What is a Living Will?
|
|
|
- Stuart Bruce
- 9 years ago
- Views:
Transcription
1 What is a Living Will? With today s advances in medical technology, the process of dying can be prolonged by what are often referred to as artificial means. A Living Will can be used to let your healthcare team and family members know whether or not you wish to have such interventions used on your behalf. The instructions in a Living Will are followed only if you are permanently unconscious or terminally ill and unable to communicate. A Living Will is a legal document that states your wishes about medical treatment if a doctor determines that you are terminally ill or permanently unconscious. It is important to make sure your doctors know that you have a Living Will and where it is located because it tells your doctors, nurses and family members what you want. It states which medical treatments you wish to use or not use, if you have a condition from which you cannot recover. The Living Will can go into effect only if your doctor knows it exists and he/she decides that you are terminally ill or permanently unconscious. What types of treatment are affected by a Living Will? In your Living Will, you can tell your doctor you do not want certain treatments. For example, you may not wish to be hospitalized if you are terminally ill or permanently unconscious. You may decide against any treatments that will not cure you, but only postpone the moment of death by artificially keeping your bodily functions going. Some examples include: Artificial Feeding: If you are no longer able to swallow food, your doctor may have you tube fed through your nose, your abdomen or intravenously (through the vein). Artificial Breathing: Ventilators, sometimes called respirators, are machines that breathe for you. Some patients become dependent on ventilators and would die without their support. In your Living Will, you can make it clear whether or not you want to be on a ventilator if your condition is not likely to improve. Cardiopulmonary Resuscitation (CPR): When the heart stops (cardiac arrest), doctors and nurses use special measures called cardiac resuscitation to try to restart the heart. This may include massaging the heart, giving medicine, or using electric shock. In accordance with your wishes, a Living Will may direct your doctors to use or not to use any or all of these measures.
2 What is a Durable Power of Attorney for Healthcare? A Durable Power of Attorney for Healthcare is a document in which you name a Healthcare Proxy. A Healthcare Proxy is a person you appoint to make your medical decisions if you are unable to make them for yourself. This person may make decisions that are not clearly stated in your Living Will. The proxy you appoint must be 18 years or older. If you have decided to appoint a proxy, you must fill out the Appointment of a Healthcare Proxy/Healthcare Representative form. In addition to your own signature, your Advance Directives must be signed in the presence of two adult witnesses. However, do not sign anything unless you fully understand what you are signing. Once you have completed your Advance Directives, you should give copies to your attorney, doctor(s) and family members. Copies should also be placed in your medical record/hospital chart. You can revoke your Advance Directives at any time simply by telling your physicians, nurses, family members or other witnesses. Changes can be made by completing new Advance Directives. All copies of the old directives should immediately be retrieved and destroyed because they are no longer in effect. If you would like to talk to someone about Advanced Directives, please contact your nurse, Chaplaincy Services representative or Social Worker. Remember that Advance Directives are an important personal matter. However, we do encourage you to discuss these with your family and personal physician before making any decisions. Should I have a Living Will and a Healthcare Power of Attorney? You do not have to be seriously ill or even expect to be ill in order to benefit from having these documents. If you sign them when you are still able, you will be protecting your family members from emotional stress in an unexpected crisis. You will be deciding in advance who will make healthcare decisions for you based upon your wishes. These documents will give you control over the extent to which doctors will use various medical means to prolong your life. By doing this, you will relieve others from the responsibility of having to decide what you want because you would have made your wishes known. Does this mean giving up or stopping care? No. The only care that will be discontinued is the treatment your Advance Directive indicates you do not wish to receive. In that case, your doctors and nurses will continue to care for you, making every effort to help you be comfortable and pain-free. Can my healthcare representative make decisions even if I am not terminally ill? Yes. For example, if you are in a car accident and you become unconscious, your healthcare representative can make decisions on your behalf about your medical care until you are able to do so. Therefore, you should talk with your representative, so that person will know what your wishes are.
