1. Brief Introduction.
An advance health care directive or advance directive is a legal document that tells the doctor the wishes of a patient concerning health care. It provides a better chance of receiving the kinds of treatment a patient may or may not have when they are unable to voice those wishes to a doctor or family members. A patient may choose a living will, a medical directive, or a health care power of attorney or health care proxy, or a combination of the three.
2. Explanation of topic.
Advance directives might have many guidelines for patient’s preferences with regard to any number of life-affecting, or end of life situations, such as chronic disease or accident resulting in traumatic injury. It can include directions for other health situations, such as short-term unconsciousness, impairment by Alzheimer disease or dementia. These guidelines may consider do-not- resuscitate (DNR) orders if the heart or breathing stops, tube-feeding, or organ and tissue donation. The directive might name a specific person, or proxy, to direct care or may be very general with only basic instructions given for treatment in time of the incapacitation of a patient. Some states say that if you do not have a written directive, a spoken directive is acceptable.
An advance health care directive has nothing to do with control of finance, property, inheritance, or regular wills. It only concerns issues of medical care. Any health care directive may be changed, revoked or amended by the patient at any time and should be kept current. Potential or possible future mental health issues may be addressed in advance also by use of an instrument called a mental health care directive or psychiatric care directive.
3. Discussion of Topic.
One form o...
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...and medical power of attorney choices. Under the Patient Self-Determination Act of 1990, healthcare providers ask their patients about advance directives and provide information about available directives, enabling a conversation to take place between them.
While navigating the abundant and sometimes confusing legal language of advance directives can be time consuming, it would benefit every person to consider their end of life wishes and have some form of written statement available for their doctor and family to understand those wishes. Doing this in advance can prevent emotional anguish, suffering and expensive litigation. In the end, clearly and when possible, written, documentation of a medical directive, a living will, or a chosen health care power of attorney will lessen the burden for the medical professionals and family of a dying or incapacitated person.
Once I explained exactly what a living will is because some were unaware they were very comfortable with the idea of filling out a living will. The responses that I got all varied to different degrees. My brother stated that he did not yet have a living will but that they are very important to have and everyone should get one. He said that his wishes would be to pretty much “pull the plug in every circumstance”. He absolutely did not want to be put on life support, be artificially supplied with food, or get life sustaining drugs, machines, or other medical procedures. My mother had wishes the same as I would have which is to consider the circumstances and give me a month to evaluate if I have the possibility of making a full recovery. If there is no hope of having a full recovery then I want all life sustaining measures to be stopped because I don’t in any way want to be a burden on
Wiener, Lori, Elizabeth Ballard, Tara Brennan, Haven Battles, Pedro Martinez, and Maryland Pao. 2008. "How I wish to be remembered: the use of an advance care planning document in adolescent and young adult populations." Journal Of Palliative Medicine 11, no. 10: 1309-1313. MEDLINE with Full Text, EBSCOhost (accessed May 26, 2014).
An effective advance care planning process follows a series of steps that incorporates the patient’s preferences, their values, and a dialog to help identify proxies. The educated person must first consider a proxy and determine the goals of their care. Ideally, the chosen proxy will then partake in the advance care planning process. It is important that the person completing the advance directive make the proxy aware of their authority, the goals of treatment, important personal factors, and the scope of discretion for that individual. It is also imperative that the advance care directive be available to both the proxy and healthcare providers.
In this context, new emphasis is being placed on the rights of patients. Recent federal legislation, for example, requires all health care facilities receiving Medicare or Medicaid monies to inform patients of their right to make medical treatment decisions. This includes the right to specify "advance directives," [1] which state what patients wish to be done in case they are no longer able to communicate adequately.
Social Attitudes Survey noted that 78% of respondents believe that “the law should require doctors to carry out the instructions of a Living Will” (Park et al, 2007). These decisions become important once patients lose their mental capacity, are unconscious, or unable to communicate” (BMA, 2009). The Mental Capacity Act 2005 defines an “advance decision” as a decision made by a person 18 or over, when he or she has the capacity to do so. The implications of a Living Will, make the case against legalising assisted dying weaker. This is because if a person is legally allowed to set out which treatments they will or will not agree to, and can refuse life sustaining treatments by creating a legal document, then why shouldn’t an individual in extreme pain who is able to make the request at the time be able to ask for assistance in
A living will is a type of advanced health care directive, which states an individual’s wishes for health care treatment when he/she is terminally ill. Living wills are often applied to end-of-life decision making when patients are no longer deemed competent to direct care for themselves. The form of living wills can vary widely. But, most address whether or not to use life-prolong medical treatment such as CPR, respirators, and artificial nutrition and hydration. These documents can also contain information about the importance of quality of life for patients and can name a healthcare proxy to make medical decisions in their place. Having a living will allows individuals to state their
Nurses take an active role in advocacy and policy development regarding assisted death and other end of life choices. Through the help of advance care planning, nurses has helped patient think about what gives their life a meaning, learn about medical procedure offered at end-of-life care, help them communicate about their future health care wishes, choosing a person who would speak for them when they cannot speak for themselves and recording goals and wishes. The role of the nurse in end-of-life care is very crucial, they might be getting more queries on physician-assisted death. So, it is significant for nurses to understand the law and professional standard for better continuity of care and also to protect themselves against potential
California State law needs clear and convincing proof of what the client would desire. Of all the numerous acceptable forms of proof, a health care statement (called a Living Will) can be the very best. It simply documents a person’s desires worrying treatment when those wishes can no longer be personally communicated. Even in CA, such a file is recognized if it is clear, specific and
One of the greatest dangers facing chronic and terminally ill patients is the grey area regarding PAS. In the Netherlands, there are strict criteria for the practice of PAS. Despite such stringencies, the Council on Ethical and Judicial Affairs (1992) found 28% of the PAS cases in the Netherlands did not meet the criteria. The evidence suggests some of the patient’s lives may have ended prematurely or involuntarily. This problem can be addressed via advance directives. These directives would be written by competent individuals explaining their decision to be aided in dying when they are no longer capable of making medical decisions. These interpretations are largely defined by ones morals, understanding of ethics, individual attitudes, religious and cultural values.
