The Importance Of Establishing A Durable Power Of Attorney For Healthcare

* Patient must sign an elective statement indicating they understand the nature of their illness or condition, and of hospice care. By signing the statement, the patient surrenders their right to other Medicare benefits related to their illness. (A family member may sign the election statement on behalf of the patient if they are unable to do so.)

In dementia care we often look to family, advocates other professionals and carers in order to gain consent when the individual no longer has the capacity.

The Patient Protection and Affordable Care Act (PPACA), also known as the Affordable Care Act (ACA) or, more commonly, Obamacare, is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law mandates United States citizens to obtain health insurance coverage and businesses of 50 or more full time employees) to provide health insurance to its’ employees. Should you not be covered, a penalty will be imposed.

The Federal Patient Self-Determination Act (PSDA) of 1991 first brought attention to the importance of advance directives (GAPNA, n.d.). Although regulatory bodies continue to promote advance directives, little has been done to encourage and enforce this initiative, highlighting the need for directed efforts to improve AD completion rates. The overall prevalence of completed advance directives in the United has been estimated that 5-15% (Tung & North, 2009). This indicates a need for programs to educate and empower patients and providers to ensure that dialogue about advanced care planning is initiated early on, and that advance directives are completed. Studies have shown that patients prefer that their primary care doctor initiate such planning while they are in good health and that such planning should occur earlier than it did in terms of age, natural history of disease, and patient-physician relationship. The barriers to advance care planning that have been identified include availability of trained staff, organizational commitment and policy to support advance care planning, and understanding/support of providers (Ramsaroop, Reid, & Adelman, 2007).

Documentation and communication are constant challenges that healthcare providers face when seeking continuity of care for their patients. Every time a patient moves from a hospital to a nursing home, or from a skilled nursing facility to home health or hospice, the staff that cares for the patient is at risk for a gap in patient care and communication. Home health and hospice agencies rely heavily on Medicaid and other insurance for reimbursements in order to continue to provide care for their patients and keep the doors to their agencies open. Thorough and timely documentation is the key to ensuring proper reimbursement for nursing services and other therapies provided from insurance agencies. This same

In the implementation phase of this regulation, it was faced with myriad of political, economic, technical, ethical and legal challenge and the end result of universal access to high quality healthcare which was far from assured. He further argues that nursing facilities in the additional public disclosure requirements, long time service and support (LTSS) were not a pressing priority of ACA drafters and its proponents. The LTSS was for people who needed assistance in order to perform daily activates over a long period die to chronic illness or disabilities in community based and institutional

The nurse in the case study is faced with an ethical and professional, dilemma. How can she be an advocate for her patient Mr. E? Dr G. is proceeding on a course of action or plan of care that is directly contrary to the patients advance directive and his verbalized objections to the course of treatment proposed by the physician and that is concerning for her. There are multiple issues to consider. For the nurse, she needs to think about her code of ethics, her scope of practice and the legal issues regarding advance directives and Durable Power Of Attorney (DPOA). She also needs to consider the patients right to privacy and confidentiality. As with most areas and issues in modern healthcare the statues can be

Arkansas Durable Power Of Attorney For Health Care is a legal document signed and executed to appoint attorney in fact or an agent for taking crucial healthcare decisions on behalf of the signing principal when the signing principal is incapable of taking decisions for him/her self. This document is pursuant to Arkansas Durable Power of Attorney for Health Care Act (Ark. Code Ann. § 20-13-104). The document furthermore provides a source to appoint secondary agent in case of failure in delivering promised services by the primary agent or attorney in fact. Annulling this legal document is possible only upon revocation by the signing principal and/or death of the signing principal.

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.

In the assignment for Week 5, you completed the four must-have documents: a will, living revocable trust, advanced directive, and durable power of attorney for health care. Congratulations! You have done something unfortunately too few people take the time to do, yet something that is absolutely essential to your ability to protect yourself and your family. If you have not already done so, take a moment to give yourself a pat on the back. You deserve it! Now it is time to talk about what you have done.

An 89 year old patient came to the emergency room from a nursing home. Per the nursing home staff, the patient had a “floppy leg” and grimaced when that leg was moved. The patient’s advance directive paperwork was provided. The patient is non-verbal. An advance directive is a document composed by competent patient’s that ensure the right of self-determination: the right of every person to make their own decisions about their medical treatment, including the right to refuse treatment (Martin, 2013).

A medical power of attorney, also known as a health-care proxy, gives parents permission to make medical decisions if their student is physically unable to do so. Although it is extremely uncomfortable and unsettling to discuss such situations with your child beforehand, don't find out too late that your student has been admitted to a hospital and you're not authorized to discuss treatment plans or make emergent decisions regarding care.

We agree with Laurel Creek that Gilbert created an actual agency relationship between him and his wife. According to his sister, Rachel, Gilbert specifically asked that his wife be brought to the nursing home so that she could sign the admissions documents for him, and Anna acted upon that delegation of authority and signed the admissions papers. This is consistent with the creation of actual authority as described in the Restatement (Third) of Agency § 2.01, comment c (2006). The Restatement explains the rationale for the creation of actual agency in three steps. First, “the principal manifests assent to be affected by the agent’s action.” In the instant case, Gilbert asked that Anna come to the hospital to sign the papers for him. Second, “the agent’s actions establish the agent’s consent to act on the principal’s behalf.” Here, Anna signed all the admissions papers per her husband’s request and therefore consented to act on Gilbert’s behalf. Third, by acting within such authority, the agent affects the principal’s legal relations with third parties. Clearly here, Anna’s actions affected Gilbert’s relations with Laurel Creek, a third party.

This is illustrated in Mrs. Smith’s case. Mrs. Smith is an 85 year old who has suffered from a large stroke that extends to both of her brain hemispheres which has left her unconscious and unable to make medical decisions for herself. She only has some brain stem reflexes and requires a ventilator for life support. Mrs. Smith did not set up an advanced directive, which is defined by Miracle (2011) “mechanism by which individuals make known how they want medical treatment decisions made when they can no longer make them for themselves” (p.229). Without an advanced directive, medical decisions will fall to Mrs. Smith’s children, Sara and Frank. Each of which have different views regarding their mother’s plan of care. The decision that needs to be made is whether to prolong Mrs. Smith’s life with continued medical intervention, as Sara would like to do, or stop all treatments and care, as Frank

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.