Advance care directives allow patients to provide instructions about their preferences regarding the care they would like to receive if they develop a terminal illness or a life-threatening injury. Advance care directives can also designate someone the patient trusts to make decisions about medical care if the patient becomes unable to make (or communicate) these decisions. This is called designating “power of attorney (for health care)”.
Federal law requires hospitals, nursing homes, and other institutions that receive Medicare or Medicaid funds to provide written information regarding advance care directives to all patients upon admission.
Advance care directives can reduce:
- Personal worry
- Feelings of helplessness and guilt by family members
- Futile, costly, specialized interventions that a patient may not want
- Overall health care costs
- Legal concerns for everyone involved
Forms for North Carolina Advance Directives, including Living Will and Health Care Power of Attorney are available at the 2nd Floor Nurses Station at Northern Hospital.
However, advance care directives cannot predict what situations may arise in the future or what new modes of care may be available for situations considered nearly hopeless today.
EXAMPLES OF ADVANCE DIRECTIVES
Verbal instructions. These are any decisions regarding care that are communicated verbally by an individual to health care providers or family members.
Organ donation. This may be accomplished by completing an organ donation card and carrying it in your wallet. A second card may be placed with important papers (such as a living will, insurance papers, and so on). Most hospitals or other major health care centers have organ donor information available.
Many states offer people who are applying for new or renewed driver's license the opportunity to make a decision regarding organ donation and have it recorded on the driver's license. More information may be obtained by calling 1-800-24-DONOR.
Living will. This is a written, legal document that conveys the wishes of a person in the event of terminal illness. This document can speak for a patient who is unable to communicate. A living will may indicate specific care or treatment the person does or does not want performed under specific circumstances. This may include specific procedures, care, or treatments such as the following:
- CPRCPR (if cardiac or respiratory arrestrespiratory arrest occurs)
- Artificial nutrition through intravenousintravenous or tube feedings
- Prolonged maintenance on a respirator (if unable to breathe adequately alone)
- Blood culturesBlood cultures, spinal fluid evaluations, and other diagnostic tests
- Blood transfusions
State laws vary regarding living wills. Information specific to individual states usually may be obtained from the state bar association, state medical association, state nursing association, and most hospitals or medical centers.