OF RIGHTS

Guidelines for DNR Policies in Nursing Facilities

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