Advance Directives
Healthcare Decisions for Your Future
People everywhere are facing decisions about the issues such as life support, nutrition and resuscitation efforts for themselves and family members. Perry County Memorial Hospital (PCMH) knows the importance of such issues. We would like to provide you with information to help answer questions you might have.
Advance Directives—Stating Your Wishes in Writing
The U.S. Supreme Court ruling states that all competent people can refuse medical treatment. This includes life-prolonging procedures. This ruling also gives you the right to name someone else to make these decisions for you, if you cannot make them for yourself.
An advance directive is a paper, such as a living will or durable power of attorney, for healthcare. This allows you to let others know what you would want if you could not speak for yourself. If properly enacted, your advance directives should be honored in any state according to that state's law and medical center policy.
Living Will
A living will is a signed, dated and witnessed paper. It can be used to state what you would want done, or not done, should you become terminally ill or permanently unconscious.
Your living will may not cover everything. Your living will probably does not allow you to name an agent. There is clearly a benefit to being as specific as possible when making an advance directive.
Durable Power of Attorney
Durable power of attorney names the person who can make healthcare decisions for you. This person is sometimes called an agent. This paper should have detailed instructions on what types of treatment you want or do not want in the case that you are unable to make your own healthcare decisions.
General power of attorney refers to business and money matters. A durable power of attorney for healthcare covers medical issues.
Naming an Agent
You should name someone who knows your wishes and whom you trust to act according to your wishes. You may name a family member, but you do not have to do so. You might choose your spouse, an adult child or a friend. Talk with your agent about your wishes in detail and confirm that he or she agrees to act according to your wishes.
When Durable Power of Attorney for Healthcare Decisions Goes Into Effect
Durable power of attorney becomes effective only when you are no longer able to make your own decisions, such as if you are seriously ill, injured, or terminally ill an in a temporary or permanent unconscious state.
Discussing Your Advance Directive
It is up to you to let your agent or agents, doctors, family members, clergy, and significant other know you have an advance directive. You should give them a copy and discuss the details of your advance directive with them.
Carrying Out Wishes Stated in an Advance Directive
Healthcare providers and your agent must honor your wishes, so long as the directions you have made comply with state law and PCMH policy. If a provider refuses to honor your wishes, he or she must help you transfer to someone who will honor your advance directive.
Your family cannot make changes to the advance directive. Only your agent has legal authority to make healthcare decisions on your behalf. However, your agent may wish to obtain more information from your family to assist him or her in making those decisions.
Changing or Revoking Advance Directives
Your advance directive is effective until the time of your death or until you revoke it. You should review your advance directive periodically. Each time that you do this, date and initial it in the margins of your documents. This will indicate that your directions are current. An advance directive can be revoked orally, however, it is better to sign and date a written revocation and destroy all previous copies of the document.
Organ and Tissue Donations in an Advance Directive
You may express your wishes for organ or tissue donations in an advance directive. If you plan to donate organs or tissues, you should complete the back section of your driver's license. You should also discuss organ and tissue donation with your family members.
Questions
If you have questions, or would like assistance completing a living will or advanced directive, please contact Social Services at 573.768.3387.
Code Status
Should you or your loved ones become very ill, the doctor or nurse may ask you about a "code status," or what efforts should be made to revive someone should his or her heart stop beating or if he or she stops breathing. The following are definitions of common terms the nurse and doctor may use when discuss a code status.
- CARDIOPULMONARY RESUSCITATION (CPR)
- An emergency procedure consisting of artificial breathing and compression on the chest. This is performed in an attempt to revive a patient who has gone into cardiac arrest (no heartbeat) or respiratory arrest (no breathing).
- LIFE SUPPORT TREATMENT
- Medical treatment that helps to maintain life, without which the person could possibly die. Example: Drugs to support blood pressure or the use of a breathing machine (ventilator).
- CODE BLUE or FULL CODE
- An emergency response in which CPR is applied in an effort to restore breathing and/or heartbeat. This may result in the use of a ventilator and/or drugs if the code blue is successful.
- DESIGNATION OF CODE STATUS
- Under certain circumstances, such as cardiac or respiratory arrest, it may be appropriate for a physician to enter one of the following orders in the patient's medical record at the request of the patient or family:
- No Code Blue: No CPR
- Code Blue: No Intubation: CPR with no breathing tube
- Under certain circumstances, such as cardiac or respiratory arrest, it may be appropriate for a physician to enter one of the following orders in the patient's medical record at the request of the patient or family:
- COMPASSIONATE CARE
- The patient will receive supportive care from the medical and nursing staff. No CPR or aggressive life support measures will be done. Drugs will still be given to relieve pain and control sign and symptoms of disease. The patient will be watched closely, so changes will be noticed.