Planning And Decisions
Accredited Healthcare of America would like to assist you and your family in the planning process and decisions necessary for hospice care. We understand discussing and making these types of decisions can be very difficult, perhaps the most challenging of a lifetime. Once the process and paperwork are complete, however, it often provides a sense of relief for both the patient and their family because everyone is aware of the patient’s wishes regarding medical care and all decisions can be based on those desires. Family members are no longer required to make difficult choices and determine your wishes without sufficient information.
Advanced Directives
Hospice patients should understand and express their treatment choices and other medical options. There are legal documents, known as advance directives, available to help ensure that your wishes will be honored.
Living Will
A Living Will (also called a Directive to Physicians) is a document which instructs doctors of a patient’s wishes for end-of-life medical care, in case the patient becomes seriously ill and is unable to make and/or communicate their medical decisions.
Purpose
A Living Will is a document that lets people state their wishes for end-of-life medical care, in case they become unable to communicate their decisions.
As an example, a Living Will can direct that “palliative care”, care to decrease pain and suffering, always be administered, but that “extraordinary measures” such as cardiopulmonary resuscitation (CPR) or artificial nourishment (feeding tube) not be used.
Execution of document
- Forms can be obtained through doctors, lawyers, health care facilities and other health organizations.
- Signed by the patient.
- Signed by two witnesses – neither of whom can be at all associated with Accredited Healthcare of America or persons who may inherit any of the patient’s money or property
- Does not need to be notarized.
Before directives within the document can be carried out
Two physicians must certify that
- You are unable to make medical decisions, and
- You are in the medical condition specified in the state’s living will law (such as “terminal illness” or “permanent unconsciousness”).
Power of Attorney (PoA)
A Power of Attorney (PoA) is a document used to appoint someone to make decisions on your behalf that becomes effective once you are unable to make decisions on your own.
Purpose
A Medical Power of Attorney (POA) allows you to appoint a healthcare agent to make medical decisions on your behalf.
- Appointed person must be at least 18 years of age.
- Appointed person must be someone you trust.
- Document authorizes agent to make medical decisions on your behalf.
This document does not allow the appointed agent to make decisions regarding the patient’s money or property.
Execution of document
Must be notarized
Before directives within the document can be carried out
A person’s physician must conclude that they are unable to make their own medical decisions.
Additional information
- If a person regains the ability to make decisions, the agent cannot continue to act on the person’s behalf.
- This document ceases to be in effect at the time of death.
- Many states have additional requirements that apply only to decisions about life-sustaining medical treatments. For example, before your agent can refuse a life-sustaining treatment on your behalf, a second physician may have to confirm your doctor’s assessment that you are incapable of making treatment decisions.
Accredited Healthcare of America does not require, but strongly encourages patients to complete a Living Will and Medical Power of Attorney BEFORE entering hospice care. Unfortunately, there are times when the progression of a patient’s disease can take all involved by surprise. This can leave family and caregivers unprepared to make decisions about your care and sometimes powerless to carry out care you’ve verbally expressed a desire for but have not legally documented.
Other Legal Documents
There are other legal documents you should be aware of before and after you decide to use hospice care. You will need to seek legal counsel for some of these documents.
Medical Durable Power of Attorney (MDPOA)
A signed document that gives authority to an adult at least 18 years of age allowing them to make necessary medical and health care decisions if you become incapacitated. This document does not need to be notarized or witnessed and it does not need to be completed by an attorney.
Texas Cardiopulmonary Resuscitation (CPR) Directive
A document stating that emergency health care personnel or others may not perform CPR on you. This document is available from a health care provider and must be signed by both you and your doctor.
Proxy Decision Maker
The individual appointed to make health care decisions when a MDPOA has not been identified. The appointment is made by a mutual agreement (consensus) of family members and interested persons.
Durable Power of Attorney
A notarized document stating that the designated POA can continue their authority to make decisions regarding your money or property even if you become incapacitated, disabled, or incompetent. This document ceases to be in effect at the time of death. Please note that the Social Security Administration (SSA) will require you to complete one of its forms as well. A statement to this effect must be included in the POA document: “The power of attorney will continue to be in effect even if I become disabled, incapacitated, or incompetent.“
What Else Do I Need to Know?
- Advance directives are legally valid throughout the United States. While you do not need a lawyer to fill out an advance directive, your advance directive becomes legally valid as soon as you sign them in front of the required witnesses. The laws governing advance directives vary from state to state, so it is important to complete and sign advance directives that comply with your state’s law. Also, advance directives can have different titles in different states.
- Emergency medical technicians cannot honor living wills or medical powers of attorney. If you do not wish for emergency personnel to perform CPR, you MUST complete a CPR Directive, obtainable from your physician. Otherwise, once emergency personnel have been called, they must do what is necessary to stabilize a person for transfer to a hospital, both from accident sites and from a home or other facility. After a physician fully evaluates the person’s condition and determines the underlying conditions, advance directives can be implemented.
- One state’s advance directive does not always work in another state. Some states do honor advance directives from another state and others will honor out-of-state advance directives as long as they are similar to the state’s own law. If you spend a significant amount of time in more than one state, you should complete the advance directives for each of those states.
- Advance directives do not expire. An advance directive remains in effect until you change it. If you complete a new advance directive, it invalidates the previous one.
- You should review your advance directives periodically to ensure that they still reflect your wishes. If you want to change anything in an advance directive once you have completed it, you should complete a whole new document.
Disclaimer: Any information available on this web site is for informational purposes only and not for the purpose of providing legal advice. You should contact an attorney to obtain advice with respect to any particular issue or problem. The opinions expressed at or through this site are the opinions of the individual author and should not constitute legal advice.