3 How do I make a Living Will and a Healthcare Power of Attorney? You can make a Living Will and Healthcare Power of Attorney by completing and signing the forms included in this pamphlet. You must have two adults, other than your healthcare representative, witness your signature and sign the forms before they are considered legal. What do I do with my Living Will and Healthcare Power of Attorney? Give copies to your doctors, hospital, healthcare representative, family members and important people in your life. It is important for them to know your wishes relative to your own healthcare. What if I change my mind? You can change or cancel your Living Will at any time. Make sure you tell your doctors, hospital, healthcare representative, family members and important people in your life that your wishes have changed. Ask them to tear up and destroy all copies of the old Living Will. What can be done if my wishes are not being carried out? The issue should be discussed with your doctor(s) first. If it is not resolved at this point, discuss with your nurses, social worker and /or chaplain. If it is still not resolved, present the issue to the hospital Ethics Committee. Help is Available. Your Living Will and Healthcare Power of Attorney involve some of life s most important choices and ethical considerations. Do not hesitate to ask for help. Ask your doctor to discuss these questions with you or to refer you to someone who is qualified to help. Organ/Tissue Donation The Uniform Anatomical Gift Act, adopted by all 50 states and the District of Columbia, regulates who may donate organs/tissues for transplantation and who may receive an organ/tissue donation. What should I do if I want to donate my organ/tissues for transplantation? If you are at least 18 years of age and a Minnesota resident, you may contact the Minnesota Department of Motor Vehicles Branch Office nearest you and have them indicate on your Driver s License that you wish to be an Organ Donor. Your designation will then be printed on your license. Or you may call the Clerk of the District Court in your county.
4 What organs can be donated? Organs needed for transplantation are kidneys, lungs, heart, liver and pancreas. Tissues used for transplantation are eyes/corneas, bone, skin and heart valves. If you have specific questions about organ/tissue donations, contact any of the organizations listed below: State Anatomical Committee The National Kidney Foundation 262 Jackson Hall 920 South 7 th Street University of Minnesota Minneapolis, MN Minneapolis, MN (612) (612) Minnesota Lions Eye Bank American Red Cross Tissue Services Box 493 MAYO North Central Area 420 Delaware Street SE 100 South Robert Street Minneapolis, MN St. Paul, MN DONATE ( ) SHARE ( ) [email protected] Department of Anatomy LifeSource MSB 3115 Upper Midwest Organ Procurement Mayo Clinic 2550 University Avenue West Rochester, MN Suite #315 South (507) St. Paul, MN [email protected] (651) [email protected] Should I talk with my family about donating my organs? Yes, even if you have signed an Organ Donor Card, your family will be consulted upon your death and prior to the removal of any organs/tissues. The best way to avoid any conflicts is to talk with them beforehand and make sure they understand your wishes. (One way to involve family members in your decision is to show them the designation on your Driver s License or notify them that you have registered with an organization that accepts organ donations). Do I have to pay anything to donate my organs? No. The recipient pays the cost of organ donation.
5 Ethics Statement Catholic Health Initiatives (CHI) and St. Francis Healthcare Campus will conduct their activities in accordance with the Ethical and Religious Directives for Catholic Health Care Services, developed by the United States Conference of Catholic Bishops and reflecting those principles important to the delivery of health care in the Catholic faith tradition. This faith tradition is rooted in a commitment to contribute to the common good of the community, to promote and defend the human dignity of each member of that community, especially those who are poor and vulnerable. All activities of CHI and St. Francis Healthcare Campus support the ministry of providing health care to the communities we serve and doing so based upon CHI s Core Values of Reverence, Integrity, Compassion and Excellence. As a living expression of these values: CHI and St. Francis Healthcare Campus are committed to the highest standards of business ethics and integrity. Everyone associated with CHI and St. Francis Healthcare Campus will conduct his or her activities in compliance with applicable laws. Everyone associated with Catholic Health Initiatives and St. Francis Healthcare Campus has a duty to act in a manner consistent with our Core Values and to adhere to the following standards: To exercise good faith and honesty in all dealings and transactions To create a workplace that fosters community, respects the inherent dignity of every person, promotes employee participation and ensures safety and wellbeing To maintain a high level of knowledge and skill among all who serve in order to provide a high quality of care To provide accurate and truthful information in all transactions To maintain and protect the confidentiality of patient, employee and organizational information To exercise responsible stewardship of both human and financial resources To avoid conflicts of interest and/or the appearance of such conflicts.
