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Do Not Resuscitate Order For Target Employees

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What Is It?

As a Target employee, you have the right to decline medical treatment, even if you die as a result of your decision. Depending on your medical condition, your prognosis, and your views on the quality of life, you may wish to refuse lifesaving measures, such as cardiopulmonary resuscitation (CPR). Executing a do not resuscitate (DNR) order is one way of doing this. A DNR is a doctor's order that tells all other medical personnel not to perform CPR if you go into cardiac arrest. Cardiac arrest occurs when your heart stops beating, blood flow to your brain stops, and you stop breathing. If the blood flow is not quickly restored, permanent damage to the brain and other organs can occur. CPR simulates heartbeat and breathing, while attempting to restart these functions.

The term  CPR  actually encompasses a variety of separate procedures, including cardiac compression, endotracheal intubation, assisted ventilation, defibrillation, and cardiac medications. Most states recognize two types of DNRs. One is effective only while you are hospitalized. The other is used by people outside the hospital--for example, nursing home residents, hospice patients, and even those who are not receiving medical treatment.

Typically, terminally ill patients and elderly individuals execute DNRs to avoid prolonging their final illnesses. However, some states allow healthy adults to execute the orders, as well. Depending on the laws of your state, a DNR used outside the hospital may be called a 'pre-hospital DNR,' 'out-of-hospital DNR,' 'outpatient DNR,' 'DNR for EMS,' or 'CPR directive.' As a result of your request, your doctor generally notes an in-hospital DNR order on your chart. Out-of-hospital DNRs take various forms, depending on the laws of your state. ID bracelets, MedicAlert necklaces, and wallet cards are some methods of noting DNR status.

When Can It Be Used?

Availability of DNRs Is Determined By State Law

Not all states have DNR laws. For Target employees, you may want to consider how your state's laws govern whether DNRs are permissible, who can execute a DNR, and what form the order must take. These laws may permit in-hospital DNRs, out-of-hospital DNRs, both of these, or neither of these. Some state laws allow any person of legal age to execute a DNR, while others permit DNRs only for individuals with terminally ill conditions. Some states allow children to participate in decisions regarding DNR in certain cases. Check the laws of your state and any other states where you spend a significant amount of time.

Strengths

Allows You to Exercise Choice In Medical Treatment

Cardiopulmonary resuscitation (CPR) has produced some miraculous results when used on normally healthy individuals in trauma situations. However, it can be a painful and even violent procedure. Its effectiveness is limited when used on terminally ill or hopelessly deteriorated patients. In some cases, CPR only delays the moment of death.

For example, CPR could restore your heartbeat, but if permanent brain or organ damage occurs during cardiac arrest, you may be dependent on life support machines. Executing a do not resuscitate (DNR) order allows you to choose a natural death.

Example(s):  Hal is hospitalized with a terminally ill condition. He is on a respirator and knows he has only a short time to live. Hal consults his doctor and learns that the laws of his state permit in-hospital DNRs. This will allow him to forego CPR if his heart fails. Hal asks his doctor to execute a DNR as soon as possible. The following week, Hal's heart stops. Because of Hal's DNR, hospital personnel do not attempt CPR.

Specifically Intended for an Emergency Situation

If you go into cardiopulmonary arrest, your DNR lets medical personnel know that you don't want CPR. Because of the emergency nature of this situation, other types of advanced directives are usually not timely enough to accomplish this goal.

Tradeoffs

Extremely Limited Usefulness

Although a do not resuscitate (DNR) order is a very powerful instrument, it is only effective under specific conditions. Generally, a DNR comes into play only if you go into cardiac arrest, and it frequently only allows you to refuse cardiopulmonary resuscitation (CPR), although in some states it may allow you to decline other drastic medical treatment as well. A living will or durable power of attorney for health care may be needed to convey other medical treatment instructions, such as your wishes regarding life support and intravenous feeding.

Out-of-Hospital DNR May Not Be Effective In Other States

As a Target employee, it is beneficial to understand how an out-of-hospital DNR that is valid in your state may not be valid in other states. Therefore, if you spend a significant amount of time in another state, you should find out whether that state's laws recognize DNRs, whether you are eligible to have a DNR in that state, and what restrictions are placed on the form of the DNR.

Doctors May Be Hesitant to Broach This Topic or Reluctant to Write a DNR

If you are hospitalized with a serious illness, your doctor may not bring up the option of executing a DNR. If you don't want to be resuscitated, you should initiate this discussion with your doctor. Also, studies indicate that many doctors are slow to write DNRs, even when they are aware of their patients' preferences, although the reasons for this vary. If you are a Target employee and want to ensure your wishes are followed, you should touch base with your doctor to make sure the DNR is placed on your chart.

