TYPES OF ADVANCE DIRECTIVES
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- Nigel Stone
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2 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 to make decisions because of illness or incapacity. (Wikipedia)
3 TYPES OF ADVANCE DIRECTIVES Living Will Power of Attorney of Health Care (POAHC) Certification for Surrogate Decision Making POLST (Physician Order for Life Sustaining Treatment)
4 WHO NEEDS ADVANCE DIRECTIVES? Everyone over the age of 18 should have a Power Attorney for Health Care in place! Others are for more specific situations.
5 A LITTLE HISTORY In 1991, Congress passed the Patient Self Determination Act. This law requires hospitals, nursing homes, home health agencies, hospice providers, HMO s and other health care institutions to provide information about advance health care directives to patients upon admission.
6 PATIENT SELF DETERMINATION ACT The requirements of the PSDA are as follows: Patients are given written notice upon admission to the health care facility of their decision-making rights, and policies regarding advance health care directives in their state and in the institution to which they have been admitted. Patient rights include: The right to facilitate their own health care decisions. The right to accept or refuse medical treatment. The right to make an advance health care directive. Facilities must inquire as to whether the patient already has an advance health care directive, and make note of this in their medical records. Facilities must provide education to their staff and affiliates about advance health care directives. Health care providers are not allowed to discriminately admit or treat patients based on whether or not they have an advance health care directive.
7 LIVING WILL Oldest form of advance directive- created in Limited in scope: If I suffer from an incurable, irreversible illness, disease or condition and my attending physician determines that my condition is terminal, I direct that life sustaining treatment measures that will serve only to prolong my dying be withheld or discontinued Does NOT address alternate decision makers, pain control, antibiotics or many others treatment options at end of life. If you have a POAHC, you do not need a living will. Often overlooked if other AD s are in place.
8 POWER OF ATTORNEY FOR HEALTH CARE Standardized form in Illinois Most important AD to have Gives a person the ability to name a decision maker in the event they are incapacitated Allows naming a back-up decision maker Can only name one (1) person as the primary agent Must have mental capacity to execute
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14 ILLINOIS HEALTH CARE SURROGATE Limited powers Only applies in certain situations: Person has been deemed incompetent by at least 2 physicians No other advance directives can be located after reasonable effort is made. Person has a terminal diagnosis Option of last resort
15 ILLINOIS HEALTH CARE SURROGATE Statute outlines order of succession: Guardian of person Spouse Adult children (all of equal appointment- oldest does NOT have preference) Parent Adult Sibling Adult grandchild Close friend Guardian of the estate
16 ILLINOIS HEATH CARE SURROGATE If there are multiple candidates at the same level of priority, it is their duty to reach agreement No agreement = majority rules More about the process than the paperwork Illinois Health Care Surrogate Act (755 ILCS 40/25) for more details
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18 POLST Replaces former standard Do Not Resuscitate (DNR) form Released by IDPH in March 2013 Revised 2017 Addresses patient choices- more than just CPR Medical Interventions Artificial nutrition Discussion on end of life preferences
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20 TRANSITIONS HOSPICE HEATHER BARRERA, MSW BEREAVEMENT COORDINATOR Please contact Heather if you have any questions about of the advance directives discussed today. Heather has extensive education on advance directives and can assist you in executing these documents.
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