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Advance Directives

Advance Directives

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.

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What is an advance 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.”

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.

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Download Advance Directive forms.

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Page last updated on Jul. 30, 2009