Importance Of Advance Directives

The topic of end-of-life care may seem daunting and uncomfortable, and yet most individuals do have unique desires and concerns regarding their provision for the future. Providing the opportunity for that communication, the advance directive and POLST forms allow an individual to explicitly state their wishes before the future. Developed to lessen the apprehensions concerning patients undergoing any extensive and unwanted measures to preserve life at any cost, these medical directives lighten the decision-making burden for physicians and families alike and help comply with the patient’s utmost end-of-life wishes.

As a patient advocate, the nurse should engage in multidisciplinary support to help family understand the legal aspects and obligation of the power of attorney in making life end decisions and the legal obligations of the Advance Directives. Nurse must be firm in stressing these considerations to family so they may realize the full legal and ethical implications of their decisions.

An Advance directive is a living will, which allows one to document their wishes concerning medical treatments at the end of life. Even though it’s optional, but all health care facilities are required by law to ask patients if they have one, and offer them the appropriate information, and documents to sign if they want it. There are two basic kinds of advance directives, living wills, and

I, as a Registered Nurse, am bound by duty to protect the patient’s rights. This includes the treatment or withdrawal of medical care. Critical Care Quarterly states “The Advance Directive is a legally binding document written by a competent adult and should be carried out as such in the health care facility.”(Lark & Gatti, 1999, p. 1)

Advanced care directives are legal documents provided to physicians and health care workers with an outline containing preferences for the treatment at end of life. Patients often do not discuss their wishes regarding end-of-life care with family members or health care providers prior to the event of a serious illness or traumatic event. Educational interventions focus on raising awareness and providing patients with information on advance care planning.

There are two types of advance directives: a Living Will and the Durable Power of Attorney for Health Care. A Living Will requires a witness or be notarized and consists of a directive that instruct the acting physicians to not utilize medical interventions in an instance that the patient is unable to make their immediate medical decision. The Living Will is the oldest form of advanced directives, requires a patient be terminally ill and it states that its interpretation is only to be assumed by the patient and their physician, there is never to be any family influence or interpretation of a Living Will. Durable Power of Attorney for Health Care is also witnessed or notarized and identifies an ‘agent’ to make health care decisions if the signer is unable to make their own decision. An agent is an individual that the patient chooses with great care, due to the amount of power/authority that is assumed to making such decisions. The Durable Power of Attorney does not require that a patient be terminally ill and is interpreted by the identified ‘agent’. There have also been known to be hybrid documents that combine elements of a Living Will and Durable Power of Attorney for Health Care that acts as an Advanced Directive. (Advanced Directives.,

The Advance Directives form is somewhat different but its purpose is the same: to let an individual make end of life decisions. It is a longer form, with more involved questions.

Within the past ten years, multiple studies have been conducted regarding the completion rates of advance directives. Topics discussed include structure, evolution, benefits and challenges of advance directives (Perkins, 2007; Castillo, Hooper, Sabatino, Weithermon & Sudore, 2011; Cohen, MCannon, Edgman-Levitan & Kormos, 2010; Halpern et. all, 2013; Johnson, Zhao, Newby & Granger, 2012;Later & King, 2007; Mickelsen, Bernstein, Marshal & Miles, 2013; Yoo, Nakagawa & Kim, 2013; Waite et. all, 2013; Watson, 2010). Through initial research the same articles also provided possible solutions and recommendations that could be used to improve advance directives education procedures. However, the data did not provide a guideline that instructed how to conduct patient education procedures for advance directives. Therefore, the discovered data will be used to develop a possible guideline.

Every person except one did not know what an advanced directive states. The only interview that knew what I was asking was because they had just lost a loved one and their family was going through the situation. There were five children in the family. They had two children as execrator of the will and one child as a healthcare power of attorney. Before the death, the client states to have a full code with no artificial nutrient or ventilation. They only sought out partial interventions which made their status a code C. During this time the patient coded, and the wishes the client states stood strong. Therefore, it is so important to have an advance directive on file or with the next of kin. You never know when this time will happen but you can be proactive, and be prepared for any situation to

In a world of advancing healthcare, it is important to keep the patient’s dignity and autonomy as the focus of practice. One way to further patient centered care is the implementation of advance directives. Advance directives are written wishes or instructions relating to an individual’s extent of care when they are unable to communicate themselves. (Galambos, 1998). This written document is recognized under State law and should be recognized and honored by healthcare providers while caring for the patients. Two of the most common forms of advance directives include a living will or durable power of attorney for healthcare. It is common during a hospital admission for a patient to be presented with a living will, or a checklist of medical interventions the individual is willing or unwilling to accept (Mahon, 2011).

Advance Directives allow an individual to state his or her personal end of life health care choices in advance of an incapacitation illness or injury. According to U.S. Living Will Registry (2015), there are two types of directives:

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

In the older patient that has planned for end-stage diagnosis, an advance directive provides a means to articulate patient requests. However, in the patient who has sustained

It’s never easy for a family to say they want someone taken off life support. We want our family member to live; therefore, leaving this decision to them in their time of fear and grief is not fair. According to an article I found not many have made this choice, the article states, “but if we mirror the larger US population, only 25% to 30% of us have completed an advance directive” (Alspach, J. G., 2016). It’s often thought that just telling your family what you want will be enough, but without written proof, at that time, it’s no longer your

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.