Mardy Chizek, RN, FNP, BSN, MBA, AAS Charism Eldercare Services

Size: px
Start display at page:

Download "Mardy Chizek, RN, FNP, BSN, MBA, AAS Charism Eldercare Services"

Transcription

1 Mardy Chizek, RN, FNP, BSN, MBA, AAS Charism Eldercare Services

2 Conflict of Interest Margaret Chizek has no: Financial relationship with companies who manufacture products used in the treatment of subjects under discussion. Financial relationships between the planner, content specialist or presenter and commercial supporter/s of the activity and Intent to discuss of-label uses of a commercial product or an investigational use of a product not yet approved for this purpose.

3 Purpose To increase understanding of advance directives for customer and family guidance and education

4 Goals Differentiate between competency and decision making capacity Be able to differentiate between the mandates of state and federal regulations and statutes Be able to articulate the elements of healthcare advance directives

5

6 Advance Directive A document in which the principal (patient/resident) instructs and specifies for the attorney-in fact (decision maker) the care the principal wishes to receive in anticipation of a time when the principle is unable to communicate their wishes. Does not mean do not resuscitate Does not mean do not treat

7 Power of Attorney Alternatives The Five Wishes Living Will that addresses medical, personal, emotional and spiritual wishes Valid in most States Physician Order for Life Sustaining Treatment (POLST) Mandated in some States Brightly colored paper copies Specifies measures that the patient wants

8 Case Study A resident sustained a fall and struck her head. She was a DNR. Neuro checks were done and over the following 24 hours she had a change in mental status. Recognizing the change, the nurse called the doctor and the resident coded during the phone call. Should the staff do CPR?

9 Competency All adults are presumed legally competent. Free to exercise all rights and responsibilities of an adult until determined and declared otherwise in a court of law.

10 Decision Making Capacity Elements of capacity 1. Posses set of values and goals necessary for evaluating different options 2. Ability to communicate and understand information 3. Ability to reason and to deliberate about the choices provided Capacity is not equal to Competence

11 Case Study A resident who had early stage dementia on admission, had been a long standing resident. There was no advance directive or living will, but the resident had always told the staff she did not want a feeding tube. A niece demanded a feeding tube for the resident when the resident had weight loss. Once the tube was placed the resident constantly pulled the tube out and would cry no, no, no. Should the PEG have been inserted and then reinserted?

12 Federal Statute Patient Self Determination Act (PSDA) All providers who participate in Medicare or Medicaid Mandatory information on advance directives to all patients Provider can not mandate advance directive as condition of providing care If unable to abide by advance directive, must transfer to a facility which will follow the advanced directive or DNR

13 Illinois Statute Comply with Federal Act Standardized Do Not Resuscitate (DNR) document Advance Directives in IL Health Care Power of Attorney Living Will Mental Health Treatment Declaration

14 Illinois Statute POAHC Unless a time limit is stipulated in the document it holds until your death May cancel POA HC at any time either in writing or verbally May name secondary and tertiary agent Primary agent must decline or be incapable of serving before secondary agent assumes role Changes must be in writing

15 Illinois Statute POAHC Executed when no longer able to make own decisions Created by patient or principal Chose agent for decision making Healthcare provider may not be your agent Witness should not be agent Document should be witnessed Agent required to abide by specific treatment be withheld of provided

16 lllinois Statute Terminal Condition Terminal condition incurable, irreversible such that death is imminent and application of death delaying treatment or procedures serve only to prolong the dying process. Food and water may not be withheld Requires two witness signatures Must alert healthcare provider to presence of living will May cancel at any time verbally or in writing

17 Case Study On admission, the family asked the admission coordinator if she had all of the necessary paper work. The admission person stated she did. The POAHC daughter signed the no advance directive document. After the third admission, the daughter was incensed because the mother s advance directives were not on the record and threatened and notified multiple agencies.

18 Do Not Resuscitate Medical treatment will not be attempted if your heart and breathing stops Physician order required Illinois Uniform DNR form is advance directive and also physician order on one document Must be signed by the physician to be valid

19 Case Study A co-morbid resident is a full code. The resident arrests while her two sons are visiting and a physician is making rounds. CPR is initiated. When the sons see what CPR entails they beg the physician to cease CPR and allow their mother to die. The physician ceases CPR and talks to the sons about their decision. When the long standing attending physician is notified, he is livid and reports the facility to the State. Should CPR have been discontinued?

20 Living Will/POLST Directives DNR do not resuscitate DNAR do not attempt resuscitation DNI no not intubate No artificial ventilation or ventilator No vasopressors No antibiotics No inotropic agents No enteral nutrition No parenteral nutrition Do not hospitalize Hydrate Organ donation Palliative care Hospice care

21 CPR Facts 2% to 30% success when administered outside the hospital 6% to 15% success for hospitalized patients Less than 5% success for elderly victim with medical problems 70% of time people stated they did not want life sustaining treatment if they had a poor prognosis and were incompetent

22 CPR Facts 75% successful rate of CPR short term and 67% long term on TV shows CPR on TV is on young patients and victims of trauma and near drowning which have highest success rates Most CPR is performed on sick, older individuals with cardiac disease 20% survival if V tach or V fib, but only 8% with other arrhythmias

23 Case Study A 97 year old man with Alzheimer s disease is a long standing resident at a nursing facility. His wife has been his decision maker until she died. Within days of his wife s death, one of his two daughters came to the facility with new POA for health care documentation designating her as his new POA. On the death of the wife/mother, the successor was the second daughter. The first daughter had the document signed and witnessed by a staff member from the facility. This daughter is an attorney and consistently threatens the staff at the facility with litigation. Because of their fear of her anger and threats, everyone attempts to comply with her wishes.

