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Advanced Care Directives

This post is part of course requirements for Dr. Farzin Madjidi, EDLT724.20, Ethics and Personal Leadership.

Advanced Care Directives

Advanced Care Directives are written wishes of patient and potential patients, but particularly the elderly regarding medical treatment, end of life decisions, and financial preferences. Also known as advanced healthcare planning, advanced care directives communicate

You may not be able to make health care choices for yourself if you are very ill or injured. The form tells doctor, medical staff and emergency medical attendants in advance how to proceed with medical care and end-of-life choices. Most hospitals have Advance Directive forms, such as the ones at the links below. Studies show that most people believe having an advance directive is a good idea; yet, most people have not created one for themselves.

With an advance directive, you can let your doctor and your family know what medical treatment you want and don’t want. You can change your decisions at any time. Be sure to tell everyone involved — family, proxies, and health care providers — if a living will is changed. Copy, save, and share the new instructions with them.

What to consider before completing an Advanced Directive:

  • Know and understand your treatment options
  • Decide future treatment options you may want
  • Consider becoming an organ donor. You can fill out an organ donation card and also have this choice listed on your driver’s license.
  • Discuss your choices with your family

What to do after completing an Advanced Directive

  • Carry a copy of your Advanced Directives with you
  • Let your family know that you have Advanced Directives in place.
  • Keep a folder in a central place in your home with a copy of your Advanced Directives, your doctors’ names and contact information and any and all medicines currently prescribed, including dosage amounts.

The following information is from the Texas Hospitals’ Association website

There are four types of advance directives. You can execute one, or several, depending on your needs and situation. Download and complete the Texas forms below in English or Spanish. Share copies with your doctor and your family, and take copies with you to the hospital.

Directive to Physicians and Family or Surrogates (PDF in English | PDF in Spanish)

  • This directive allows you to specify for the provision, withdrawal or withholding of medical care in the event of a terminal or irreversible condition.
  • Your condition must be certified by one physician.

Medical Power of Attorney (PDF in English | PDF in Spanish)

  • This directive allows you to designate another person as your agent for making health care decisions if you become incompetent.
  • You do not have to have a terminal or irreversible condition for a medical power of attorney to be used.

Out-of-Hospital Do-Not-Resuscitate Order (PDF in English | Instructions in Spanish)

  • This directive allows competent adults to refuse certain life-sustaining treatments in non-hospital settings where health care professionals are called to assist, including hospital ERs and outpatient settings.
  • You should carry a photocopy of your written form or wear a designated ID bracelet.
  • This directive cannot be executed for minors unless a physician states the minor has a terminal or irreversible condition.
  • Note: The PDF form in English must be properly executed in accordance with the instructions on the opposite side (download Spanish instructions separately) to be considered a valid form by emergency medical services personnel.

Declaration of Mental Health Treatment (PDF in English | PDF in Spanish)

  • This directive allows a court to determine when you become incapacitated, and when that declaration becomes effective.
  • You may opt not to consent to electro-convulsive therapy or to the use of psychoactive drugs.
  • The declaration expires in three years, unless you are incapacitated at that time.

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References

Kapp MB. Ethical and legal issues. In: Duthie EH, Katz PR, Malone ML, eds. Practice of Geriatrics. 4th ed. Philadelphia,Pa: Saunders Elsevier; 2007:chap 6.

Texas Hospitals Association website. Retrieved From: http://www.tha.org/generalpublic/advancedirectives/whataremyoptionsfor09c0/

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