start the discussion: the importance of advance directives
DESCRIPTION
We will discuss the importance of planning ahead about end-of-life decisions, provide useful information about how to prepare advance directives, and distribute sample forms.TRANSCRIPT
Start the Discussion: The Importance of Advance Directives
Presented by:
Rebecca A. Levy, Esq.
Mary M. Petti, MPA, RN
October 24, 2012
Please hold all questions until the end of the slide presentation. There will be plenty of time for questions.
The Patient Self Determination Act (PSDA)
• Passed by Congress in 1990• Effective December 1, 1991• Applies to Hospitals, Nursing Homes,
home health agencies, hospice providers and HMOs
• Does not apply to individual doctors
PSDA Patients’ Rights Include
• The right to facilitate their own healthcare decisions
• The right to accept or refuse medical treatment
• The right to make an advance healthcare directive
PSDA Requires Certain Facilities to:• Inquire whether the patient already has an
advance healthcare directive and make note of this in their medical records
• Give the patient written information about preparing an advance directive (specifically the patient’s rights under law)
• Provide education to their staff and affiliates about advance healthcare directives
What is an Advance Directive?
• An advance directive is a legal document that you can complete on your own that can help ensure your preferences for various medical treatments are followed if you become unable to make your own healthcare decisions.
When does an Advance Directive go into effect?
• An advance directive goes into effect when you are unable to make medical/treatment decisions on your own behalf.
• An advance directive is not effective for a competent adult patient who is able to communicate his/her own wishes for medical care.
Types of Advance Directives
• Health Care Proxy Directive/Power of Attorney
Allows you to choose who will make decisions on your behalf if you become incapacitated
• Instruction Directive (“Living Will”)
Provides specific instructions for how your representative should make decisions
Who can I appoint as my healthcare representative?
• Spouse/Domestic Partner• Family Member (adults only)• Friends• Religious/Spiritual Advisor• Any adult EXCEPT your physician,
employees/administrator of a healthcare institution where you are a patient/resident unless they are related to you.
Where do I get an advance directive form?
• WWW.state.nj.us/health/advancedirective/document
• Five Wishes booklet prepared by Aging with Dignity
What do I need to do?• Study and understand the terminology
used in discussing treatments and end-of-life decisions
• Identify someone you would like to be your healthcare agent/representative and get their agreement to assume that role if you become unable to make decisions for yourself
Have the discussion…
• With your healthcare agent/representative
• With your spouse/partner• With your family members/loved ones• Using the form, make your choices for
treatment clear
Complete the Form
• Sign the form• Get signatures of two witnesses (may
not be witnessed by your healthcare representative)
• New Jersey does not require notarization (but may be notarized)
What do I do with my advance directive?
• Keep the original in an easily accessible place in your home (Not the safe deposit box)
• Give copies to: Your healthcare agent/representative Your Primary Care Physician or Summit Medical
Group The hospital or extended care facility if you are
admitted there Fill out the wallet card and carry it with you
Still have questions?
• Mary Petti, RN• Patient Relations, 908-277-8928
• Spend some time preparing your advance directive. It could become a great gift to your loved ones in the future.
What is POLST?• Practitioner Orders for Life
Sustaining Treatment• 12/21/2011 legislation that
enables patients to indicate their preferences regarding life-sustaining treatment
What is the POLST Form?• Standardized form for practitioner
orders• Signed by a physician or advanced
practice nurse• Provides instructions for health care
personnel to follow for a range of life prolonging interventions
Who Should Have a POLST Form?• Seriously ill patients• Medically frail persons with limited life
expectancy• Those living in a nursing home or
hospice• Those afraid of losing the capacity to
make their own healthcare decisions in the near future
POLST
Questions?