24 Health Care Surrogate Illinois Do not have an advanced directive Unable to make own healthcare decisions No designated agent Agent can act on your behalf if you have Qualifying condition Terminal condition Permanent unconsciousness Incurable, irreversible condition Order of priority Guardian Spouse Any adult child/ren Either parent Any adult brother or sister Any adult grandchild/ren A close friend Guardian of the estate

25 Glossary Artificial nutrition or hydration Delivery of nutrient and fluids when unable to eat or drink. May be delivered by tube in stomach, tube in nose or through IV tube. Decision making capacity Ability to make decisions that reflect understanding of the risks (nature) and benefits (consequences) of one s actions.

26 Glossary Hospice Delivery of palliative care at the end of life. Legal guardian Person appointed by the court who is responsible for managing property and rights of another person considered incapable of administering own affairs.

27 Glossary Life sustaining treatment Intervention which administered prolongs life and delays death. Palliative care Medical care or treatment to reduce severity of disease symptoms not striving to halt, delay or reverse progress of the disease or cure.

28 Glossary Persistent vegetative state American Academy of Neurology Form of eye opening permanent unconsciousness in which the patient has periods of wakefulness and physiologic/sleep wake cycles but at no time is aware of himself or his environment.

29 Glossary Terminal condition Status that is incurable or irreversible and which death will occur in a short time. No specific definition, but generally a short time is considered less than one year in many jurisdictions.

TYPES OF ADVANCE DIRECTIVES

TYPES OF ADVANCE DIRECTIVES ADVANCE DIRECTIVES Definition: An advance health care directive is a set of written instructions that a person gives that specify what actions should be taken for their health if they are no longer able

More information

Deciding About. Health Care A GUIDE FOR PATIENTS AND FAMILIES. New York State Department of Health

Deciding About. Health Care A GUIDE FOR PATIENTS AND FAMILIES. New York State Department of Health Deciding About Health Care A GUIDE FOR PATIENTS AND FAMILIES New York State Department of Health 2 Introduction Who should read this guide? This guide is for New York State patients and for those who will

More information

Directive To Physicians and Family Or Surrogates (Living Will)

Directive To Physicians and Family Or Surrogates (Living Will) Directive To Physicians and Family Or Surrogates (Living Will) INSTRUCTIONS FOR COMPLETING THIS DOCUMENT: This is an important legal document known as an Advance Directive. It is designed to help you communicate

More information

2

2 1 2 3 4 Designation of Health Care Surrogate I, (please print) want Phone Address to be my Health Care Surrogate and make health care decisions for me as indicated by my initials below: Effective only

More information

HealthStream Regulatory Script

HealthStream Regulatory Script HealthStream Regulatory Script Advance Directives Version: [May 2006] Lesson 1: Introduction Lesson 2: Advance Directives Lesson 3: Living Wills Lesson 4: Medical Power of Attorney Lesson 5: Other Advance

More information

DIRECTIVE TO PHYSICIANS AND FAMILY OR SURROGATES Advance Directives Act (see , Health and Safety Code) DIRECTIVE

DIRECTIVE TO PHYSICIANS AND FAMILY OR SURROGATES Advance Directives Act (see , Health and Safety Code) DIRECTIVE DIRECTIVE TO PHYSICIANS AND FAMILY OR SURROGATES Advance Directives Act (see 166.033, Health and Safety Code) Instructions for completing this document: This is an important legal document known as an

More information

NEBRASKA Advance Directive Planning for Important Healthcare Decisions

NEBRASKA Advance Directive Planning for Important Healthcare Decisions NEBRASKA Advance Directive Planning for Important Healthcare Decisions Caring Connections 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program of

More information

Advance Directives The Patient s Right To Decide CH Oct. 2013

Advance Directives The Patient s Right To Decide CH Oct. 2013 Advance Directives The Patient s Right To Decide CH80850040 Oct. 2013 Advance Directives Your Right To Make Health Care Decisions Under The Law In Tennessee Tennessee and federal law give every competent

More information

vv POLST for Hospice Providers

vv POLST for Hospice Providers vv. 2.2.17 POLST for Hospice Providers Permission to Use This slide presentation may be used without permission. To promote consistency across the state, the slides may not be altered. You may freely take

More information

Directive to Physicians and Family or Surrogates

Directive to Physicians and Family or Surrogates Directive to Physicians and Family or Surrogates This is an important legal document, known as an Advance Directive. It is designed to help you communicate your wishes about medical treatment at some time

More information

Health Care Directive. Choose whether you want life-sustaining treatments in certain situations.

