End of Life Care…Not Storage

Is it necessary for (A) patient and family have to ask the Nursing Staff and the Doctor writing the admission orders exactly what does DNR and CMO mean to them? Is there not a standard of practice that should be in force at Nursing Homes in regard to end of life? If such a standard is present, then, who enforces it? Who advocates for the patient who has no family, or whose family is far away, or if present, does not understand why sedation for the sake of sedation is wrong.