Nursing Home Info at patrick.net

Featured Article

By Sharon Johnson, February 9th, 2009

The Importance of Advanced Directives

Advanced Directives are the decisions that you make about the treatment you would like if you suffer a life-ending event such as a heart attack. The ideal time to make choices about your healthcare is when you are able to make informed decisions, and you have the opportunity to consider all of the treatment options and decide exactly what you would or wouldn't want done if you have no chance for recovery. You can complete Advanced Directives on your own, or you can make an appointment to discuss the treatment options with your doctor. Most doctors welcome such discussions and will explain the treatment options in detail so that you fully understand the choices you can make about your healthcare.

If there are no Advanced Directives on file, each state has a law that addresses the succession of decision-makers (known as "next of kin") on a person's behalf. Although this covers family relationships, it doesn't address people who live together and aren't married, close friendships, and any number of other possibilities.

There are many different types of Advanced Directives. They can be found separately or can be combined into one form. The ones most generally used to make healthcare decisions are:

Durable Powers of Attorney for Health Care (DPOA) - a type of Advanced Directive that designates the person that the patient wants to make decisions if he is unable to make informed decisions on his own. It is always best to name one person as P.O.A., and alternates if he/she isn't able to perform. Social Security, Medicare, Medicaid, the Veteran's Administration, insurance companies, and most other providers will honor a DPOA so that the P.O.A. can intercede on the patient's behalf to apply for benefits.

Do Not Resuscitate Order (DNR) - an Order that is given by a Physician that directs the medical staff to allow the patient to die if his heart stops beating or he stops breathing.

Living Will - a form that a person completes to tell Medical Providers what type of care he would like if he has no likelihood of recovery. Most modern Living Wills give the patient the opportunity to choose which of the treatment options they would prefer, such as CPR, Intravenous Fluids and Antibiotics, placement on a Ventilator, etc.

Advanced Directives should be reviewed at least every two years because situations change, and it's possible that the Healthcare Power of Attorney you chose is no longer able to make decisions, or that he/she is no longer the person that you wish to speak for you.

The forms can be found at office supply stores, online, or can be completed by an attorney. People spend hundreds of dollars to seek legal advice because they aren't aware that each state offers Advanced Directive forms that you can easily download and complete for free. The forms must be notarized or witnessed in accordance with state law, or the documents aren't legal. The form will also clearly state who can be a witness, in most cases it must be a non-related person who isn't providing care to the patient. Once completed, copies should be given to the treating physician and hospital, the designated Power of Attorney, and to other family members or friends so that there will be no question as to how you wish to be treated.

Remember, a person can only complete an Advanced Directive for himself when he is competent to make decisions. If he doesn't know who he is, where he is, the date, and the situation he isn't competent to make a decision as to his healthcare. At that point, a family member will have to step in according to the laws of the state in which the patient resides.

Sharon Johnson, BSW, is a Social Worker with over18 years of direct experience working with the elderly. She is the author of several books on senior care issues and Executive Director of Case Management Solutions, LLC. Her books can be purchased at www.cmseldercare.com