Health Care Directive. Choose whether you want life-sustaining treatments in certain situations. Durable Power of Attorney (DPOA) for Health Care Health Care Directive Documents are legally valid in Washington What is advance care planning? Advance care planning is for all adults 18 and older. It

More information

Health Care Directive. Choose whether you want life-sustaining treatments in certain situations.

Health Care Directive. Choose whether you want life-sustaining treatments in certain situations. Durable Power of Attorney (DPOA) for Health Care Health Care Directive Documents are legally valid in Washington What is advance care planning? Advance care planning is for all adults 18 and older. It

More information

LOUISIANA ADVANCE DIRECTIVES

LOUISIANA ADVANCE DIRECTIVES LOUISIANA ADVANCE DIRECTIVES Legal Documents that Ensure that Your Choices for Future Medical Care or the Refusal of Same are Honored and Implemented by Your Health Care Providers Peoples Health is a Medicare

More information

REVISED 2005 EDITION. A Personal Decision

REVISED 2005 EDITION. A Personal Decision REVISED 2005 EDITION A Personal Decision Practical information about determining your future medical care, including living wills, powers of attorney for health care, mental health treatment preference

More information

Your Guide to Advance Directives

Your Guide to Advance Directives Starting Points: Your Guide to Advance Directives Values Statements Healthcare Directives Durable Power of Attorney for Healthcare 1 2 Advances in medicine are helping people to live longer than ever before.

More information

What Are Advance Medical Directives?

What Are Advance Medical Directives? What Are Advance Medical Directives? UAMS would like you to know there are ways to let others know what decisions you would want to make about your medical treatments, even when you are unable to speak

More information

WYOMING Advance Directive Planning for Important Healthcare Decisions

WYOMING Advance Directive Planning for Important Healthcare Decisions WYOMING Advance Directive Planning for Important Healthcare Decisions Caring Connections 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CARING CONNECTIONS Caring Connections,

More information

A Personal Decision. Illinois State Medical Society. Practical Information About Determining Your Future Medical Care.

A Personal Decision. Illinois State Medical Society. Practical Information About Determining Your Future Medical Care. A Personal Decision 2016 EDITION Practical Information About Determining Your Future Medical Care Living wills Powers of attorney for health care Mental health treatment preference declarations Uniform

More information

An Advance Directive For North Carolina

An Advance Directive For North Carolina Introduction An Advance Directive For North Carolina A Practical Form for All Adults This form allows you to express your wishes for future health care and to guide decisions about that care. It does not

More information

ADVANCE DIRECTIVES AND HEALTH CARE PLANNING

ADVANCE DIRECTIVES AND HEALTH CARE PLANNING OPTIONS AND DEVELOPMENTS RELATING TO ADVANCE DIRECTIVES AND HEALTH CARE PLANNING Advance Directive for a Natural Death Living Will Health Care Power of Attorney Advance Instruction for Mental Health Treatment

More information

ALLINA HOME & COMMUNITY SERVICES ALLINA HEALTH. Advance Care Planning. Discussion guide. Discussion Guide. Advance care planning

ALLINA HOME & COMMUNITY SERVICES ALLINA HEALTH. Advance Care Planning. Discussion guide. Discussion Guide. Advance care planning ALLINA HOME & COMMUNITY SERVICES ALLINA HEALTH Advance Care Planning Discussion guide Discussion Guide Advance care planning Advance care planning Any of us could think of a time when we might be too sick

More information

YOUR RIGHT TO DECIDE YOUR RIGHT TO DECIDE YOUR RIGHT TO DECIDE

YOUR RIGHT TO DECIDE YOUR RIGHT TO DECIDE YOUR RIGHT TO DECIDE YOUR RIGHT TO DECIDE YOUR RIGHT TO DECIDE YOUR RIGHT TO DECIDE YOUR RIGHT TO DECIDE Communicating Your Health Care Choices In 1990, Congress passed the Patient Self-Determination Introduction Act. It requires

More information

Medical Advance Directives

Medical Advance Directives Chapter 24 Medical Advance Directives Michael A. Kirtland, Esq. Kirtland & Seal, L.L.C. SYNOPSIS 24-1. Living Wills 24-2. CPR Directives and DNR Orders 24-3. Medical Orders for Scope of Treatment 24-4.

More information

Maryland MOLST for the Health Care Practitioner. Maryland MOLST Training Task Force July 2013

Maryland MOLST for the Health Care Practitioner. Maryland MOLST Training Task Force July 2013 Maryland MOLST for the Health Care Practitioner Maryland MOLST Training Task Force July 2013 What is the Health Care Decisions Act? Health Care Decisions Act Applies in all health care settings and in

More information

ADVANCE DIRECTIVE PACKET Question and Answer Section

ADVANCE DIRECTIVE PACKET Question and Answer Section ADVANCE DIRECTIVE PACKET Question and Answer Section Please review the following facts regarding what an Advance Directive is, as well as your right as an adult to create one. If you decide to complete

More information

TheValues History: A Worksheet for Advance Directives Courtesy of Somerset Hospital s Ethics Committee

TheValues History: A Worksheet for Advance Directives Courtesy of Somerset Hospital s Ethics Committee TheValues History: A Worksheet for Advance Directives Courtesy of Somerset Hospital s Ethics Committee Advance Directives Living Wills Power of Attorney The Values History: A Worksheet for Advanced Directives

