Advance Directives

Provider's orders

must order a "DNR" or "AND" (per patient/family consultation and wishes) in order to not administer CPR

Advance directives do not

not go into effect unless the patient is not able to speak for him/herself

The Patient Self-Determination Act requires

that asking all patients whether they have advance directive It does not require that patients have advance directives. It does require that healthcare facilities give information on how to obtain advance directives

DNR

Do Not Resuscitate

AND

Allow Natural Death

Durable Power of Attorney for Healthcare

Names a specific person to speak for the patient in the event that the patient is not able to speak for himself

Nursing Responsibilities

Provide written information about advance directives. Document the patient's advance directive status. Ensure that the advance directives reflect the patient's current decisions. Inform all members of the health care team, especially the providers, of the patient's advance directives and update immediately if the patient's directives change.

Exlpains

The designated person is known as the healthcare proxy or surrogate decision maker. Usually a family member or close personal friend, but may be anyone the patient says. The proxy/surrogate should be aware and discuss the patient's directives/wishes

Isnt the same as

The durable power of attorney for healthcare is only for healthcare and is NOT the same thing as a general power of attorney and does not have the same legal powers

Typically discusses

Use or withholding of hydration and nutrition at the end of life Use or withholding of medical treatment at the end of life Resuscitation or intubation in the event of a life-threatening emergency (including expected cessation of life in the case of a terminal illness)

Durable power of attorney for healthcare

designates a person to speak for the patient, if the patient is unable to speak for himself

Living will

expresses the patient's wishes for what he does or does not want done at the end of life, if he is not able to speak for himself

Living Will discusses

in general terms, what the patient would or would not want done at the end of life, if he is unable to speak for himself

Advance directives are

legal instruments to let others, including healthcare providers, their wishes for end-of-life care if they are not able to speak for themselves