6 Instructions for using this document: This document has a Living Will and an Appointment of Healthcare Proxy /Healthcare Representative (Power of Attorney) forms. Indicate your wishes before signing. Fill them out and sign them in front of two witnesses. You may sign one or both forms. If you want a Living Will and a Healthcare Proxy /Healthcare Representative, you will have to sign both documents. The documents do not have to be notarized. Completing these forms is voluntary. LIVING WILL DECLARATION By (Name of person signing document) Age Social Security Number If I am terminally ill or permanently unconscious, and I am not able to make decisions about my medical treatment, I direct my physician to withhold or withdraw treatment that prolongs the process of my dying and is not necessary to my comfort. Specifically, if I am terminally ill or permanently unconscious, I do not want (check all appropriate items below): Surgery Blood Products Antibiotics Artificially Administered Feeding (feeding tubes) Artificially Administered Fluids Artificial Breathing Machine (respirator/ventilator) Cardiac Resuscitation (CPR) Kidney Dialysis You may add further instructions here: Signed this day of 20. Signed: (signature of person this form is for) Witnesses: (two witnesses must sign for either or both documents) The declarant has voluntarily signed this writing in my presence. Address (If not hospital employee) Address (If not hospital employee)
7 APPOINTMENT OF HEALTHCARE PROXY /HEALTHCARE REPRESENTATIVE Should I become temporarily incapacitated or permanently unconscious I direct my attending physician, to follow the instructions of:, whom I appoint as my healthcare proxy/healthcare representative. My healthcare proxy /healthcare representative may make all decisions about: Yes No Withholding or withdrawing life sustaining treatments that are no longer necessary to my comfort or to alleviate pain pursuant to the Minnesota Rights of the Terminally Ill or Permanently Unconscious Act; My personal care; My medical care; Hospitalization; Whether I shall receive medical treatment or procedures, including artificial feeding and fluids, even though I may die as a result of this decision; Visitors, if problems arise concerning visits by friends or family. Such decisions will be consistent with my wishes, or, if my wishes are not known, will be consistent with my best interests. Additional Instructions: This document is intended to be a durable power of attorney for healthcare matters under and a declaration and proxy statement under the Patient Self-Determination Act. Signed this day of 20. Signed: Witnesses: (two witnesses must sign for either or both documents) The declarant has voluntarily signed this writing in my presence. Address (If not hospital employee) Address (If not hospital employee)
ADVANCE DIRECTIVE. Your Right to Make Health Care Decisions
ADVANCE DIRECTIVE Your Right to Make Health Care Decisions 1 Saint Peter s University Hospital provides you with this booklet which explains your rights to decide about your health care under New Jersey
Health Care Directive
PATIENT EDUCATION Health Care Directive Honoring Choices My Health Care Directive I created this document with much thought to give my treatment choices and personal preferences if I cannot communicate
State of Ohio Living Will Declaration Notice to Declarant
State of Ohio Living Will Declaration Notice to Declarant The purpose of this Living Will Declaration is to document your wish that life-sustaining treatment, including artificially or technologically
GEORGIA ADV ANCE DIRECTIV E FOR HEALTH
GEORGIA ADV ANCE DIRECTIV E FOR HEALTH CARE Advance Directives: Your Right To Decide Georgia law gives competent adults the right to make choices about their own health care. This includes the right to
Advance Health Care Planning: Making Your Wishes Known
Page 1 of 26 Advance Health Care Planning: Making Your Wishes Known Page 2 of 26 What s Inside Why Health Care Planning Is Important... 2 What You Can Do... 4 Work through the advance health care planning
TALKING ABOUT YOUR HEALTH CARE CHOICES: ADVANCE DIRECTIVE INFORMATION, FORM AND GUIDELINES
TALKING ABOUT YOUR HEALTH CARE CHOICES: ADVANCE DIRECTIVE INFORMATION, FORM AND GUIDELINES Adults have a right to accept or refuse medical care. You have the legal right to make an advance directive. In
The La Crosse Region Power of Attorney for Healthcare Document and The Instructions for Completing this Document
Overview The La Crosse Region Power of Attorney for Healthcare Document and The Instructions for Completing this Document The attached power of attorney for healthcare form is a legal document, developed
What Are Advance Medical Directives?
