end of life issues a focus on advance directives by latashia gilkes
TRANSCRIPT
Advance Directive
What is an advance directive?
An advance directive is any type of statement made by an individual to determine the medical care they would like to receive.
You can decide to continue to live or end life if and emergency decision has to be made
Purposes for advance directive
To make decisions before the client becomes
unable to make decisions for themselves
To be involved in and responsible for medical care
To ensure the proper care is taken
Purposes for advance directives
Preparation for a serious illness in the near future
To have someone provide a voice when incapacitated
Clarification of what the client wants
Topics to cover
Advance directives
Living wills
Durable power of attorney
Benefits
Ethical issues
Things you can do
Types of advance directives
Living wills
Power of attorney
Do not resuscitate
Do not hospitalize
Organ donation
Feeding restrictions
Medical restrictions
Request for autopsy
General Information
Advance directives are mostly used by the elderly and terminally ill individuals
Can have more than one advance directive (i.e. organ donation and do not resuscitate)
However, less than 25% of individuals have at least one advance directive.
General Information
Anyone over the age of 18 can have one or more types of advance directive.
Individuals with terminal Illnesses or in an vegetative state would be more likely to have AD’S
History of Advance directives
Cruzan v Director of the Missouri Department of Health (1990)Supreme Court case involving a client’s right to refuse
treatment during incapacitated state
Patient Self- Determination Act (1990)Gives individuals the right to obtain advance directivesAll health care providers are required to inform their
clients can accept or refuse medical care or treatment
Living Wills
Living wills are the statements made by the individual to determine what will happen to them in an emergency or temporary medical care.
They can be very specific in detail or simple
All parties need to be aware of the client’s wishes and comply with them
Types of Living Wills
Living wills can be
– Verbal (with family members, doctors)
– Written up by an attorney (legal documents)
– Discussed with a doctor or health care provider
Durable Power of Attorney (POA)
Appointing someone to make decisions if the client becomes incapacitated
The person can be a family member (children, sibling, spouse)
A trusted friend
Lawyer or doctor
Responsibilities of POA
To serve as a mediator for the client and the doctor
Voice for client
Comprehend the decisions made
Understand the client’s health
Meet the needs of the client
Benefits of advance directives
A medical plan for the future
Legal regulations to inform and provide individuals with advance directives
Ability to be involved and direct their medical decision
Can accept or refuse medical treatment
Connection between the client and POA
Disadvantages of advance directives
Clients can change their mind about their decisions
Difficult to predict what health issues will occur
Not being specific enough
Client may not want to make any decisions
Disadvantages
Misunderstanding the wishes of the client
Miscommunication between the client and POA
Disagreeing or ignoring the wishes of the client
Ethical issues
Doctors not meeting the client’s needs
Not giving the client all options
Cultural differences of the client
Religious differences of the client
Health care providers going against the client’s/family’s wishes
Word to the wise
GET AN ADVANCE DIRECTIVE!
Be responsible for your own health by any means necessary
You have the power to control of your medical care
Get all the information you can to make the choices necessary for your own medical circumstance
Things you can do
Obtain all the information about your health care to
make the right decisions
Make clear and precise decisions of what you
would want
Contact your doctor and/or attorney about advance
directive options