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Welcome back everyone.
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End of life decisions can be very
emotional for the patient or family.
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Sometimes, decisions need to be made
quickly and this becomes complicated
if the patient has not previously
made his or her wishes known.
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The very best way to avoid this challenging situation
is to ensure the patient has an advanced directive.
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The term "advance directives" refers to treatment preferences
and the designation of a surrogate decision-maker
in the event that a person should become unable to
make medical decisions on her or his own behalf.
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Advance medical directives are designated to
outline a person's wishes and preferences
in regard to medical
treatments and interventions.
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When a patient is incapable of making his/her own medical
decisions, a health care proxy can act on the patient's behalf
to make decisions consistent with and
based on the patient's stated will.
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Now, in advance directive, the policies
can differ from one state to another.
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It might require the assistance from a
personal physician and an attorney.
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These should be included in important
documents as well as the medical record,
There are different categories.
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One - living will,.
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Health care proxy
And the power of attorney
A living will is a written document that specifies
what types of medical treatment are desired
should the individual become incapacitated.
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It can be very general or
it can be very specific.
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The most common statement in a living will is "to the
effect that if I suffer an incurable, irreversible illness,
disease or condition and my attending physician
determines that my condition is terminal,
I direct that life sustaining measures that would serve
only to prolong my dying be withheld or discontinued".
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Additional inclusions may identify a patient's
desire for analgesia or pain relief
or antibiotics or artificial
intravenous or IV hydration.
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Artificial feeding through a feeding tube,
CPR or cardiopulmonary resuscitation,
Life support equipment including
ventilators or breathing machines,
or a Do Not Resuscitate order, a DNR.
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Now, a healthcare proxy is a legal document in
which an individual designates another person
to make health care decisions if he or she is
rendered incapable of making their wishes known.
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Anyone identified as a healthcare proxy has the
same rights to request or refuse treatment
that the individual would have if capable
of making and communicating decisions.
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A Durable Power of Attorney.
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This provides the ability to execute legal documents
in the case of an incapacitating medical condition.
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Anyone who is identified as a durable power of attorney has the
ability to make bank transactions or sign social security checks,
apply for disability or
write checks to pay bills.
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Now, some common scenarios where an advance
directive becomes helpful could include
a coma, a persistent vegetative
state, severe brain injury, strokes,
advanced Alzheimer's disease
or other form of dementia,
critical medical illness
affecting mental capacity.
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Now let's talk about what to
assess and to document.
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You need to review and verify the patient's advance
directive status with the first patient contact.
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Be sure to encourage all patients
to initiate advance directives.
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Document and communicate all information
with other members of the healthcare team
so that the patient's choices are
upheld in all aspects of care.
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Remember, advance directives not only help with
the decision-making in times of incapacity,
but they can also clarify one's preferences during
times of uncertainties while still cognitively intact.
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So in thinking of what we've all covered
today, I'd like you to consider this question:
What are three categories of
advance medical directives?
They are living will, a health care
proxy and a durable power of attorney.
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I hope you've enjoyed today's
video on advance directives.
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Thank you so much for watching.