Welcome back everyone.
End of life decisions can be very
emotional for the patient or family.
Sometimes, decisions need to be made
quickly and this becomes complicated
if the patient has not previously
made his or her wishes known.
The very best way to avoid this challenging situation
is to ensure the patient has an advanced directive.
The term "advance directives" refers to treatment preferences
and the designation of a surrogate decision-maker
in the event that a person should become unable to
make medical decisions on her or his own behalf.
Advance medical directives are designated to
outline a person's wishes and preferences
in regard to medical
treatments and interventions.
When a patient is incapable of making his/her own medical
decisions, a health care proxy can act on the patient's behalf
to make decisions consistent with and
based on the patient's stated will.
Now, in advance directive, the policies
can differ from one state to another.
It might require the assistance from a
personal physician and an attorney.
These should be included in important
documents as well as the medical record,
There are different categories.
One - living will,.
Health care proxy
And the power of attorney
A living will is a written document that specifies
what types of medical treatment are desired
should the individual become incapacitated.
It can be very general or
it can be very specific.
The most common statement in a living will is "to the
effect that if I suffer an incurable, irreversible illness,
disease or condition and my attending physician
determines that my condition is terminal,
I direct that life sustaining measures that would serve
only to prolong my dying be withheld or discontinued".
Additional inclusions may identify a patient's
desire for analgesia or pain relief
or antibiotics or artificial
intravenous or IV hydration.
Artificial feeding through a feeding tube,
CPR or cardiopulmonary resuscitation,
Life support equipment including
ventilators or breathing machines,
or a Do Not Resuscitate order, a DNR.
Now, a healthcare proxy is a legal document in
which an individual designates another person
to make health care decisions if he or she is
rendered incapable of making their wishes known.
Anyone identified as a healthcare proxy has the
same rights to request or refuse treatment
that the individual would have if capable
of making and communicating decisions.
A Durable Power of Attorney.
This provides the ability to execute legal documents
in the case of an incapacitating medical condition.
Anyone who is identified as a durable power of attorney has the
ability to make bank transactions or sign social security checks,
apply for disability or
write checks to pay bills.
Now, some common scenarios where an advance
directive becomes helpful could include
a coma, a persistent vegetative
state, severe brain injury, strokes,
advanced Alzheimer's disease
or other form of dementia,
critical medical illness
affecting mental capacity.
Now let's talk about what to
assess and to document.
You need to review and verify the patient's advance
directive status with the first patient contact.
Be sure to encourage all patients
to initiate advance directives.
Document and communicate all information
with other members of the healthcare team
so that the patient's choices are
upheld in all aspects of care.
Remember, advance directives not only help with
the decision-making in times of incapacity,
but they can also clarify one's preferences during
times of uncertainties while still cognitively intact.
So in thinking of what we've all covered
today, I'd like you to consider this question:
What are three categories of
advance medical directives?
They are living will, a health care
proxy and a durable power of attorney.
I hope you've enjoyed today's
video on advance directives.
Thank you so much for watching.