Health Care Directive
Health Care Directive
A Health Care Directive or Advanced Directive is a set of instructions that will govern how you would like your health care managed when you are unable to communicate those instructions or decisions for yourself. The Advanced Health Care Directive includes both a instructive directive and proxy directive. The instructive directive is sometimes called a Living Will and the proxy directive may be called a Health Care Proxy, Health Care Power of Attorney or Durable Power of Attorney for Health Care. The Living Will includes your written instructions while the Health Care Proxy appoints an agent to act on your behalf.
Health Care Proxy
A Health Care Proxy, sometimes also called a Durable Power of Attorney for Health Care, is a document that identifies a person or persons appointed to make decisions for your health care when you are unable to do so. This person is called your Health Care Personal Representative to Agent. They will make the same decisions that you would make under those conditions, and if your express instruction is unknown or unclear due to unforeseen events, your Health Care Personal Representative will make the decision that they believe to be in your best interest, and aligned with your wishes.
A Current Advanced Health Care Directive should include a Health Insurance Portability and Accountability Act (HIPAA) provision. This clause will permit you to appoint a personal representative, as defined under the act, to have the same access to your health care and treatment information as you would have if you were able to act for yourself.
A Living Will is a document that is completed by you that directs medical staff what life sustaining treatments you do or do not want if you are diagnosed with a terminal condition or become permanently unconscious and are unlikely to recover. It is important to note the difference between medical treatment which assists recovery and medical treatment which merely prolongs the process of dying. A Living Will speaks only to the treatment prolonging the process of dying.
What Does that Mean?
A terminal condition is defined as the final stages of a fatal illness, disease or condition. There is no requirement that a diagnosis includes a certain amount of time to live.
Permanently unconscious means that you have permanently lost the ability to interact with your environment are are completely unaware of your surroundings.
Life-sustaining treatment is any medical device or procedure that increases your life expectancy by restoring or taking over a vital bodily function.
What are Some Types of Life-Sustaining Treatments?
Some opt to direct that all medically appropriate measures be provided to sustain their life regardless of their physical or mental condition, while others do not want life prolonged by medical treatment. Still others wish to decide which types of life sustaining treatments may be acceptable to them. Some, but not all, life sustaining treatments are listed below:
1. Breathing Machine or Ventilator - which would breath for you by pumping air into your lungs
2. Dialysis - which artificially performs the functions of the kidney
3. Cardiopulmonary Resuscitation (CPR) - which is performed when the heart stops beating and may involve the use of electrical shock to try to jump start your heart, by using chest compressions to keep blood pumping, or by injecting medicines into your vein
4. Feeding Tube - which is used if you cannot swallow and may be placed though your nose down into your throat and stomach or may be surgically placed into your stomach. Its purpose is to provide fluids and nutrition to you.
5. Blood and Water Transfusions (IV) - which is used to put blood and water into your body through an intravenous drip.
6. Surgeries and Medicines - life sustaining surgeries and medicines.
7. Ventilator - A breathing machine used to pump oxygen into your body.
While terminal conditions and permanently unconscious conditions are the most frequently addressed scenarios, incurable and irreversible conditions that are not terminal, experimental and/or futile treatment and brain death may also be considered, as well as listing provisions for specific procedures and/or treatments you may wish to include or exclude.
In addition to life sustaining measures, considerations relating to comfort including pain and symptom management together with social and spiritual support can be identified in your Advanced Health Care Directive.
Organ Donation may be considered and your wishes relating to same may be considered in your Advanced Health Care Directive Planning.
When Should You Prepare You Health Care Directive
As soon as possible! You have the right to accept or refuse any appropriate medical treatment aimed at supporting your organs which may prolong your life. Your choices may not coincide with those left to make choices on your behalf by default. As such, planning in when crisis exists allows you to make choices with clear intent, and frees your loved ones from making those difficult unguided decisions.
Often, an Advanced Health Care Directive is discussed at a time of crisis, for example, upon being admitted into a hospital. Assuming your crisis does not leave you incapacitated upon arrival, you will be asked if you have and advanced directives in place, and if not, if you would like to complete forms for that institution.
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