What Are Advance Medical Directives? UAMS would like you to know that there are ways to let others know what decisions you would want to make about your medical treatments, even when you are unable to
State of Ohio Living Will Declaration Notice to Declarant
State of Ohio Living Will Declaration Notice to Declarant The purpose of this Living Will Declaration is to document your wish that life-sustaining treatment, including artificially or technologically
GEORGIA ADVANCE DIRECTIVE FOR HEALTH CARE
Page1 GEORGIA ADVANCE DIRECTIVE FOR HEALTH CARE By: Date of Birth: (Print Name) (mm/dd/yyyy) This advance directive for health care has four parts: PART ONE HEALTH CARE AGENT. This part allows you to choose
Georgia Advance Directive for Health Care
Georgia Advance Directive for Health Care In order to have a legal document that expresses your wishes for the health care you want to receive at the end of your life, you should complete a Georgia Advance
KENTUCKY LIVING WILL PACKET. The Office of the Attorney General Jack Conway, Attorney General
KENTUCKY LIVING WILL PACKET The Office of the Attorney General Jack Conway, Attorney General Living Wills in Kentucky A Living Will gives you a voice in decisions about your medical care when you are unconscious
DISTRICT OF COLUMBIA Advance Directive Planning for Important Health-Care Decisions
DISTRICT OF COLUMBIA Advance Directive Planning for Important Health-Care Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the
FLORIDA Advance Directive Planning for Important Health Care Decisions
FLORIDA Advance Directive Planning for Important Health Care Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National Hospice
NOTICE TO THE INDIVIDUAL SIGNING THE ILLINOIS POWER OF ATTORNEY FOR HEALTH CARE
NOTICE TO THE INDIVIDUAL SIGNING THE ILLINOIS POWER OF ATTNEY F HEALTH CARE No one can predict when a serious illness or accident might occur. When it does, you may need someone else to speak or make health
Making Health Care Decisions in North Dakota:
Making Health Care Decisions in North Dakota: A Summary of North Dakota Law Regarding Health Care Directives Published by: North Dakota Department of Human Services Aging Services Division 1237 W.Divide
AN ADVANCE CARE DIRECTIVE A GIFT OF PREPAREDNESS
Rhode Island Durable Power Of Attorney For Health Care AN ADVANCE CARE DIRECTIVE A GIFT OF PREPAREDNESS INTRODUCTION YOUR RIGHTS Adults have the fundamental right to control the decisions relating to their
Your Rights To Make Health Care Decisions. A Summary of Connecticut Law
Your Rights To Make Health Care Decisions A Summary of Connecticut Law prepared by the Office of the Attorney General for the Department of Social Services and Department of Public Health 2011 Your Rights
COLORADO Advance Directive Planning for Important Health Care Decisions
COLORADO Advance Directive Planning for Important Health Care Decisions Caring Connections 1731 King St., Suite 100 Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program of
Health Care Proxy Appointing Your Health Care Agent in New York State
Health Care Proxy Appointing Your Health Care Agent in New York State The New York Health Care Proxy Law allows you to appoint someone you trust for example, a family member or close friend to make health
Connecticut Attorney General's Office -- Attorney General Richard Blumenthal Your Rights to Make Health Care Decisions
1 The Connecticut Attorney General offers a free living will form that you can print and complete. While it isn't pleasant to contemplate being unable to communicate your preferences to health care providers,
Georgia Advance Directive for Health Care
Georgia Advance Directive for Health Care By: (Print Name) Date of Birth: (Month/Day/Year) This advance directive for health care has four parts: PART ONE Health Care Agent. This part allows you to choose
Power of Attorney for Health Care For
Power of Attorney for Health Care For Name: Date of Birth: Address: Telephone: This document is on file at Copies of this document have been given to my health care agent(s) and: 1. 2. 3. 4. 5. Courtesy
DURABLE HEALTH CARE POWER OF ATTORNEY AND HEALTH CARE TREATMENT INSTRUCTIONS (LIVING WILL) PART I INTRODUCTORY REMARKS ON HEALTH CARE DECISION MAKING