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How to Do It

Research Your State's Laws Regarding Dnrs

Not all states provide for these orders. Each state has its own eligibility requirements, particularly for out-of-hospital DNRs.

Discuss Your Wishes With Your Doctor

Your doctor should be able to provide information on your prognosis and counsel you on your options. If you are a Target employee, your doctor's signature will most likely be required on any DNR you execute.

Execute Your Out-of-Hospital DNR Properly And Keep It With You

If you are a Target employee interested in DNR, you must consider how if your state allows out-of-hospital DNRs, there is probably a required format for the order. Examples of state-required DNR formats include ID bracelets, necklaces, wallet cards, and letter-size forms. If your DNR is not in the required form, it may not be honored. If medical personnel can't find your DNR order, they are obligated to give full and immediate care. Thus, it is extremely important to execute your DNR order properly and keep it with you (or in an appropriate place) at all times.

Example(s):  Hal is a resident of an assisted-living facility. Hal is 89 years old and feels he has lived a good life. He does not want to die in a hospital or be dependent on machines for his survival. Hal discusses his feelings with his doctor. Hal's doctor suggests executing an out-of-hospital DNR, which will instruct medical personnel not to perform cardiopulmonary resuscitation (CPR) if Hal goes into cardiac or respiratory arrest. Hal agrees and receives an ID bracelet noting his DNR status. Hal wears his bracelet faithfully. Six years later, Hal's heart fails as he jogs in the park. Medical personnel arrive on the scene, but immediately notice  Hal's DNR ID bracelet. CPR is not attempted.

Tell People About Your Decision

In general, other people cannot reverse your decision once you execute a DNR. As a Target employee however, if your DNR is misplaced or for some reason is not followed, it would be important for your family and friends to understand your wishes. Although this topic may be difficult to discuss, those close to you are more likely to support and uphold your decision if they understand how you feel and why you feel that way. If you have appointed a representative in a durable power of attorney for health care (DPAHC) , it is especially important that this person be aware of your decision.

Coordinate All Advanced Directives

Since a DNR is so limited in scope, you may wish to establish a living will and/or DPAHC as well. If you do so, make sure your wishes are stated consistently throughout these documents. In some states, the most recent document will govern if there is a conflict, so you must make sure your wishes are clear.

Tax Considerations for Target Employees

Income Tax

None

Gift And Estate Tax

None

Questions & Answers for Target Employees

What If You Go Into a Coma Before Executing Your DNR, And You Can't Express Your Wishes?

Your healthcare representative, if you have appointed one, may be able to have a DNR executed on your behalf. As a Target employee, there must be evidence that this is what you would want. You might include these instructions in your durable power of attorney for health care , especially if the laws of your state do not allow out-of-hospital DNRs. Be aware, however, that this method of instruction is useless in an emergency if your representative is not present. In some states, with your family's consent, your doctor may be able to execute a DNR on your behalf. Again, it would be unwise to rely on this course of action in an emergency.

Can You Change Your Mind?

Yes, it is possible to revoke a DNR order. If you have an out-of-hospital DNR, you may be able to revoke it by simply removing the bracelet or the wallet card. However, some states also have a database of DNR patients. If this is true in your state, you may need to take additional steps to revoke your DNR. When your doctor writes the DNR, ask what steps are necessary to revoke the order.

Additionally, medical personnel must give emergency care to anyone who requests it. For example, Emergency Medical Service guidelines in Wisconsin instruct personnel to perform cardiopulmonary resuscitation (CPR) if a person rips off his or her DNR bracelet or asks for CPR during cardiac arrest.

What are the key benefits provided by Target Corporation's Personal Pension Account and Traditional Plan for employees approaching retirement, and how do these plans ensure financial security during retirement years? Understanding the synergy between these two plans is essential for retirees, as they work together alongside Social Security and personal savings to replace a portion of an employee's paycheck after retirement.

Key Benefits of the Personal Pension Account and Traditional Plan: Target Corporation's pension plan includes two components: the Personal Pension Account and the Traditional Plan. These plans work in tandem to replace a portion of an employee's paycheck during retirement. The Personal Pension Account provides pay credits and interest that accumulate over time, while the Traditional Plan uses a final average pay formula. Together with Social Security and personal savings, these plans help ensure financial security in retirement​(Target Corporation_Dece…).

How can employees elect different payment options, such as the Single Life Annuity or the Joint and Survivor Annuities, within Target Corporation's pension plans? It is crucial for employees to grasp not only the financial implications of these choices but also the necessary spousal consent required when designating a joint annuitant, particularly if the chosen joint annuitant is not the employee's spouse.

Payment Options and Spousal Consent: Employees can elect different payment options, including the Single Life Annuity, which provides the highest monthly benefit and ceases at the retiree’s death, or the Joint and Survivor Annuity, which continues payments to a surviving spouse. To elect a non-spouse as a joint annuitant, spousal consent is required, and this must be notarized to ensure compliance with plan rules​(Target Corporation_Dece…).

