USF-COM
Department
of Family Medicine
Patient Education Information on...
Index of
Patient Education Topics
INTRODUCTION
As a patient you have certain rights in any hospital, nursing home facility,
and healthcare setting. Those rights include confidentiality of your
records, understanding the treatments and options, being involved in the
decisions regarding your healthcare and choosing what you need and want.
But what happens when you can no longer be involved in making the decisions?
Who decides for you? Your doctor? The Insurance company? A lawyer? Your
family? A neighbor?
We all diligently make our provisions regarding our estate and assets
in case anything should happen to us. But what about our health care in
the event that we are unable to make our decisions? We all have the right
to decide or to let our wishes be known before hand, but if we cannot tell
the doctors and medical personnel then how will they know?
Advanced directives(AD) such as a “living will” or “durable power of
attorney for health care” provide a way to decide how you want things done
and who you want making important life decisions. It can be done
in the privacy of your own home and at your leisure while you can voice
your opinions and ideas regarding end of life issues.
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What is an advanced directive?
An advance directive is a written document in which you specify what type
of medical care you want in the future should you lose the ability to make
decisions. In it, you can state how you want medical decisions to be made
if you should loose the ability to make such decisions or let your wishes
be known.
There are two types of advanced directives.
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“Living Will” - a form or statement which describes the kind
of medical care you want (or do not want) regarding death-delaying procedures
if you are unable to make decisions due to a terminal illness.
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“Durable Power of Attorney for Health Care” – a signed, dated and
witnessed document in which you name another person (husband/wife, son,
daughter, a close friend or other relative) to be your authorized spokesperson
to make medical decisions, including particular instructions of treatments
you wish to avoid.
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Frequently Asked Questions
Who can complete an advanced directive?
Anyone who is 18 years old or older and is of sound mind, memory and judgment
can complete an advanced directive.
What do I choose in an advanced directive?
-
Someone (an agent) to make all healthcare
decisions when you are too sick to decide. The person must be over the
age of 18 and cannot be the primary doctor or any individual being paid
to prove healthcare.
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Decide whether or not you want certain
treatments (CPR, feeding tubes, electric shock to the heart if it stops…)
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State a desire to donate your organs
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Name your primary doctor
Does an agent need to accept the responsibility before acting?
The document must be signed and agreed upon by the individual and their
agent (and it must be witnessed). When choosing the agent be sure
that they accept and will carry out your wishes. It is also a good
idea to name a successor if for some reason your agent is unable to carry
out the duties.
When does AD go into effect?
AD is typically used in cases when you are too ill to choose your care
or are unable to tell others what you want. Your doctor will help
decide if and when that time has come.
What rights do I have as a patient?
Patients always have certain rights as discussed at the beginning.
This also includes the right to know what the nature of your medical problem
is and what tests and treatments may be used. You should be able
to discuss with the doctor what the options are and associated risks.
Always, a patient has the right to refuse care and you should be informed
of the risks and benefits of this.
Will signing a living will affect my insurance?
Laws state that insurance companies cannot base anything in an existing
or future life insurance policy on whether a person has a Living Will or
not.
Can I have both a Living Will and a Durable Power of Attorney for Health
Care?
Yes. In the case of a patient with both documents, the Living Will does
not take effect unless the agent is not available.
What should I do with an AD after it is signed?
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Give a copy to your agent, lawyer, doctor and other family members
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Ask your doctor to make it part of your permanent medical record
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Keep a copy for your self, in a safe place
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Keep a small card in your purse or wallet stating that you have an AD,
where it is located and the name of your agent
Can I change my AD and what should I do?
AD can be revoked by the patient at anytime regardless of their mental
or physical condition. It can be terminated by burning, tearing or any
other method of completely defacing the paper. Modifications can only be
made in writing.
Must a nursing home or hospital comply with the directions of my agent?
No. The statute does not require compliance with an agent.
It is imperative to discuss your desires with your health care professional
and make necessary changes to ensure compliance.
Are health care agents applicable in a home setting?
Yes.
Remember:
You can plan in advance for the time when you may not be able to state
your healthcare choices. Discussing these issues and your concerns
with your physician, family members, spiritual leaders and anybody else
you may choose to include, and then putting your decisions in writing ,
may save your family from making painful worrisome decisions later on down
the line.
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Sources of More Information on Advanced
Directives
If you need help to prepare an advanced directive, or if you would like
further information you can contact a lawyer, any nearby hospital, hospice
or long-term care facility, or your state attorney general’s office.
You also can find more information at the following internet sites.