Advance directive assignment

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Feb 20, 2024

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May Sanderson Training Manual Assignment Role of Advance Directives (AD) in treatment and end of life care. Week 2- Advance Directives are legal documents that provide instructions for medical care and go into effect if the patient cannot communicate their own wishes . End of life care refers to health care provided in the time leading up to a person’s death. This care can be provided in the hours, days, or months before a person dies and encompasses care and support for a person’s mental and emotional needs, physical comfort, spiritual needs and practical tasks. Why should you talk to patients about Advance Directives?  Advance care planning is valuable for everyone, regardless of age or health status.  Advance directives eliminate guesswork.  Advance care planning helps promote better care.  Tools and templates help simplify the process.

The two most common advance directives for health care are the living will and the durable power of attorney for health care.  Living will : A living will is a legal document that tells doctors how you want to be treated if you cannot make your own decisions about emergency treatment. In a living will, you can say which common medical treatments or care you would want, which ones you would want to avoid, and under which conditions each of your choices applies.  Durable power of attorney for health care: A durable power of attorney for health care is a legal document that names you health care proxy, a person who can make health care decisions for you If you are unable to communicate these yourself. Your proxy, also known as representative, surrogate, or agent, should be familiar with your values and wishes. A proxy can be chosen in addition to or instead of a living will. Having a health care proxy helps you plan for situations that cannot be foreseen, such as a serious car accident or stroke. Do not resuscitate (DNR) order: This becomes part of a patient’s medical chart that they do not want CPR or other life-support measures to be attempted or other life-support measures to be attempted should the heartbeat and breathing stop. This could also be called an allow natural death (AND) order. Even though a living will might state that CPR is not wanted, it is helpful to have a DNR order as part of the medical file. Without a DNR order, medical staff will attempt every effort to restore your breathing and the normal rhythm of the heart. Do not intubate (DNI) order: A similar document, a DNI informs medical staff that you do not want to be on a ventilator. Do not hospitalize (DNH) order: Primary used for long term care providers. Stating that the patient would not like to go to be sent to a hospital for treatment at the end of life.

Out of hospital DNR order: An out of hospital DNR alerts emergency medical personnel the wishes regarding measures to restore heartbeat or breathing if not present at a hospital. Physician orders for life-sustaining treatment (POLST) and medical orders for life sustaining treatment (MOLST) forms: These forms provide guidance about the patient’s medical care that health care professionals can act on immediately in an emergency. They serve as a medical order in addition to the advance directive. Typically, the POLST and MOST are created near the end of life or critically ill and understand the specific decisions that might need to be made on your behalf. These forms may also be called portable medical orders or physician orders for scope of treatment (POST). T At any age, a medical crisis could leave you unable to communicate your own health care decisions. Think of advanced directives as living documents that you review at least once a year and update if a major life event occurs such as retirement, moving out of state, or a significant change in your health. If you do not have an advance directive and you are unable to make decisions on your own, the state laws where you live will determine who makes medical decisions on your behalf. This is typically your spouse, your parents if they are available or your children if they are adults. If you are unmarried and have not named your partner as proxy, it’s possible they could be excluded from decision making. An advance directive is legally recognized but not legally binding. This means that your health care provider and proxy will do their best to respect your advance directives, but there may be circumstances in which they cannot follow the patients wishes exactly. Reasons where the health care provider may refuse to follow the advance directives.  If the decision goes against the health provider’s conscience

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 The health care institution’s policy  Accepted health care standards. Approximately One in Three US Adulte completes any type of Advance Directive for End of Life care. That is around 37 percent of Americans. Nurses have a role in promoting advance directives that is increasingly important. The aging population is increasing, and individuals are living longer and often seeking health care alone. Nurses must understand the history and nature of advance healthcare directives to help patients make informed decisions prior to a crisis. Every day across the United States, nurses find themselves caring for a patient who has never made and indication of their wishes or someone who presumed that the end of life was far in the future. Some of these times are in less-than- ideal circumstances. Physicians: can be role models for patients by doing their own advance directives. This can help encourage their patients to complete their own directives to protect themselves and show them the value of advance care planning. REFRENCES Advance Care Planning: Advance Directives for Health Care | National Institute on Aging (nih.gov) Nurses in the Know: The History and Future of Advance Directives | OJIN: The Online Journal of Issues in Nursing (nursingworld.org) Health Information Management and Litigation: How the Two Meet (ahima.org)

Advance directive assignment

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