More information

TO HELP EASE DECISION MAKING IN THE FUTURE ADVANCE CARE PLANNING TOOLKIT

TO HELP EASE DECISION MAKING IN THE FUTURE ADVANCE CARE PLANNING TOOLKIT TO HELP EASE DECISION MAKING IN THE FUTURE ADVANCE CARE PLANNING TOOLKIT Advance Care Planning Toolkit Your health care decisions are important. Providing Patient Centered Care is the guiding principle

More information

North Dakota: Advance Directive

North Dakota: Advance Directive North Dakota: Advance Directive NOTE: This form is being provided to you as a public service. The attached forms are provided as is and are not the substitute for the advice of an attorney. By providing

More information

POLST Cue Card. If you die a natural death, would you want us to try CPR? If yes Requires Full Treatment in Section B. (Ask about Ventilator Trial)

POLST Cue Card. If you die a natural death, would you want us to try CPR? If yes Requires Full Treatment in Section B. (Ask about Ventilator Trial) POLST Cue Card It s important to talk about your health and your wishes for medical care if you got really sick. We talk about this with everyone with serious illness. Your doctor will review what we talk

More information

COLORADO Advance Directive Planning for Important Healthcare Decisions

COLORADO Advance Directive Planning for Important Healthcare Decisions COLORADO Advance Directive Planning for Important Healthcare Decisions Caring Connections 1700 Diagonal Road, Suite 625, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program

More information

MY CHOICES. Information on: Advance Care Directive Living Will POLST Orders

MY CHOICES. Information on: Advance Care Directive Living Will POLST Orders MY CHOICES Information on: Advance Care Directive Living Will POLST Orders My Choices Adults have the right to accept or refuse medical care. As long as you can make health care decisions for yourself,

More information

Colorado CPR Directives. Colorado Department of Public Health and Environment Emergency Medical and Trauma Services Section

Colorado CPR Directives. Colorado Department of Public Health and Environment Emergency Medical and Trauma Services Section Colorado CPR Directives Colorado Department of Public Health and Environment Emergency Medical and Trauma Services Section Course Objectives Upon completion of this class, you should be able to: Identify

More information

ADVANCE DIRECTIVE INFORMATION

ADVANCE DIRECTIVE INFORMATION ADVANCE DIRECTIVE INFORMATION NOTE: This Advance Directive Information and the form Living Will and Durable Power of Attorney for Health Care on the Arkansas Bar Association s website are being provided

More information

Planning Ahead: How to Make Future Health Care Decisions NOW. Washington

Planning Ahead: How to Make Future Health Care Decisions NOW. Washington Washington Planning Ahead: How to Make Future Health Care Decisions NOW Your Questions Answered About Washington Living Wills and Powers of Attorney for Health Care Table of Contents P 1 What You Need

More information

MAKING YOUR WISHES KNOWN: Advance Care Planning Guide

MAKING YOUR WISHES KNOWN: Advance Care Planning Guide MAKING YOUR WISHES KNOWN: Advance Care Planning Guide ADVANCE CARE PLANNING The process of learning about the type of medical decisions that may need to be made, considering those decisions ahead of time

More information

ILLINOIS Advance Directive Planning for Important Health Care Decisions

ILLINOIS Advance Directive Planning for Important Health Care Decisions ILLINOIS Advance Directive Planning for Important Health Care Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National Hospice

More information

MASSACHUSETTS Advance Directive Planning for Important Healthcare Decisions

MASSACHUSETTS Advance Directive Planning for Important Healthcare Decisions MASSACHUSETTS Advance Directive Planning for Important Healthcare Decisions Caring Connections 1700 Diagonal Road, Suite 625, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a

More information

DURABLE POWER OF ATTORNEY FOR HEALTH CARE (Rhode Island Version) You must be at least eighteen (18) years of age.

DURABLE POWER OF ATTORNEY FOR HEALTH CARE (Rhode Island Version) You must be at least eighteen (18) years of age. MASSASOIT INTERNAL MEDICINE (401) 434-2704 massasoitmed.com DURABLE POWER OF ATTORNEY FOR HEALTH CARE (Rhode Island Version) THE DURABLE POWER OF ATTORNEY FOR HEALTH CARE DOCUMENT lets you appoint someone

More information

Northwest Community EMS System POLICY MANUAL

Northwest Community EMS System POLICY MANUAL Policy Title: ILLINOIS POLST forms and Advance Directive Guidelines No. D - 5 Board approval: 11/10/16 Effective: 12/1/16 Supersedes: 1/30/15 Page: 1 of 9 References: Public Act 094-0865 that amends the

More information

Your Right to Make Health Care Decisions

Your Right to Make Health Care Decisions 42 P O Box 10600 Grand Junction, CO 81502-5600 Your Right to Make Health Care Decisions Advance Directives What is an Advance Directive? It is a type of written instruction about your health care to be

