I understand how difficult this must be for you. I have been in LTC for several years and have been in LTC management for most of the time. Resident's have RIGHTS. Be it a nursing home or private care home(often referred to as Adult Family Home), and even Assisted Living. If your resident is a 'DNR', that specifies what you do 'if' you found the person without heart beat or breathing. DNR does not specify exactly what one is to do for someone who is refusing medical treatment. However, in the LTC facilities I have worked in, when we have a resident who is of the same mind-set as the patient you care for, we honor their wishes. Some things you need to chart in the resident's record or keep personal charting for protection for yourself are: Any Risk vs. Benefit of not complying with medical/nursing treatment, and make sure your resident understands there is a very real risk of dying by refusing medical treatment, chart that you have alerted the resident's MD and any family member or Durable Power of Attorney of the resident's wishes. If the home has a MSW, alert them, to. Please offer and chart offers of Hospice services to the resident. If you are concerned that your resident is suffering and will ultimately die, offer Hospice Services, or recommend your employer offer Hospice to the resident. If you still remain worried, call your local Long Term Care Ombudsman and speak with them annonymously. Alert them to what is going on and ask if they have any recommendations. Call your Board of Nursing and see what thoughts they have on your situation. Better to call everyone in the whole world, than making a HUGE mistake and having to pay the price.
One last thought: I made my significant other, who is a nurse, also, promise to honor my wishes. My wishes are if I get a disease that causes dementia or Alzheimer's (or any other brain trauma/injury/brain disease), that my significant other will honor my wishes and allow me to die. Do not force me to live beyond what nature intended.