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Advance Directives Importance

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End of Life Planning and the Importance of Advance Directives
As people begin to age and become ill, the need for end of life planning becomes imminent. Thorough thought and consideration should be taken as one plans for some of the most life influencing moments of medical care. The use of Advance Directives allows for autonomy in choosing the medical treatment one receives, while offering the ability to die with ones dignity intact, and ensures that a person’s final wishes are honored. An Advance Directives main purpose is to appoint a surrogate to act on ones behalf when they cannot (Benson & Aldrich, 2012). Universally, decisions concerning life and death issues affect a large and increasing number of individuals, spurring the need for …show more content…

An Advance Directive appoints a surrogate decision maker also known as the durable power of attorney for health care agent, to make medical decision on a person’s behalf (Nabili & Shiel Jr., 2015). Similarly, some states recognize orally spoken advance directives as legal. Advance directives primarily consist of three types a living will, durable power of attorney, and Do-Not-Resuscitate Order. “A living will is a document that specifies the kinds of medical treatment a patient desires and can be very specific or very general” (Alfonso, 2009, p. 43). This document only becomes effective when it reaches the hands of the health care team caring for the patient (Alfonso, 2009, p. 43). A durable power of attorney is enacted by a legal document which names a person of 18 years of age or older as a surrogate decision maker allowing them to make all health care decisions if a person become unable to do so (Goldberg & Bennington Jr., 2013). This individual may also make bank transactions, sign social security checks, apply for disability, or simply write checks to pay the utility bill while an individual is medically incapacitated (Nabili & Shiel Jr., 2015). A Do-Not-Resuscitate Order is A do-not-resuscitate order also known as a DNR order, is a written document in which it expresses the wish that if breathing and …show more content…

An Advance directive serves as an important set of documents for any individual to have but even more so, for older adults who may potentially be at an even greater risk of hospitalization. Every competent adult has the legal right to be informed of the purpose, benefits, risks, and alternatives of any medical treatment to be given, along with the right to refuse any medical procedures (American Cancer Society, 2015). Advance directive allows for choices regarding medical care to be within a patient’s control and for ease in decision making of circumstances, where unwanted medical treatments and procedures would be used in effort to preserve life at any cost. This legal document also helps to alleviate the burden potentially felt by a patient’s family. As seen with the legal case of Terri Schiavo, a young woman who at 27 years old lived in a persistent vegetative state as a result of cardiac arrest, went through a publicized legal battle between her husband and family to determine whether to discontinue the use of tube feeding (Annas, 2005, p. 2). With no Advance directive in place to express Terri Schiavos medical wishes, her husband and family were both equally burdened by the battle of deciding whose final wishes would be best for Terri

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The requirements of the Self Determination Act of 1990 are that most hospitals and other health facilities must provide information on advance directives at the time of admission when it occurs. They must have a summary of health care decisions as well as the facility’s policies. What it does for long term consumers is that it provides written information to patients when they are admitted and make decisions that involves medical care and the right to refuse medical treatment and to formulate directives. It also ensures compliance and maintains policies with respect and provides education for all fellow staff of the

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Today in America the homeless account for almost 1.8 million with nearly 44 % of them being men. Disease and mortality are greatest in the homeless, there has “been a 51% increase in the number of patients age 50 or older between 2008 and 2014 (Healthcare).” With these increasing numbers, the growing need for advanced care planning in the homeless is becoming more relevant. The case study that was examined was Paul: No Surrogate.

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The ethical principle of autonomy provides for respect for the patient’s autonomy to make decisions and choices concerning their life and death. Respecting the patient’s autonomy goes against the principles of beneficence and non-maleficence. There also exists the issue of religious beliefs the patient, family, or the caretaker holds, with which the caretaker has to grapple. The caretaker thus faces issues of fidelity to patient welfare by not abandoning the patient or their family, compassionate provision of pain relief methods, and the moral precept to neither hasten death nor prolong life.

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Terminally ill patients lose control over so many aspects of their lives, in many ways physician-assisted death gives them back some of the control they lost. Illness is not discriminatory. Therefore, people of all ages and backgrounds are diagnosed with things like cancer, kidney failure, and heart disease every day. Also, for anyone who is unfortunate enough to be diagnosed with any terminal illness, it can feel like their disease controls every aspect of their lives and they have no choice in the matter. Authors for the Journal of the American Society on Aging Lee Combs and Grube describe how persistent pain took control of a young woman named Brittany Maynard’s life, “Even after undergoing a sophisticated surgery and numerous cancer treatments,

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Make and keep your major health decisions with advance health care directives. While they vary by state, advance directives can carry significant importance, especially as one gets older and increasingly concerned with health care and end-of-life decisions. Typically, two basic advance directives can cover a patient’s needs: the durable power of attorney for health care and the living will. Both serve the purpose of empowering the individual concerning personal health care in the case of incapacitation by illness or injury.