More information

PHYSICIAN S GUIDELINES FOR WRITING DO NOT RESUSCITATE ORDERS

PHYSICIAN S GUIDELINES FOR WRITING DO NOT RESUSCITATE ORDERS PHYSICIAN S GUIDELINES FOR WRITING DO NOT RESUSCITATE ORDERS THE PURPOSE OF CPR IS THE PREVENTION OF SUDDEN UNEXPECTED DEATH. CPR IS NOT INDICATED IN CERTAIN SITUATIONS SUCH AS CASES OF TERMINAL IRREVERSIBLE

More information

ADVANCE CARE PLANNING DOCUMENTS

ADVANCE CARE PLANNING DOCUMENTS ADVANCE CARE PLANNING DOCUMENTS Legal Documents to Assure Your Future Health Care Choices Distributed as a Public Service by THE NEVADA CENTER FOR ETHICS & HEALTH POLICY University of Nevada, Reno Revised

More information

Ambulatory Surgery Center Patient Consent to Resuscitative Measures

Ambulatory Surgery Center Patient Consent to Resuscitative Measures Ambulatory Surgery Center Patient Consent to Resuscitative Measures Not a Revocation of Advance Directives or Medical Power Of Attorney All patients have the right to participate in their own health care

More information

Advance Care Planning Guide

Advance Care Planning Guide Advance Care Planning Guide How to think about, talk about and plan for serious illness or injuries which may keep you from making your own health care decision. New Hampshire Advance Directives: Durable

More information

What would you like to accomplish in the process of advance care planning and/or in completing a health care directive?

What would you like to accomplish in the process of advance care planning and/or in completing a health care directive? Completing a health care directive is an important step in making sure your loved ones and health care providers understand your values and choices for health care treatment if you are not able to speak

More information

Advance Directive for Health Care

Advance Directive for Health Care Advance Directive for Health Care respecting your right to: Choose Your Healthcare Agent Choose the Authority Given to Your Healthcare Agent Choose Your Preferences Related to Treatment & Care Printed

More information

Ethical Issues: advance directives, nutrition and life support

Ethical Issues: advance directives, nutrition and life support Ethical Issues: advance directives, nutrition and life support December 12, 2013 2013 LegalHealth Objectives Discuss parameters of consent for medical treatment and legal issues that arise Provide overview

More information

My Voice - My Choice

My Voice - My Choice My Voice - My Choice My Advance Directive Table of Contents Introduction... 2 Words You Need to Know... 3 Legal Document... 4 Helpful Information about your Advance Directive... 10 What makes your life

More information

2 North Meridian Street Indianapolis, Indiana March 1999 Revised May 2004 ADVANCE DIRECTIVES YOUR RIGHT TO DECIDE

2 North Meridian Street Indianapolis, Indiana March 1999 Revised May 2004 ADVANCE DIRECTIVES YOUR RIGHT TO DECIDE 2 North Meridian Street Indianapolis, Indiana 46204 March 1999 Revised May 2004 ADVANCE DIRECTIVES YOUR RIGHT TO DECIDE The purpose of this brochure is to inform you of ways that you can direct your medical

More information

WARNING: LIVING WILLS AND GENERAL POWERS OF ATTORNEYS ARE VERY POWERFUL DOCUMENTS. CHOOSE YOUR AGENT VERY CAREFULLY. Sample Living Will 2

WARNING: LIVING WILLS AND GENERAL POWERS OF ATTORNEYS ARE VERY POWERFUL DOCUMENTS. CHOOSE YOUR AGENT VERY CAREFULLY. Sample Living Will 2 Stateside Legal Living Will Sample Packet (Protections under the Servicemembers Civil Relief Act) This self-help resource was created by the Stateside Legal Project. Stateside Legal provides these sample

More information

Objectives. 1. Understand the different Advance Directives options available in WI. 2. Understand the benefits of completing an Advance Directive

Objectives. 1. Understand the different Advance Directives options available in WI. 2. Understand the benefits of completing an Advance Directive Advance Directives Objectives 1. Understand the different Advance Directives options available in WI 2. Understand the benefits of completing an Advance Directive 3. Define the role that IDT staff in educating

More information

ADVANCE MEDICAL DIRECTIVES

ADVANCE MEDICAL DIRECTIVES ADVANCE MEDICAL DIRECTIVES Health Care Declaration (Living Will) and Medical Power of Attorney What is an Advance Directive? Many people are concerned about what would happen if, due to a mental or physical

More information

For more information and additional resources go to Name:

For more information and additional resources go to  Name: Durable Power of Attorney for Health Care & Health Care Directive Documents are legally valid in Alaska, California, Idaho, Montana, and Washington. What is advance care planning? Advance care planning

More information

Your Right to Make Health Care Decisions in Colorado

Your Right to Make Health Care Decisions in Colorado Your Right to Make Health Care Decisions in Colorado This e-book informs you about your right to make health care decisions, including the right to accept or refuse medical treatment. It explains the following

More information

Advance Directives. Important information on health care decision-making: You Have the Right to Decide

Advance Directives. Important information on health care decision-making: You Have the Right to Decide Advance Directives Important information on health care decision-making: You Have the Right to Decide The documents provided in this package are being presented to you in accordance with the Federal Patient

