Advanced Directives

Question 1

A legal document executed by an individual that expresses that person’s desires about medical treatment that may be used once the person is no longer able to communicate their preferences directly.

Answer 1

Healthcare advanced directive.

Question 2

The patients right to use advanced directives is guaranteed by what?

Answer 2

The Patient Self-Determination Act.

Question 3

If a healthcare facility received federal funding they must honor what?

Answer 3

Patient Self-Determination Act.

Question 4

What does the Patient self-determination act require of facilities?

Answer 4

1 - At admission, pt. given written summary of facility policies & healthcare decision-making rights.
2- Ask pt. if they have an advanced directive - document answer in chart.
3- Educate staff & community about ADs
4- Ensure person knows that no discrimination will occur whether or not they have an AD.

Question 5

Advance Directives are a _______.

Answer 5

formal written document

Question 6

What does an AD include?

Answer 6

• Use /withholding of hydration &/or TPN
• CPR or intubation in life-threatening emergency (DNR)
• Who has authority to make decisions on pt. behalf if pt. not able to (surrogate).

Question 7

Document that provides specific instructions about what medical treatment pt. chooses to refuse.

Answer 7

Living Will

Question 8

Pt. may designate another person as a healthcare surrogate (proxy) & give them power to make healthcare decisions on their behalf if pt. unable to do so.

Answer 8

Durable power of attorney for healthcare.

Question 9

Surrogate decision makers have authority to do what?

Answer 9

• Consent to or Refuse any medical Tx or Dx procedure r/t persons physical or mental health - including TPN & hydration.
• Have access to all medical records
• Hire/Fire medical professionals
• Authorize admit to medical or LTC.
• Consent to comfort care, pain relief measures.
• Do whatever to carry out wishes, grant releases, waivers, seek judicial remedies etc.

Question 10

How many people need to witness an AD.

Answer 10

two

Question 11

Does a lawyer need to review an AD?

Answer 11

No.

Question 12

Role of the Nurse

Answer 12

Inform pt:

• they can always change their decision if they are competent.
• Instruct clients to provide copy of AD to next of kin, PCP, hospital, etc.
• Assess understanding and educate about life saving measures & actions that sustain life.
• Be supportive of pt. decisions.