Advance Directives – Health Care Law (Nursing)

00:00 Welcome back everyone.

00:03 End of life decisions can be very emotional for the patient or family.

00:07 Sometimes, decisions need to be made quickly and this becomes complicated if the patient has not previously made his or her wishes known.

00:15 The very best way to avoid this challenging situation is to ensure the patient has an advanced directive.

00:21 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.

00:34 Advance medical directives are designated to outline a person's wishes and preferences in regard to medical treatments and interventions.

00:43 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.

00:55 Now, in advance directive, the policies can differ from one state to another.

01:00 It might require the assistance from a personal physician and an attorney.

01:05 These should be included in important documents as well as the medical record, There are different categories.

01:13 One - living will,.

01:15 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.

01:29 It can be very general or it can be very specific.

01:32 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".

01:52 Additional inclusions may identify a patient's desire for analgesia or pain relief or antibiotics or artificial intravenous or IV hydration.

02:05 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.

02:21 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.

02:33 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.

02:44 A Durable Power of Attorney.

02:46 This provides the ability to execute legal documents in the case of an incapacitating medical condition.

02:53 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.

03:06 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.

03:29 Now let's talk about what to assess and to document.

03:32 You need to review and verify the patient's advance directive status with the first patient contact.

03:38 Be sure to encourage all patients to initiate advance directives.

03:42 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.

03:53 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.

04:06 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.

04:27 I hope you've enjoyed today's video on advance directives.

04:30 Thank you so much for watching.