Connecticut DNR Form and MOLST: What They Cover and How to Get Them

A living will tells doctors what you want. A MOLST tells paramedics what to do right now. Connecticut treats these as two separate legal instruments, and the gap between them is where families run into problems — usually during a hospital discharge or hospice transition when there is no time to fix paperwork.

Here is how Connecticut's DNR, MOLST, and living will work together, who can sign each document, and what happens when you have one but not the other.

What a Connecticut MOLST Is

MOLST stands for Medical Orders for Life-Sustaining Treatment. In Connecticut, it is an active medical order — not a planning document — that takes effect immediately when signed by both a clinician and the patient or their legally authorized representative.

A MOLST covers specific clinical decisions:

• Resuscitation status — CPR or DNR (Do Not Resuscitate)
• Medical interventions — full treatment, selective treatment, or comfort measures only
• Antibiotics — full use, limited use, or none
• Artificially administered fluids and nutrition — long-term, trial period, or none

The form must be completed on the state-prescribed template from the Connecticut Department of Public Health. A clinician who can sign includes a licensed physician, advanced practice registered nurse (APRN), or physician assistant.

MOLST vs. Living Will: The Critical Difference

The practical implication: if a paramedic arrives at your home and you are in cardiac arrest, they look for a MOLST — not a living will. A living will requires a physician to determine that you meet the statutory threshold before it becomes operative. A MOLST is already operative.

Families frequently report being told in the ICU that their parent's living will is "useless" because the patient does not meet the terminal or permanently unconscious criteria. This is not a failure of the document — it is a failure to understand that a living will and a MOLST serve different functions.

How to Get a DNR in Connecticut

A DNR (Do Not Resuscitate) order in Connecticut is one component of the MOLST form — specifically, the resuscitation section. You cannot get a standalone DNR order without completing the full MOLST.

To obtain a MOLST with a DNR designation:

1. Initiate a conversation with your physician, APRN, or PA. The clinician must determine that MOLST is clinically appropriate — it is designed for patients with serious illness or advanced frailty, not healthy adults doing general planning.

2. Discuss your treatment preferences. The MOLST conversation covers resuscitation, medical interventions, antibiotics, and nutrition — not just DNR.

3. Sign the state-prescribed form. Both you (or your legally authorized representative) and the clinician must sign. There are no witness requirements for a MOLST.

4. Keep the original accessible. The MOLST should travel with you — on your refrigerator, in a folder by the front door, or clipped to your medical chart. Paramedics cannot honor a document they cannot find.

When You Need Both

For most Connecticut residents doing advance care planning, the recommendation is to complete both documents:

The advance directive (with living will) establishes your long-term legal framework — who speaks for you, what you want if you become permanently incapacitated, and how specific scenarios should be handled. It is executed once and updated as life changes.

The MOLST provides immediate clinical instructions that paramedics and emergency personnel can follow without waiting for a physician to activate your living will. It is reviewed and updated as your medical condition changes.

A common scenario: a parent is discharged from a Connecticut hospital to home hospice. The family has a living will on file, but when a medical crisis occurs at home, the paramedics arriving cannot honor the living will directly — they need a MOLST. Without one, default protocol is full resuscitation.

What Happens Without Either Document

If you have neither a living will nor a MOLST and you lose decision-making capacity, Connecticut law establishes a default hierarchy for who makes medical decisions:

1. Court-appointed conservator
2. Spouse or civil union partner
3. Adult child
4. Parent
5. Adult sibling

Family disagreements in this hierarchy can delay treatment decisions and, in contested cases, require probate court intervention to resolve.

Key Points to Remember

• A DNR in Connecticut is part of the MOLST form, not a standalone document
• A living will and a MOLST serve different functions — one is a planning document, the other is an active medical order
• You typically need both for comprehensive coverage
• The MOLST requires a clinician's signature; a living will requires two witnesses
• Neither document requires notarization, though the advance directive benefits from the optional witness affidavit

The Connecticut Advance Directive & Living Will Kit includes a MOLST conversation guide and explains how to coordinate your living will with clinical orders so there are no gaps when a medical crisis actually occurs.

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