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These decisions include those relating to future health care, end of life care, personal arrangements and living arrangements, but not financial matters. In the event of a serious health issue, if the person has signed the advanced care directive, dictating that they refuse health care and it is directly relevant to the situation, then it is legal binding. All other aspects of the advanced care directive are only recommendations to the nominated person and/or the health care team (Advanced Care Directives - SA

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To balance out the pros and cons of co-guardianship regarding life-sustaining treatment is not an easy task, and the law fails to provide any guidance for those that are lead into this type of situation. LIVING WILLS In New York, there is little guidance on the use of a living will, but it is used to express an individual’s wishes as to end of life decisions in advance. Similar to a health care proxy, it is a legal document whereby an individual sets forth their wishes regarding medical treatment. It provides directives if the individual becomes permanently unable to participate in decisions for their medical treatment, including life-sustaining treatment. Enacted by the Courts, rather than legislation, living wills have little guidelines for its use.

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It is nearly impossible for the patient to rely on another person to make the best decision that they would have made for themselves, particularly when it involves personal interests such as profiting from a will. If there is something to gain, the family members’ motives seem questionable. If the patient falls ill, then there lies a possibility that their heirs will hope for the patient’s death so that they could receive their inheritance. The inability to confirm whether the family actually has the patient’s best interest in mind supports the argument that any form of euthanasia is unethical. Moreover, health care costs for terminally ill patients, including nursing homes, prescription drugs, and home health care deserves consideration.

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After reviewing the forms for advance directives, I learned there are many options people have for life care planning. No one in my family nor have I completed any type of advance directive form because we were not educated on what advance directives are and how they can influence our care. I never really put much thought into having an advance directive, but after learning about them, I understand the importance of having an advance directive and how it can affect my life if something tragic were to happen to me. I plan to have an advance

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Examples of advanced directives can include a power of attorney, health care surrogate, and a will (Sabatino, 2010). There

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In order for a patient to receive the prescription for medication, a physician must declare the patient to be terminally ill, which means they have an incurable and irreversible illness, and they must have no more than six months to live. Also, a second doctor must agree with the first doctor. In addition, the terminally ill patient has to be mentally competent and able to administer the medication themself (“Threat” A12). These rules act as safeguards to ensure that the patient requesting aid in dying is making an informed decision and is acting voluntarily (Gopal

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This act would mirror the legislation regarding death with dignity in Oregon, and the requirements set by the legislation. The CARE Act would allow for terminally ill patients who meet certain criteria to request medication that will end his/her life in a dignified and humane manner that is completely up to the discretion of the patient. The requirements would be that the patient has to be as resident of the state of Pennsylvania, the request must come from the patient themselves on a form that would be standardized by the statute, the request must be witnessed by two individuals, one of the individuals being someone who is not related to the patient making the request and has absolutely no financial stake in the process. The patient making the request must be at least 18 years of age, and must be deemed competent by all health officials providing treatment. The next requirement would be that witnesses must agree that the patient is of sound mind at the point of signing, and the patient’s physician must attest to the fact that the patients illness is terminal with less than six months projected to live, there is no hope of recovery, and all options have been exhausted in terms of palliative or comfort care.

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The Death with Dignity Act has two arguments: those who believe we have the right to choose how and when we die, and those who believe we do not possess that right; that we should not interfere with the natural order of life. Every year, people across America are diagnosed with a terminal illness. For some people there is time: time to hope for a cure, time to fight the disease, time to pray for a miracle. For others however, there is very little or no time. For these patients, their death is rapidly approaching and for the vast majority of them, it will be a slow and agonizing experience.

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As a nurse, it is my job to help with this thought process and converse with my client about their life. On major end of life issue is who will take care of the older adult when they are no longer able to take care of themselves. Older adults will

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A living will, also known as advance directives, states which life-saving measures the signor does and does not want; can specify that he or she wants such treatment to stop if doctors determine that there is no hope of recovery (Cheeseman). Without a living will in place your family members and doctors have to play the guessing game when it comes to the type of treatment one wish to have if they are seriously ill and becomes unable to communicate or make those types of decisions for themselves. Although a living will lets healthcare professionals and family members know who should be informed or involved in treatment decisions (Haas), they may not benefit from new medical treatment if they are

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