Dementia patients must have the right to participate in all decisions concerning their care. Every person in this world has the same equal rights, no matter the situation. Doctors, caregivers, nurses, and even family members brush off the request of the person suffering from dementia each and every day. Most people call this carelessness while others call it freedom and in all reality, it is far from freedom. Luckily, there are many people who fight for the freedom everyone deserves. The majority of "Health professionals are usually keen to keep people with dementia at the center of decisions. Independent advocacy can support this by giving the extra time and skills needed to help people have a voice without the tensions of any other role"
The care of patients at the end of their live should be as humane and respectful to help them cope with the accompanying prognosis of the end of their lives. The reality of this situation is that all too often, the care a patient receives at the end of their life is quite different and generally not performed well. The healthcare system of the United States does not perform well within the scope of providing the patient with by all means a distress and pain free palliative or hospice care plan. To often patients do not have a specific plan implemented on how they wish to have their end of life care carried out for them. End of life decisions are frequently left to the decision of family member's or physicians who may not know what the patient needs are beforehand or is not acting in the patient's best wishes. This places the unenviable task of choosing care for the patient instead of the patient having a carefully written out plan on how to carry out their final days. A strategy that can improve the rate of care that patients receive and improve the healthcare system in general would be to have the patient create a end of life care plan with their primary care physician one to two years prior to when the physician feels that the patient is near the end of their life. This would put the decision making power on the patient and it would improve the quality of care the patient receives when they are at the end of their life. By developing a specific care plan, the patient would be in control of their wishes on how they would like their care to be handled when the time of death nears. We can identify strengths and weakness with this strategy and implement changes to the strategy to improve the overall system of care with...
Prior to discussing why Advanced Directives are so essential the definition of Advanced Directives is crucial. An Advanced Directive is made up of several legal components which ultimately online the patient’s wishes if one was to be incapacitated or unable to verbally make wishes know regarding healthcare. The understanding of what a living will and a durable power of attorney both need to be discussed before one is able to compare and contrast. A living will ensures that anyone reading this paper will understand how the patient wanted to continue their form of treatment. With a living will anyone ranging from patients to healthcare professions should be able to determine the specific actions the patients would want taken if they are unable to make said wishes known. A
The end-of-life nurse’s primary objective is to provide comfort and compassion to patients and their families during an extremely difficult time. They must satisfy all “physical, psychological, social, cultural and spiritual needs” of the patient and their family. (Wu & Volker, 2012) The nurse involves their patient in care planning, as well as educating them about the options available. They must follow the wishes of the patient and their family, as provided in the patient’s advance directive if there is one available. It is i...
For example, their choice ( if they want to do it) is taking the patient's specific directions when helping them with their ADL routine, choosing their ADL products and outfits. It is also important to continue to respect them, encourage them, respect their ideas/desires to incorporate a family member (only family member(s) designated by them that they want involved in their care), being addressed by the name they prefer to be called, and in incorporating them as full partners in deciding and providing their care. Don Berwick in the YouTube video is sad today about his right knee surgery which he didn't think was necessary. To avoid cases like this, we can “do for them” by incorporating them into their care plan as a full partner. The goal is to work with them with encouragement to regain their strengths again.
Taking an example of EOL decision again, death and dying of self or immediate family is the most difficult subject to talk about. She arranges a meeting with next of kin and other health professional depending on the situation and explains the whole situation, the pros and cons of each decision in an unbiased manner (Burgess, Braunack-Mayer, Crawford & Beilby, 2014). With the previous experience and the training received on end of life care, geriatric nurse gets a well-written treatment plan by the treating physician. She communicates the decision among the multi-disciplinary team (Stewart, Goddard & Schiff, 2011) and documents all discussions and decisions for shift handover and as a legal record for later (Chan &