Are of a competent communicative patient must always be based on the presence of an advance directive in the chart or decisions listed in the directive?

What if I'm too sick to decide?
If you can't make treatment decisions, your doctor will ask your closest available relative or friend to help decide what is best for you. Occasionally there will be disagreement about what course to take. That's why it is helpful if you say in advance what you want to happen if you can't speak for yourself. There are several "advance directives" you can use to indicate preferences or designate who you'd like to speak on your behalf. One kind of advance directive under California law lets you name someone to make healthcare decisions when you can't. This form is called an Advance Health care Directive.

Who can fill out this form?
You can if you are 18 years or older and of sound mind. You do not need a lawyer to fill it out.

Who can I name to make medical treatment decisions when I'm not able to do so?
You can choose an adult relative or friend you trust as your "agent" to speak for you if you're too sick to make your own decisions.

How does this person know what I want?
After you choose someone, talk to that person about what you want. You can also write down in the "Advance Health Care Directive" when you would or wouldn't want medical treatment. Talk to your doctor about what you want and give your doctor a copy of the form. Give another copy to the person named as your agent. And take a copy with you when you go into a hospital or other treatment facility. Sometimes treatment decisions are hard to make and it truly helps your family and your doctor if they know what you want. The "Advance Health Care Directive" also gives them legal protection when they follow your wishes.

What if I don't have anybody to make decisions for me?
You can use another kind of advance directive to write down your wishes about treatment. This is often called a "Living Will" because it takes effect while you are still alive but have become unable to speak for yourself. "The California Natural Death Act" lets you sign a living will, called a Declaration. Anyone 18 years or older and of sound mind can sign one. When you sign a Declaration it tells your doctors that you don't want any treatment that would only prolong your dying. All life-sustaining treatment would be stopped if you were terminally ill and your death was expected soon, or if you were permanently unconscious. You would still receive treatment to keep you comfortable.

The doctors must follow your wishes about limiting treatment, or turn your care over to another doctor who will. Your doctors are also legally protected when they follow your wishes.

Living Will and Durable Power of Attorney for Healthcare

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It is the belief of Trinitas Regional Medical Center that competent adults have the right to make decisions affecting their health care. To this end, Trinitas employees will attempt to determine whether a patient being admitted has a Living Will, or a Durable Power of Attorney for Healthcare document. These documents, commonly referred to as Advance Directives, express the patient's wishes in advance of medical treatment or medical emergencies and solve a number of problems and clear up a number of issues in advance.

Advance Directives will be honored according to the patient's wishes. The Pastoral Care or Department of Social Work will follow up with the patient/family requesting information regarding an Advance Directive/Living Will.

Patients receive written information regarding their individual rights, including the right to make an Advance Directive/Living Will.

Trinitas will not discriminate against any patient with regard to provision of care or in any other way based upon the presence or absence of an Advance Directive/Living Will.

Key Facts

• Advance Directives are legal documents

• A person must be over 18 years of age to create their own Advance Directives

• The completion of Advance Directives documents must be witnessed by 2 adults

• The Advanced Directive document must comply with state law

• The law protects healthcare workers from any legal action

• A patient's medical record must indicate presence of an Advance Directive (or lack thereof)

• The Patient Self-Determination Act (PSDA) requires health-care facilities that receive federal funding to discuss Advance Directives with patients.

• At the time of admission, staff must provide patients with written information about their right to make health-care decisions.

Documentation of Advance Directives

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The existence of an advance directive, or lack of one, must be entered into the patient's permanent medical record.

If the patient has a copy of an existing advanced directive, 3 copies will be made with 2 copies placed on the medical record and one forwarded to the Director of Mission Effectiveness.

If the patient does not have a copy, they will be asked to bring a copy to be placed on medical record

If the patient has no advanced directive, the patient or family will be offered a copy of the Advance Directive Informant packet.

Frequently-Asked Questions

What are Advance Medical Directives?
Advanced Directives are written documents that allow patients to give directions about future medical care.

What is a Living Will?
A Living Will provides written instructions regarding a person's wishes regarding health care. Without a Living Will family members make some or all healthcare decisions. It allows one to name a person (called a proxy) to make decisions if you are unable to do so.

These decisions may concern health care, legal matters, finances and other important matters.

Problems can occur if your family members do not know your wishes, or disagree about the best course of action to take in regard to your medical treatment.

Without a Living Will or Durable Power of Attorney for Healthcare documents in place, a hospital physician who does not know you may become your decision maker.

Could my family prevent my advance directive from taking effect?
Generally, no - though it depends on state law. When families object, hospital staff may be called in to help them understand that the right thing to do is to honor the patient's wishes.

Do I need to talk to a lawyer?
It's up to you. You can sign - and even create an Advance Directive without a lawyer's assistance. However, some people feel more secure if a lawyer looks the documents over.

Can I still get treatment for pain if I have an Advance Directive?
Absolutely. An Advance Directive gives you the ability to be very specific about what kinds of treatment you do or do not want.

Can I change or cancel my Advance Directive?
Yes. As with a will, changes can be made to an advance directive at any time by adding or removing items. An Advance Directive can be canceled by saying "I revoke my Advance Directive" before a witness.

Related Terms

Cardiopulmonary Resuscitation (CPR)
An emergency procedure for reviving a patient whose heart has stopped beating.

Respirator
A machine (also known as a ventilator) to keep the lungs working when a patient has lost the ability to breathe on his or her own.

DNR
"Do Not Resuscitate" A DNR order prevents the health-care team from taking any measures to revive the patient. The DNR must be noted on the patient's chart.

Total Parenteral Nutrition
Artificial nutrition and hydration, this is a method for supplying water and nutrients to a patient who can no longer eat or drink.

Terminal Illness
In general, a terminal illness is one that is incurable and is expected to bring about death within one year.

Dialysis
The use of a special machine to help clean the blood when the kidneys aren't working properly.

Which of the following is an advance directive quizlet?

What is the most meaningful description of patient rights?

Who may a patient's medical records be shared with?

What is an example of patient's rights quizlet?