Background: This study increases our knowledge and understanding of factors influencing DNR decision-making by family members of terminally ill older adults in the emergency department. Emergency medical staff should keep abreast of the attitudes and wishes of family members and terminally ill older adults regarding DNR, and initiate DNR decision-making discussions as early as possible. Emergency nurses should pay more attention to the desire of family members to improve the quality of life of terminally ill older adults with DNR.