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Advance Directives

Definition: A document in which a person’s medical treatment choice is clearly outlined. AD consists of:
Adult Definitions A person 18 years or older, who is legally capable of consenting to his/her own medical treatment A legal document prepared by a person or representative that outlines specific direction for medical care and treatment RHH policy Same as definition Documentation Same as definition

Living will

Ask for a copy. The copy needs to be verified with the original for accuracies. On the last page of the document, indicate “provided by” and record the name of the provider and “received by” and sign and date the document. This document needs to be a part of the patient medical record. If copy is not available, must instruct to provide one. Same as living will

Document the receipt of the living will copy and brief summary of contents in patient’s medical record. If copy is requested document the date, time and who was asked to provide the copy in patient’s medical record

Durable Power of Attorney (DPOA)

DNR

A legal document in which an agent, a proxy or surrogate, is appointed to make medical decisions in the event the person is incapable of making appropriate treatment decisions. A signed MD’s order preventing clinicians from performing cardiopulmonary resuscitation. Clinicians need to be

Same as living will

“Do not resuscitate”-a medical order to refrain from cardiopulmonary resuscitation if the person’s heart stops beating. The form must be completed and signed by

Document: • the receipt of the copy of DNR order • Brief content summary in patient’s clinical record.

DNI-Do not intubate POLST-“Physic ian Orders for LifeSustaining Treatment” “No advance directives” aware that DNR order might be different from state to state. if need arises”. The form must be completed and signed by MD. A copy must be placed in patient’s medical record No RHH policy Documentation Document: • the receipt of the copy of DNR order • Brief content summary in patient’s clinical record. a federal statue. A copy must be placed in patient’s medical record RHH policy “A medical order to refrain from inserting life-sustaining breathing and/or feeding tube. Document: • Patient’s inquiry in patient’s medical record. DNI could also be a part of DNR order. was enacted 1990 which requires that health care facilities provide information regarding the advance directives concerning health care decision. “Healthcare facilities provide information regarding the right to formulate Advance Directives concerning health care decision”This form is included within our SOC packet. MD. Currently Illinois and Michigan are developing the program “Patient self determination act”. Document: • The forms and • The explanations were provided in patient’s medical record. Clinicians need to be aware that DNR order might be different from state to state. Definitions A signed MD’s order preventing clinicians from placing endotracheal tube for the purpose of mechanical ventilation. POLST serves as a medical order that clearly and accurately outlines patient’s wishes related to medical treatment. Reference: .

January 2013 .Residential home health policy-advance directives policy N.1 ACHC standards-standard HH2-2A Illinois Department of Public Health website HomeCare Institute-Advance Directives in Home Care and Hospice: Computer-based training course handouts. 2-034.