Lecture 05 : Advance Directive - Week 12

[Music] I'll continue with Advanced Directive prepared by Dr push Gupta secretary National Association of ptic care for aush and Integrative Medicine what is Advanced directives relating to living will medical decisions healthare wishes and Healthcare power of attorney these four components are carried in the advanced directives it is a durable power of attorney for healthcare sometimes known as the medical power of attorney a document that names healthcare proxy proxy is a trustworthy person authorized to make Health decisions if anyone is unable to do so before creating an advanced directive people should talk to their healthcare provider loved ones and at least at least one person who may be chosen as proxy or agent substitute decision maker telling them about their situation wishes and fears because these are the ones who will help putting wishes into effect if someone is unable to do so additionally while filling the advanced directive the health care team might be able to help what kind of Medical Care would someone want if he or she were too ill or hurt to express wishes Advanced directives are legal documents that allow to spell out someone's decisions about end of Life Care ahead of time they help in telling the person's wishes to family friends and Healthcare professionals so as to avoid confusion later on a living will tells which treatment someone wants at the time of death or if permanently unconscious one can accept or refuse Medical Care and include instructions on the use of diis and breathing machines to be resuscitated if breathing or heartbeat stops two feeding organ or tissue donation the living will is a legal document used to State certain future Healthcare decisions only when a person becomes unable to make the decisions and choices on their own the living will is only applicable if a person is terminally ill can't be cured or permanent L unconscious it describes the type of medical treatment the person would want or not want to receive in their situations it can describe under what conditions an attempt to prolong life should be started or stopped including but not limited to dialysis two feedings or actual life support such as the use of breathing machines before Healthcare team uses living will for medical decisions Physicians must confirm that patient is unable to make own medical decisions and is terminally ill or permanently unconscious one can end or take back a living will at any time living will loss vary hence no specific losss of the place there are many things to think about when writing a living will such as one may want the use of equipment such as dialysis machines or for kidney or kidney machines or ventilators breathing machines to help being do not resuscitate orders instructions not to use CPR you breathing or heartbreak heartbeat stops if someone needs fluid or liquid usually by IV and or food to feeding in the stomach if couldn't eat or drink if someone needs treatment for pain nausea or other symptoms even if one can't make other decisions like Comfort or care or ptic care if someone wants to donate organs or other body tissues after death choosing not to have aggressive medical treatment is different from refusing all Medical Care a person can still get treatments such as antibiotics food pain medicines or other treatments it is just that the goal of treatment becomes Comfort rather than cure durable power of attorney for healthcare or medical power of attorney it's a legal document in which a person is named as proxy or agent to make all healthare decisions if someone is unable to do so before it is used to guide medical decisions a person's physician must certify that the person is unable to make own medical decisions if someone is unable to make own healthare decisions his proxy or agent can speak with Healthcare team and other caregivers on behalf and make decisions according to the wishes or directions given earlier if wishes in a certain situation are not known the proxy will make a decision what he or she thinks one would want if anyone regains the ability to make own medical decisions then proxy can't continue to make medical decisions on his behalf proxy or agent should be well known and trustworthy so as to carry out wishes and should asking questions and Advocate to healthcare team on someone's behalf durable power of attorney laws may vary hence your state loss puled physician orders for life sustaining treatment a puled form also helps describe wishes for healthc care but it is not an advanced directive it has a set of specific medical orders that a seriously ill person can fill in and ask their healthc care provider to sign a pul form addresses wishes in an emergency such as use of CPR cardiopulmonary resuscitation in an emergency or to go to a hospital in an emergency and put on a breathing machine if necessary or stay and be made comfortable a pul form has to be signed by a qualified member of healthcare team such as Doctor emergency Personnel like paramedics and EMTs emergency medical technicians can't use an advanced directive but they can use a pul form without a p form emergency Personnel are required to provide every possible treatment to help keep someone alive pulse forms are only available in some states do not recitate or DNR orders resuscitation means try to restart heart and breathing using methods such as CPR cardiopulmonary resuscitation and AED automated external de defibrillator in some cases they may also use life sustaining devices such as breathing machines in the hospital a do not resuscitate or DNR order means that if breathing or heart stops nothing will be done to try to keep alive in the hospital one can ask doctor to add a DNR order to medical record only if patient don't want the hospital staff to try to revive if heart or breathing stopped some hospitals require a new DNR order at the time of admission DNR order is only good in the hospital outside the hospital it is a little different outside the hospital a valet card bracelet or other DNR documents can be kept at home the nonhospital DNR is intended for the Emergency Medical Service or EMS teams in the absence of a valid and visible DNR order the EMS teams are required to revive and prolong life a nonhospital DNR must be signed by both the patient and the healthcare provider organ and tissue donation organ and tissue donation can be included in advanced directives many state also provide organ donor cards or add notations to driver's license these are the references and for further reading American Cancer Society wwwc cancer.org American Hospital Association ah aha.org cancer net cancer National Cancer Institute NCI National Institute on Aging thank [Music] [Music] [Music] you [Music]