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About advance directives
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Although no one wants to think about a time when they might be very
ill and unable to make healthcare decisions for themselves, it is
important to think about what you would want those decisions to be.
Advance directives are a way to ensure that your wishes are followed.
Here is some basic information about these documents, how they can help
you and how to create them.
Learn more about:
What is an advanced directive?
An advance directive is a legal document that explains what kind of
medical care you want to receive - or not - if you become ill or injured,
and mentally or physically unable to make your own decisions. In Connecticut,
there are three kinds of advance directives.
- Attorney-in-fact for healthcare: This person is given by you, in
writing, "durable power of attorney for healthcare" - meaning, the power
to make all medical decisions on your behalf except whether to withdraw
life support. As with a healthcare agent, your attorney-in-fact cannot be
your physician; an employee of the hospital or nursing home caring for you;
or an employee of a government agency paying for your medical care.
- Healthcare agent: This is a person you authorize, in writing, to convey
your wishes about withholding or withdrawing life support. The agent does not
make any other medical treatment decisions and does not act unless you're unable
to communicate yourself. The same person may be both your healthcare agent and
attorney-in-fact.
- Living wills: A living will applies only to a patient declared terminally ill.
It is a written, legal document that states whether you want life-support systems
(such as respirators, dialysis, cardiopulmonary resuscitation, medications or artificial
means of feeding or providing fluids) to keep you alive if there is no chance of
recovery and you have been deemed "permanently unconscious."
For more information about advance directives and other healthcare decisions,
see "Looking Ahead" in the
January/February 2001 issue of Better Health magazine. See what Saint Raphael's
advance directive policy and procedure
is.
If you would like help formulating an advance directive while you are a patient at Saint
Raphael's, our Patient Relations department will be happy to assist you and your family
and answer any questions. You may contact Patient Relations at (203) 789-3508.
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Saint Raphael's advance directive policy and procedure
Policy
We will provide written information to adult individuals receiving medical care
regarding his or her rights under Connecticut law to accept/refuse medical or
surgical treatment. We will allow individuals the right to formulate advance
directives per policy. The physician or patient representative
home health agency will honor the patient's decisions regarding advance directives.
Purpose
To comply with the Patient Self-Determination Act of 1990, which addresses
patient's rights under state law to make decisions about their health care
and their right to formulate advance directives.
Procedure
All adult patients prior to admission to the agency will be given a brochure
informing them of their rights to accept/refuse medical or surgical treatment
and their right to formulate advance directives. If the patient is unable to
comprehend or understand this information, this information should be given to
a representative of the patient. If, at a later date, the patient's condition
improves so that he or she is able to comprehend such information, the primary
care clinician will discuss advance directive information with the patient at
that time.
The hospital provides each patient or patient's representative, as appropriate,
with a description of the written policies of the hospital regarding the implementation
of the patient's right to inform consent and to formulate advance directives. This
information is available to patients prior to hospital admission.
The hospital staff person admitting the patient to the hospital will document in the
record that the patient or representative of the patient has been given the brochure
and forms.
The nurse admitting the patient will document in the clinical record whether or not
the individual has executed an advance directive. If the patient is unable to effectively
communicate this information, the nurse will obtain this information from a representative
of the patient.
The patient who has formulated an advance directive will be asked by hospital staff to
submit a copy of the directive. The copy will be included in the clinical record.
The nurse shall document in the record any information discussed by the patient regarding
advance directives.
The nurse shall document in the record if the patient has a durable power of attorney. If
a patient has a durable power of attorney, and the patient is unable to communicate
information regarding advance directives, the staff person will question the attorney-in-fact
regarding this issue. All information gathered will be documented in the patient record.
Patient representatives will make available to patients upon admission all forms regarding
advance directives.
Advance directives may be revoked or changed by a patient at any time. If a staff person has
been made aware of this information, he or she must document the information in the clinical
record.
Staff members may not act as witnesses for patients formulating advance directives unless they
are patient representatives or chaplains.
The hospital shall offer education to staff and the community regarding issues concerning
advance directives.
The hospital does not condition the provision of care or otherwise discriminate against a
patient based on whether or not the patient has executed an advance directive.
The hospital attempt to honor patients' decision regarding advance directives.
This
page was last updated on 02/28/2005
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