More information

SOUTH CAROLINA HEALTH CARE POWER OF ATTORNEY

SOUTH CAROLINA HEALTH CARE POWER OF ATTORNEY SOUTH CAROLINA HEALTH CARE POWER OF ATTORNEY INFORMATION ABOUT THIS DOCUMENT THIS IS AN IMPORTANT LEGAL DOCUMENT. BEFORE SIGNING THIS DOCUMENT, YOU SHOULD KNOW THESE IMPORTANT FACTS: 1. THIS DOCUMENT GIVES

More information

Patient Self-Determination Act

Patient Self-Determination Act Holy Redeemer Hospital Patient Self-Determination Act NOTES:: MAKING YOUR OWN HEALTH CARE DECISIONS: As a competent adult, you have the fundamental right, in collaboration with your health care providers,

More information

A PERSONAL DECISION

A PERSONAL DECISION A PERSONAL DECISION Practical information about determining your future medical care including declaration, powers of attorney for health care and organ donation Determining Your Medical Care is Your

More information

NEW YORK STATE DEPARTMENT OF HEALTH Medical Orders for Life Sustaining Treatment (MOLST) THE PATIENT KEEPS THE ORIGINAL MOLST FORM DURING TRAVEL TO DIFFERENT CARE SETTINGS. THE PHYSICIAN KEEPS A COPY.

More information

ADVANCE DIRECTIVE Planning Guide. Information Provided as a Community Service

ADVANCE DIRECTIVE Planning Guide. Information Provided as a Community Service ADVANCE DIRECTIVE Planning Guide Information Provided as a Community Service If a medical tragedy strikes, you have the RIGHT TO CHOOSE what medical care you do or do not want. It is best if you make this

More information

Thank you for your interest in completing an Advance Directive.

Thank you for your interest in completing an Advance Directive. Advance Directives Thank you for your interest in completing an Advance Directive. Writing an Advance Directive is an opportunity to direct your future health needs in advance of an illness or crisis.

More information

MY ADVANCE CARE PLANNING GUIDE

MY ADVANCE CARE PLANNING GUIDE MY DVNCE CRE PLNNING GUIDE Let s TLK! Tell us your values and beliefs about your healthcare. Take time to have the conversation with your physician and your family. lways be open and honest. Leave no doubt

More information

The Law. What is an Advanced Healthcare Directives 9/2/2016. Presented by, Ruthann McFadden, LCSW-C Director of Social Services

The Law. What is an Advanced Healthcare Directives 9/2/2016. Presented by, Ruthann McFadden, LCSW-C Director of Social Services Presented by, Ruthann McFadden, LCSW-C Director of Social Services 1 The Law In 2006, Act 169 was signed into law. The purpose of the act was to provide a comprehensive statutory framework governing Advanced

More information

HealthStream Regulatory Script

HealthStream Regulatory Script HealthStream Regulatory Script Advance Directives Release Date: August 2008 HLC Version: 602 Lesson 1: Introduction Lesson 2: Advance Directives Lesson 3: Living Wills Lesson 4: Medical Power of Attorney

More information

APPOINTMENT OF A HEALTH CARE AGENT (Part One)

APPOINTMENT OF A HEALTH CARE AGENT (Part One) ADVANCE DIRECTIVES As a public service project, the Health Law Section of the Maryland State Bar Association has prepared the attached Advance Directive. This form gives instructions as to your wishes

More information

Advanced Care Planning Guide

Advanced Care Planning Guide Advanced Care Planning Guide A process to think about, talk about and plan for life-threatening illness or end-of-life care New Hampshire Advance Directives: Durable Power of Attorney for Health Care (DPOAH)

More information

Making Decisions About Your Health Care. (Information about Durable Power of Attorney for Health Care and Living Wills)

Making Decisions About Your Health Care. (Information about Durable Power of Attorney for Health Care and Living Wills) Making Decisions About Your Health Care (Information about Durable Power of Attorney for Health Care and Living Wills) Following guidelines set by federal regulations, we would like to inform you of your

More information

ABOUT THE ADVANCE DIRECTIVE FOR RECEIVING ORAL FOOD AND FLUIDS IN DEMENTIA. Introduction

ABOUT THE ADVANCE DIRECTIVE FOR RECEIVING ORAL FOOD AND FLUIDS IN DEMENTIA. Introduction ABOUT THE ADVANCE DIRECTIVE FOR RECEIVING ORAL FOOD AND FLUIDS IN DEMENTIA Introduction There are two purposes to completing an Advance Directive for Receiving Oral Food and Fluids In Dementia. The first

More information

Minnesota Health Care Directive Planning Toolkit

Minnesota Health Care Directive Planning Toolkit Minnesota Health Care Directive Planning Toolkit This planning toolkit contains information to help you: Plan Ahead Understand Common Terms Know the Facts Complete a Health Care Directive: Step-by-Step

More information

Portable Do Not Attempt Resuscitation Orders Amendments to the Alabama Natural Death Act

Portable Do Not Attempt Resuscitation Orders Amendments to the Alabama Natural Death Act Portable Do Not Attempt Resuscitation Orders 2016 Amendments to the Alabama Natural Death Act The Natural Death Act, Ala. Code 22-8A-1 et seq., contains provisions that affirm the right of competent adult

More information

ADVANCE DIRECTIVE Your Durable Power ofattorney for Health Care, Living Will and Other Wishes

