|
Quick note as we start day 1: I was seriously frustrated by the restrictions of the post length limit during the last round of WOTD because of having to chop up relevant information and often having to leave quite a bit out. This time, I will publish a blog post for each entry/word/term and post an excerpt from it on social media each day. If it’s a topic that interests you, you’ll be able to click through to the full blog post to read more about it. If it’s not something you want to explore further, you’ll still be exposed to the term itself and its definition up front so you’re learning something either way. Also, Word of the “Day” may end up being every other day or a certain day each week if it gets too overwhelming while working my new job, keeping up with my CE hours to maintain my insurance license, studying for my AHIP Medicare certification (currently in progress), and trying to finish/maintain/create content for my website/blog, and finish my e-book (should have already been done and published by this month). I am but one woman with ADHD, insomnia, and limited patience so I’ll do the best I can and that’s the best I can do. |
That said, let’s get right into it as always with the definition first. Welcome to WOTD Round 2!
An ADVANCE DIRECTIVE is a legal document, often including a living will, that provides instructions for medical treatment and only goes into effect if you cannot communicate your own wishes.
ACP (advance care planning) is the process that helps adults and their families understand and share their values, goals, and future medical care preferences.
Advance Care Planning: Advance Directives for Health Care | National Institute on Aging
ADVANCE HEALTHCARE DIRECTIVES — AAMG Doctors
From Wikipedia.org:
An advance healthcare directive, also known as living will, personal directive, advance directive, medical directive or advance decision, is a document in which a person specifies what actions should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity.
This isn’t something we necessarily want to think about or talk about but many mistakenly believe that advance care planning is something only senior citizens need to be concerned about. This is absolutely not the case.
Taking the time now to develop a plan and get your legal documents in order will make things easier on your family and other caregivers should anything happen that renders you unable to make decisions for yourself. Examples of such situations include being unconscious, in a coma, too ill to communicate your wishes, or when you have chosen someone you trust to make these decisions. “Advance directives provide a way for you to communicate your wishes to your family, friends, and health care professionals, and to avoid confusion later on.”
Advance Directives | Texas Health and Human Services
Speaking from experience as someone with two parents who have/had Alzheimer’s disease, trust me when I say that the last thing your family needs while they’re grieving what’s happening to you (and ultimately to the entire family) is confusion over trying to figure out what you would want them to do for you. Take that weight off of them and make your plans now. Discuss your plans with your loved ones now. You can ensure that you get the care you want and need and avoid unnecessary suffering, as well as relieving your caregivers of the decision making burden during an already difficult time.
If you do not have an advance directive and you are unable to make decisions on your own, the state laws where you live will determine who may make medical decisions on your behalf. This is typically your spouse, your parents if they are available, or your children if they are adults.
NOTE:
To learn about the laws in your state, contact your state legal aid office or state bar association.
Advance Care Planning: Advance Directives for Health Care | National Institute on Aging
Advance directives have limitations. A person:
Advance Directives | HealthInAging.org
NOTE: each state has its own set of laws governing advance directives.
There are several types/components of advance directives and we’ll talk a little bit about each one. Different sources include different documents/directives.
NOTE: There is a key difference between the advance directive and the POLST: the POLST is a specific type of MEDICAL ORDER while the advance directive is a group of LEGAL DOCUMENTS. We’ll get into more about that later but the thing to remember is that while a POLST can be used WITH an advance directive, it is not a substitute for it.
Also known as the Directive to Physicians and Family or Surrogates, this form is designed to help you communicate your wishes about medical treatment at some time in the future when you are unable to make your wishes known due to illness or injury. Advance Directives | Texas Health and Human Services
You should list many possible end-of-life care decisions in your living will. Talk to your healthcare professional about any questions you may have about the following medical decisions. (Palliative and hospice care, organ and tissue donations, and body donation are three of the most frequently used designations in the living will/advance directive.)
Except to the extent you state otherwise, this document gives the person you name as your agent the authority to make any and all health care decisions for you in accordance with your wishes, including your religious and moral beliefs, when you are no longer capable of making them yourself. Your proxy, also known as a representative, surrogate, or agent, should be familiar with your values and wishes.
A proxy can be chosen in addition to OR instead of a living will. Having a health care proxy helps you plan for situations that cannot be foreseen, such as a serious car accident or stroke.
Choosing a person to act as your healthcare agent is important. Even if you have other legal papers about your care, you can't anticipate all situations ahead of time, such as emergencies and illnesses. And in some situations, someone will need to decide about your likely care wishes.
Speaking from personal experience as my mother’s POA, medical and otherwise, I highly suggest choosing more than one in case the illness/condition goes on as long as Alzheimer's. The first proxy may grow fatigued of the position while they’re also grieving for their loved one, and/or they may develop an issue of their own that renders them incapable of continuing the responsibility. After 10 years of acting as my mother's representative, I was extremely thankful that her MPOA allowed for designating a replacement representative so that my daughter could take over as I deal with my own health issues related to chronic illness.
You might want to prepare documents to express your wishes about a single medical issue or something else not
An out-of-hospital DNR alerts emergency medical personnel to your wishes regarding measures to restore your heartbeat or breathing if you are not in a hospital. (This is useful if a person is in a nursing home, memory care facility, etc.)
A similar document, a DNI informs medical staff in a hospital or nursing facility that you do not want to be on a ventilator.
A DNH indicates to long-term care providers, such as nursing home staff, that you prefer not to be sent to a hospital for treatment at the end of life.
Advance Care Planning: Advance Directives for Health Care | National Institute on Aging
Advance Directives - Texas Hospital Association
| NOTE: There are many other types of directives/orders, rules and regulations governing advance directives, etc. that vary by state. For the sake of this article, I have tried to focus on the ones that are the most commonly used across the board. Please look up the details for advance directives in your state before proceeding with creating yours. |
The provision of nutrients or fluids by a tube inserted in a vein, under the skin in the subcutaneous tissues, or in the gastrointestinal tract.
Explanation: Many serious illnesses such as cancer, failure of major organs (kidney, heart, liver, or lung), and serious brain diseases such as Alzheimer's dementia may be considered irreversible early on. There is no cure, but the patient may be kept alive for prolonged periods of time if the patient receives life-sustaining treatments. Late in the course of the same illness, the disease may be considered terminal when, even with treatment, the patient is expected to die.
You may wish to consider which burdens of treatment you would be willing to accept in an effort to achieve a particular outcome. This is a very personal decision that you may wish to discuss with your physician, family, or other important persons in your life.
Treatment that, based on reasonable medical judgment, sustains the life of a patient and without which the patient will die.
An incurable condition caused by injury, disease, or illness that according to reasonable medical judgment will produce death within six months, even with available life-sustaining treatment provided in accordance with the prevailing standard of medical care.
Explanation: Many serious illnesses may be considered irreversible early in the course of the illness, but they may not be considered terminal until the disease is fairly advanced. In thinking about terminal illness and its treatment, you again may wish to consider the relative benefits and burdens of treatment and discuss your wishes with your physician, family, or other important persons in your life.
Health Insurance Marketplace® is a registered service mark of the U.S. Department of Health & Human Services.