Advanced Care Planning: A Necessary Analysis

The increased use of advanced directives, such as do-not-resuscitate orders, has made discussions on end-of-life care much easier for patients and professionals alike.

Advanced care planning is critical element in the therapeutic alliance between healthcare team and patient in providing adequate patient-centered care, with the patient a more willing collaborator. This process provides patient, family, and caregiver with realistic expectations about result of treatment and prudent preparation for possible outcomes. Effective advance care planning has been shown to increase satisfaction with care, lower moral distress, lead to healthier bereavement after death, provide timely

.“As medical technology continues to advance and health care choices become more complicated, the preservation of end-of-life autonomy is an increasingly important issue faced by various client populations.” (Galambos, 1998).

Other barriers in implementation might include the legality of certain medical interventions, associated costs and limited resources for providing the best care possible (Mason, 2013, p.12). As nurses, a barrier in implementing advance directives might also arise when advocated end-of-life wishes are undervalued or poorly recognized by others who do not share the same comfort or high priority in the medical workplace. Finally, the patient, families, and healthcare professionals face barriers in misconceptions regarding advance directives, especially in regards to

Advance care planning is a process to help patients with decision-making. The goals should be to make sure the patient is safe and to have the best options as possible when it comes to decision making. The goals of advance care planning should be to make sure to reduce conflicts between patient and the spokesperson. We also need to make sure that we understand the patient’s views about who they want you to communicate when health care decisions are required. Some similarities I saw was how they wanted to honor your choices. Both put patients first. Important qualities should consist of being there when needed, reliable, perfection, and willing to discuss changes. I haven’t discussed my advance care planning with anyone. I think that many

Death is in a sense inevitable, we can’t escape from it. In today’s day in age, we are living longer than our parents and our grandparents due to medical technology. But there are so many ethical issues and complications that go hand and hand with death. There are two forms of death, cardiac and brain-oriented. Determining these two forms of death, along with the determined time of death is vital, simply because we don’t want to treat a living person as if they were dead. With so many issues concerning death, we have to protect those who are on the brink of death or terminally ill and can’t speak for themselves, but allowing them to make preparations for the future. Advanced directives makes this possible,

When you are able, you should put thought into the physical process you will go through. All of us love you and want to make sure that when the time comes, we know and can follow your wishes regarding the care you wish to receive. Having your decisions thoroughly and clearly stated in an advance directive will make this possible. (Berger, 2014, p. 590). Your advance directive document may contain a living will, a signed consent for Do Not Resuscitate (DNR), and information identifying your healthcare proxy. Understanding these things now, will help you make clear choices. A living will clarifies what care, or lack of care, you wish to have (Berger, 2014, p. 590). This is helpful for reference if you are ever unconscious or in any way incapable

It is very important that each individual, if possible has a say in his or her own dying and death. Facing death is hard for everyone and there are specific issues to be talked about in advance. A living will or a Physician Order for Life-Sustaining Treatment (POLST) is extremely useful. The POLST is designed for people with serious or life-threatening illnesses. “This is a standardized form that describes a patient’s wishes and is signed by his or her physician, providing both summary of an individual’s advance directive decision and the physician’s order. It can be used to inform emergency personnel about a patient’s wishes for life sustaining procedures, such as CPR. “

This film explains the legal role of advance directives in end of life issues. An advance directive is “a written document directing how medical decisions are to be made in the future when the patient lacks decisional capacity and is unable to decide and choose” (Hanlon, End of Life Issues, Slide 28, Bullet 1). All three of the cases demonstrate the importance in filling out some form of directive. When there is nothing to go off of, it makes decisions extremely tough for families and medical providers. Having legal documentation of patient wishes helps understand what treatments they would or would not consent to. In cases like

With an increasing aging population and growing numbers of individuals with chronic conditions, it is important for individuals to prepare for end-of-life care. An Advance Directive is a defined as a “legal document that provides data to critical care staff about patients’ wishes, especially when critical illness decreases decision-making ability” (McAdam, Stotts, Padilla, and Puntillo, 2005). An Advance Directive also allows for better communication between the patient and doctor, and preserves the autonomy of patients. It may also alleviate one’s family from any possible burden of uncertainty of one’s wishes. It provides guidance, which may avert arguments with family members concerning treatment choices (Cedars Sinai, 2015). The Patient

I believe that communicating your wishes for end of life care is very important. Talking about end of life care to the people close to you can make a hard process easier and go smoother. It is also important that people document their end of life care and wishes for their medical records. A patient with documented end of life care and wishes will have autonomy and justice even when they are not mentally or physically able to express their wishes.

Advance Directives are our wishes when we are at end of life stages of life that give specific direction of how, who, and when to treat us in our final days and hours. We can have documents drawn up to say what we want in the event we are in a state where we cannot voice our wishes aloud. These documents have legal and ethical basis, and they should be followed unless the legally or ethically unable to do so.

Upon reflection of the Five Wishes, several thoughts came to mind. First and foremost, having a designated advanced directive is critical. There are countless examples of clinical experiences in with which families were overwhelmed with unexpected end-of-life decisions. As an educated caregiver, we should personally take the necessary steps to assure these tough decisions are known to someone who can facilitate the level of care desired. Such consideration of these elements of care in advance can help to support our loved ones during this emotional time. After review of the five wishes, I recognized that I would not want life-support measures if faced with irreversible deleterious outcomes that resulted from

Living Wills, sometimes called Advanced Directives, are legal documents accepted in all 50 states. They clearly define a person’s wish to decline life-support or medical treatment in certain circumstances, usually when death is imminent. Generally, a living will takes effect when a person becomes terminally ill, permanently unconscious or conscious with irreversible brain damage.

The advance directive, or living will, is one way of circumventing the ethical dilemma of Quinlan, as it is essentially a set of choices by the competent patient if faced with different hypothetical circumstances. Patients can thus feel comfortable knowing that their competent wishes have been documented and can be easily interpreted in case of catastrophe. However, the authority of advance directives is a topic hotly debated amongst medical ethicists (see Advance Directive Authority). Arguments against directives state that not all factors are considered by the person creating the advance order. Also, in some cases of severe dementia, it is argued that the personal identity of the author is no longer intact and therefore has no authority over the treatment of the “new” person. The debate on this topic is extremely complex, but many of today’s cases are decided on an individual basis, with the directive often being upheld.