ADVANCE DIRECTIVE Your Durable Power ofattorney for Health Care, Living Will and Other Wishes ADVANCE DIRECTIVE Your Durable Power ofattorney for Health Care, Living Will and Other Wishes Introduction: INSTRUCTIONS AND DEFINITIONS This form is a combined Durable Power of Attorney for Health Care

More information

Making Your Wishes Known With the Help of the Five Wishes Document

Making Your Wishes Known With the Help of the Five Wishes Document Making Your Wishes Known With the Help of the Five Wishes Document Lora Rhodes, MSW, LSW Oncology Social Worker Department of Medical Oncology LBBC: Annual Conference for Women living with Metastatic Breast

More information

Planning in Advance for Your Health Care

Planning in Advance for Your Health Care Planning in Advance for Your Health Care This booklet will help you to plan ahead. If you have any questions please call for assistance: NWH Patient Relations Representative 617-243-5052 NWH Pastoral Care:

More information

Living Will Sample Massachusetts (aka "Advanced Medical Directive")

Living Will Sample Massachusetts (aka Advanced Medical Directive) Living Will Sample Massachusetts (aka "Advanced Medical Directive") Online Living Will Form $8.99 (free trial) click here ADVANCE MEDICAL DIRECTIVE AND HEALTH CARE PROXY GIVEN BY JAMES ROBERT HEDGES THIS

More information

Your Right To Make Your Own Health Care Decisions

Your Right To Make Your Own Health Care Decisions Your Right To Make Your Own Health Care Decisions Sinai Hospital of Baltimore 2401 West Belvedere Avenue Baltimore, Maryland 21215-5271 WHAT YOU NEED TO KNOW ABOUT ADVANCE DIRECTIVES Sinai Hospital is

More information

Medical Care Decisions & Advance Directives

Medical Care Decisions & Advance Directives Medical Care Decisions & Advance Directives WHAT YOU SHOULD KNOW WakeMed Health & Hospitals What is an advance directive? An advance directive is a set of directions you give about the health/mental health

More information

OREGON Advance Directive Planning for Important Healthcare Decisions

OREGON Advance Directive Planning for Important Healthcare Decisions OREGON Advance Directive Planning for Important Healthcare Decisions Caring Connections 1700 Diagonal Road, Suite 625, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program

More information

YOUR RIGHT TO MAKE YOUR OWN HEALTH CARE DECISIONS

YOUR RIGHT TO MAKE YOUR OWN HEALTH CARE DECISIONS Upon admission to Western Connecticut Health Network, you will be asked if you have any form of an Advance Directive such as a Living Will or a Health Care Representative. If you have such a document,

More information

IDAHO Advance Directive Planning for Important Healthcare Decisions

IDAHO Advance Directive Planning for Important Healthcare Decisions IDAHO Advance Directive Planning for Important Healthcare Decisions Caring Connections 1700 Diagonal Road, Suite 625, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program

More information

A PHYSICIAN S GUIDE TO ADVANCE DIRECTIVES: LIVING WILLS. Information and guidance for physicians Provided by the Illinois State Medical Society

A PHYSICIAN S GUIDE TO ADVANCE DIRECTIVES: LIVING WILLS. Information and guidance for physicians Provided by the Illinois State Medical Society A PHYSICIAN S GUIDE TO ADVANCE DIRECTIVES: LIVING WILLS Information and guidance for physicians Provided by the Illinois State Medical Society ILLINOIS LIVING WILL ACT Introduction The Illinois Living

More information

Advance Directives The Missing Conversation Why Our Patients Children Are Left Holding The Bag. End of Life Planning Barriers 10/7/2014

Advance Directives The Missing Conversation Why Our Patients Children Are Left Holding The Bag. End of Life Planning Barriers 10/7/2014 Advance Directives The Missing Conversation Why Our Patients Children Are Left Holding The Bag SC Chapter American College of Physicians October 29, 2014 Sewell I. Kahn, MD FACP End of Life Planning Barriers

More information

Advance Directive. my wish for: my voice my choice. health care power of attorney and living will

Advance Directive. my wish for: my voice my choice. health care power of attorney and living will health care power of attorney and living will print your name date of birth for information contact: patient relations at 910 615-6120 my voice my choice. my wish for: The person I want to make care decisions

More information

NO TALLAHASSEE, June 30, Mental Health/Substance Abuse

NO TALLAHASSEE, June 30, Mental Health/Substance Abuse CFOP 155-52 STATE OF FLORIDA DEPARTMENT OF CF OPERATING PROCEDURE CHILDREN AND FAMILIES NO. 155-52 TALLAHASSEE, June 30, 2017 Mental Health/Substance Abuse USE OF DO NOT RESUSCITATE (DNR) ORDERS IN STATE

More information

Family Health Care Decisions Act (FHCDA)

Family Health Care Decisions Act (FHCDA) Family Health Care Decisions Act (FHCDA) Public Health Law Article 29-CC Added by L. 2010, Ch. 8 Applies to general hospitals and residential health care facilities (nursing homes) Went into effect on

