Comfort One
Your Comfort, Your Care, Your Choice

If you have questions about Comfort One or advance directives  - - or wish to sign up for Comfort One, contact your local health care provider.

Montanans have the opportunity and the right to limit the care received in a medical emergency. Designed for the person not in the hospital, Comfort One provides on the spot identification to rescuers that you do not want to be resuscitated. You will be provided only comfort care and be allowed to die in the natural course of your illness.

Enrollment is limited to those who have a terminal illness or those whose physician has ordered "do-not-resuscitate" status. By displaying the Comfort One form, wallet card or bracelet to emergency medical service personnel, you will avoid all efforts of resuscitation.

Pursuant to the legislation creating Comfort One, no documentation except the Comfort One form, wallet card or bracelet will restrict EMS or other health care providers outside of the hospital from providing life-saving measures. Prior to the implementation of this law, several different types of documentation were presented to EMS personnel in an attempt to avoid resuscitative efforts. These documents ranged from hand-written "do- not-resuscitate" orders to living wills, all of which cannot legally stop CPR from being performed.

Comfort One forms and jewelry are the only credentials approved by the Montana Department of Public Health and Human Services.

Comfort One forms, wallet cards, and jewelry must be obtained from your health care provider. MHA or Comfort One cannot issue forms or jewelry directly to patients.

Don't be fooled by other documentation, medallions or jewelry. Unless you have the Comfort One credentials obtained directly from your health care provider, you will be resuscitated.

Do I Qualify for Comfort One?

To determine if you may qualify for Comfort One, ask yourself the following questions:

	Do I have a terminal illness and a valid living will?
	Has my doctor issued a DNR order for me?

If you answered "No" to both questions, you do not qualify for the program..

Frequently Asked Questions

Where can I get Comfort One forms and bracelets?

Montana Administrative Rule allows only physicians, hospitals, home health agencies, hospice agencies and long term care facilities to issue forms and bracelets to patients. The ultimate source of enrollment is with your physician as Comfort One requires a physician's signature on the form. Both the form and the wallet card come as a complete unit, bracelets are available for purchase separately. Blank forms or bracelets are not available to patients from the Comfort One Program.. Only health care providers can order these materials directly from Comfort One. Contact your physician to obtain enrollment information.

I have a living will and don't want to be resuscitated if my heart stops. Do I qualify for Comfort One status?

Based upon only your living will, you do not qualify for Comfort One status. However, if you have been diagnosed with a terminal condition, you qualify. Another option for qualification is to talk with your doctor about your medical treatment preferences and decide with him your options regarding DNR status. If your physician, based on medical and ethical guidelines, can order do-not-resuscitate status for you, then you will qualify for the program. Your living will is valid only in the hospital setting. If it is presented to EMS personnel, it will be disregarded.

I have a "Medic-Alert" bracelet, engraved with DNR on the back. Will that stop me from being resuscitated?

No. Only the bracelet approved by the Montana Department of Health and Environmental Sciences is approved for use in the state of Montana. Comfort One is the only bracelet that can identify you as "no CPR." These are available only from your health care provider for a nominal fee. If you see bracelets or medallions offered by other companies, while attractive and official looking, don't be fooled. Bracelets other than Comfort One will be disregarded in the state of Montana.

I am a Comfort One patient. What if I am choking or have another injury or condition? Will I be allowed to just die?

No. EMS personnel will be certain of your condition before withholding lifesaving measures. If you have an obstructed airway, they will attempt to remove the obstruction and restore normal breathing. Other injuries and conditions will be assessed and will be treated using standard procedures. If you are injured in a car accident or you slip and fall in your home, for example, your injuries will be treated following standard medical procedures. However, if your heart stops beating, they will not resuscitate you.

I am not terminally ill. However, I have many health conditions and don't want to be resuscitated if my heart stops. Do I qualify for the program?

Montana law has made a provision for patients who are not terminally ill to qualify for the program through a do-not-resuscitate order issued by a physician. As each patient's condition is uniquely different, you need to make an appointment with your physician to discuss end of life matters. He can help you decide whether Comfort One is appropriate for you. After considering all medical and ethical guidelines, if your physician is comfortable in ordering Comfort One status for you, enrollment can be immediate.

What if my doctor enrolls me in Comfort One and I change my mind. Can I revoke Comfort One and be resuscitated?

If you are uncomfortable with the program and have not committed to a decision, hold off enrolling in the program until you are sure. If you decide to proceed with DNR status, remember it goes into effect as soon as the form has been signed by your physician.

You can revoke your Comfort One status any time.
By returning your credentials to your physician or destroying them altogether, your do-not-resuscitate status is revoked immediately. If you choose to revoke, please contact your physician or other health care provider. If you have a bracelet, please return it to your health care provider for proper disposal.

If EMS has been called and at the last minute you change your mind, be sure and tell them if you can. It is also best to have them get your physician on the telephone and explain the situation to them and wait for EMS to speak with the physician. If you are unconscious and EMS personnel locate your Comfort One credentials, you will be allowed to die in the natural course of your illness.

ONLY you or a physician can revoke your DNR status, so it's best to revoke before an emergency.
Family members cannot revoke Comfort One for you. As imminent death is an emotional time for you and your loved-ones, EMS cannot rely on family members when revocation of DNR status is in question. They will rely on the Comfort One documentation they have and not resuscitate.

My family and friends know I don't want to be resuscitated if my heart stops beating. If they tell EMS at the scene of an emergency that I don't wish to be resuscitated, won't that suffice?

No. You must have a Comfort One form, wallet card or bracelet with you. EMS personnel must follow the orders of a physician, outlined on the appropriate Comfort One credentials to be within the scope of Montana law. As a patient, it is your right and responsibility to be sure that all end of life decisions and advance directives are documented and made well in advance of an emergency.