In what circumstances might benefits not be paid under the Traditional Plan, and what steps can employees take to ensure they remain eligible for their pension benefits upon termination of employment? Target Corporation's policy outlines several scenarios where benefits could be denied, making it necessary for employees to be proactive in understanding their rights and responsibilities concerning plan participation.

Circumstances for Denial of Benefits under the Traditional Plan: Benefits under the Traditional Plan may not be paid if an employee leaves before becoming vested (less than three years of service). Employees should ensure they meet the vesting requirements and maintain eligibility by avoiding termination before they reach the minimum service period​(Target Corporation_Dece…).

What procedures should employees follow to report changes in marital status, address, or beneficiaries to ensure compliance with the requirements of Target Corporation's pension plan? Employees must understand the importance of timely reporting these changes to avoid potential issues with their retirement benefits and ensure that their pension plan information remains up-to-date.

Reporting Changes in Marital Status or Beneficiaries: Employees must promptly report changes in marital status, address, or beneficiaries to Target's Benefits Center to ensure their pension records remain up-to-date. Failing to do so can lead to delays or issues in processing pension benefits​(Target Corporation_Dece…).

How does Target Corporation determine the final average pay used to calculate retirement benefits under its pension plans, and what factors may affect this calculation? Employees nearing retirement should be fully informed about how their compensation is considered in determining their pension benefits, including aspects such as bonuses and overtime that may influence their final average pay calculation.

Final Average Pay Calculation: Target Corporation calculates final average pay based on the five highest years of earnings out of the last 10 years of service. This includes regular pay, overtime, bonuses, and commissions but excludes items like workers' compensation or long-term disability payments​(Target Corporation_Dece…).

How can employees begin the process of rolling over their Target 401(k) accounts into the Pension Plan, and what advantages does this Pension Purchase Program offer? Understanding this rollover option is vital for maximizing retirement benefits, as it can provide employees with a stable income stream while avoiding unnecessary fees typically associated with purchasing annuities outside the plan.

Rolling Over 401(k) into the Pension Plan: Employees can roll over their 401(k) accounts into the Pension Plan using the Pension Purchase Program. This option offers several advantages, including avoiding fees associated with purchasing annuities outside the plan and receiving a stable income stream during retirement​(Target Corporation_Dece…).

What are the implications of a participant's age and joint annuitant's age on the payment amounts under the various Joint and Survivor Annuity options at Target Corporation? Employees should be aware of how age differences can impact their pension payouts, as the specific percentages payable under these options may vary based on the ages of both the participant and their designated joint annuitant.

Effect of Participant and Joint Annuitant’s Age on Payments: The Joint and Survivor Annuity options are influenced by the ages of both the participant and the joint annuitant. The younger the joint annuitant, the lower the monthly payout due to actuarial adjustments. Employees should consider these factors when selecting an annuity option​(Target Corporation_Dece…).

How are retirement benefits managed during potential plan terminations or amendments at Target Corporation, and what protections are in place for employees in these scenarios? Employees should be well-informed regarding their rights in the event of changes to the pension plan, including how benefits would be distributed and under what circumstances they may remain fully vested.

Plan Terminations or Amendments: In case of plan terminations or amendments, vested benefits are protected, and employees will receive their earned pension. If the plan is amended or terminated, Target ensures that vested benefits are distributed according to the plan's terms​(Target Corporation_Dece…).

For employees retiring or leaving Target Corporation, what options are available with respect to unused vacation time and how might this be factored into pension calculations? Understanding how accrued time off translates into benefits could have a significant impact on an employee's financial positioning upon retirement.

Unused Vacation Time and Pension Calculations: Unused vacation time does not directly affect pension benefits but can be included in eligible earnings calculations that determine final average pay. Employees nearing retirement should consult with Target’s Benefits Center to understand how unused time may impact their overall benefits​(Target Corporation_Dece…).

How can employees contact Target Corporation for assistance with their retirement benefits to address any questions or concerns they may have about their pension plans? Accessing the right resources and support is essential for employees to navigate their retirement benefits effectively. They can reach out to the Target Benefits Center at 800-828-5850 for more specific inquiries related to their personal circumstances. These questions aim to enhance employees' understanding of their retirement benefits, ensuring they are well-prepared for their transition into retirement.

Contacting Target for Pension Assistance: Employees can contact the Target Benefits Center at 800-828-5850 for assistance with their retirement and pension plans. This center provides support with any questions related to pension options, payments, and administrative requirements​(Target Corporation_Dece…).

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For more information you can reach the plan administrator for Target at 10 South Dearborn Street 48th Floor Chicago, IL 60603; or by calling them at 1-800-440-0680.

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