More information

MASSACHUSETTS ADVANCE DIRECTIVES

MASSACHUSETTS ADVANCE DIRECTIVES MASSACHUSETTS ADVANCE DIRECTIVES Advance directives are legal documents that protect your right to refuse medical treatment you do not want, or to request treatment you do want, in the event you lose the

More information

Advance Directives. Planning Ahead For Your Healthcare

Advance Directives. Planning Ahead For Your Healthcare Advance Directives Planning Ahead For Your Healthcare Core Values Catholic Health Initiatives core values of Reverence, Integrity, Compassion, and Excellence are the guiding principles that provide focus,

More information

DELAWARE Advance Directive Planning for Important Healthcare Decisions

DELAWARE Advance Directive Planning for Important Healthcare Decisions DELAWARE Advance Directive Planning for Important Healthcare Decisions Caring Connections 1700 Diagonal Road, Suite 625, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program

More information

MY ADVANCE CARE PLANNING GUIDE

MY ADVANCE CARE PLANNING GUIDE MY DVNCE CRE PLNNING GUIDE Let s TLK! Tell us your values and beliefs about your healthcare. Take time to have the conversation with your physician and your family. lways be open and honest. Leave no doubt

More information

I,,, Social Security number

I,,, Social Security number Durable power of attorney for health care choices & health care choices DIRECTIVE 6- FORM Part I. Durable power of attorney for health care choices I,,, Name Social Security number appoint,, Name Phone

More information

LOUISIANA ADVANCE DIRECTIVES

LOUISIANA ADVANCE DIRECTIVES LOUISIANA ADVANCE DIRECTIVES Legal Documents To Make Sure Your Choices for Future Medical Care or the Refusal of Same are Honored and Implemented by Your Health Care Providers ADVANCE DIRECTIVES INTRODUCTION

More information

Advanced Directive For Health Care

Advanced Directive For Health Care Advanced Directive For Health Care Your Right to Make Your Own Decisions About Medical Care The best source for more information about Advanced Directive is your attorney. Patients of Helen Keller Hospital

More information

NEW YORK STATE BAR ASSOCIATION. LEGALEase. Living Wills and Health Care Proxies

NEW YORK STATE BAR ASSOCIATION. LEGALEase. Living Wills and Health Care Proxies NEW YORK STATE BAR ASSOCIATION LEGALEase Living Wills and Health Care Proxies Introduction Today s advanced medical technology may result in the possibility of being subjected to various invasive medical

More information

Advance Directive. What Are Advance Medical Directives? Deciding What You Want. Recording Your Wishes

Advance Directive. What Are Advance Medical Directives? Deciding What You Want. Recording Your Wishes Advance Directive What Are Advance Medical Directives? These documents could be a living will or a durable power of attorney for healthcare (also called a healthcare proxy). They allow you to give directions

More information

PENNSYLVANIA Advance Directive Planning for Important Healthcare Decisions

PENNSYLVANIA Advance Directive Planning for Important Healthcare Decisions PENNSYLVANIA Advance Directive Planning for Important Healthcare Decisions Caring Connections 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program

More information

Advance Directives. Making your health care choices known if you can't speak for yourself.

Advance Directives. Making your health care choices known if you can't speak for yourself. Advance Directives Making your health care choices known if you can't speak for yourself. ADVANCE DIRECTIVES Making your health care choices known if you can t speak for yourself This booklet contains

More information

COMBINED ADVANCE HEALTH CARE DIRECTIVE

COMBINED ADVANCE HEALTH CARE DIRECTIVE COMBINED ADVANCE HEALTH CARE DIRECTIVE Before you sign: Read this form carefully. Choose which sections you wish to include, and fill in the blanks. If you want to add specific instructions in your own

More information

*3ADV* Patient Rights & Responsibilities Advanced Directive Page 1 of 2. Patient Rights & Responsibilities. Patient Label

*3ADV* Patient Rights & Responsibilities Advanced Directive Page 1 of 2. Patient Rights & Responsibilities. Patient Label PATIENT RIGHTS Portneuf Medical Center encourages respect for the personal preferences and values of each individual and supports the Rights of each patient and resident of the Center, or their representative

More information

PATIENT SERVICES POLICY AND PROCEDURE MANUAL

PATIENT SERVICES POLICY AND PROCEDURE MANUAL SECTION Patient Services Manual Multidiscipline Section NAME Patient Rights and Responsibilities PATIENT SERVICES POLICY AND PROCEDURE MANUAL EFFECTIVE DATE 8-1-11 SUPERSEDES DATE 7-20-10 I. PURPOSE To

More information

Advance Care Planning. Ken Brummel-Smith, MD Charlotte Edwards Maguire Professor of Geriatrics FSU College of Medicine

Advance Care Planning. Ken Brummel-Smith, MD Charlotte Edwards Maguire Professor of Geriatrics FSU College of Medicine Advance Care Planning Ken Brummel-Smith, MD Charlotte Edwards Maguire Professor of Geriatrics FSU College of Medicine 1 Principles of Ethics Autonomy/Respect for Persons Beneficence Non- maleficence Justice

More information

Health Care Directive

Health Care Directive MINNESOTA PATIENT EDUCATION Health Care Directive Making Your Health Care Choices Known My Health Care Directive My health care directive was created to guide my health care agent and family, friends or

More information