DURABLE HEALTH CARE POWER OF ATTORNEY AND HEALTH CARE TREATMENT INSTRUCTIONS (LIVING WILL) PART I INTRODUCTORY REMARKS ON HEALTH CARE DECISION MAKING You have the right to decide the type of health care
MISSOURI Advance Directive Planning for Important Health Care Decisions
MISSOURI Advance Directive Planning for Important Health Care Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National Hospice
Advance Health Care Directive. A guide for outlining your health care choices
Advance Health Care Directive A guide for outlining your health care choices Table of Contents Making Your Wishes Known 2 Part 1: Choosing a Health Care Agent 4 My Health Care Agent 5 My Health Care Agent
2 North Meridian Street Indianapolis, Indiana 46204 March 1999 Revised May 2004 Revised July 1, 2013 ADVANCE DIRECTIVES YOUR RIGHT TO DECIDE
2 North Meridian Street Indianapolis, Indiana 46204 March 1999 Revised May 2004 Revised July 1, 2013 ADVANCE DIRECTIVES YOUR RIGHT TO DECIDE The purpose of this brochure is to inform you of ways that you
Choices Living Well at the End of Life
Choices Living Well at the End of Life Advance Directives Packet Fifth Edition The Midwest Care Alliance expresses deep appreciation and gratitude for the cooperation of the Ohio State Medical Association,
My Voice. Advance Care Plan
My Voice Advance Care Plan A message from the Prince Edward Family Health Team... Since its beginning in 2006 the Prince Edward Family Health Team (PEFHT) has been striving to provide comprehensive, accessible
GEORGIA ADVANCE DIRECTIVE FOR HEALTH CARE OFFICIAL CODE OF GEORGIA 31-32-4
GEORGIA ADVANCE DIRECTIVE FOR HEALTH CARE OFFICIAL CODE OF GEORGIA 31-32-4 By: (Print Name) This advance directive for health care has four parts: PART ONE Date of Birth: (Month/Day/Year) HEALTH CARE AGENT.
ADVANCE DIRECTIVE Your Durable Power of Attorney for Health Care, Living Will and Other Wishes
Introduction: ADVANCE DIRECTIVE Your Durable Power of Attorney for Health Care, Living Will and Other Wishes This document has been prepared and distributed as an informational service of the District
NEW HAMPSHIRE Advance Directive Planning for Important Health Care Decisions
NEW HAMPSHIRE Advance Directive Planning for Important Health Care Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National
VIRGINIA Advance Directive Planning for Important Health Care Decisions
VIRGINIA Advance Directive Planning for Important Health Care Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CARINGINFO CaringInfo, a program of the
State of Ohio Health Care Power of Attorney of
State of Ohio Health Care Power of Attorney of (Print Full Name) (Birth Date) I state that this is my Health Care Power of Attorney and I revoke any prior Health Care Power of Attorney signed by me. I
OREGON Advance Directive Planning for Important Health Care Decisions
OREGON Advance Directive Planning for Important Health Care Decisions Caring Connections 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program of
INDIANA Advance Directive Planning for Important Health Care Decisions
INDIANA Advance Directive Planning for Important Health Care Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National Organization
YOUR RIGHT TO MAKE HEALTH CARE DECISIONS
This pamphlet informs you about your right to make health care decisions, including the right to accept or refuse medical treatment. It explains the following advance directives and related subjects: YOUR
NEW YORK Advance Directive Planning for Important Healthcare Decisions
NEW YORK Advance Directive Planning for Important Healthcare Decisions Caring Connections 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program of
NEW JERSEY Advance Directive Planning for Important Health Care Decisions
NEW JERSEY Advance Directive Planning for Important Health Care Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CARINGINFO CaringInfo, a program of the
LIFE CARE planning. Advance Health Care Directive. my values, my choices, my care WASHINGTON. kp.org/lifecareplan
Advance Health Care Directive WASHINGTON LIFE CARE planning kp.org/lifecareplan 60418811_NW All plans offered and underwritten by Kaiser Foundation Health Plan of the Northwest. 500 NE Multnomah St., Suite
TEXAS MEDICAL POWER OF ATTORNEY
TEXAS MEDICAL POWER OF ATTORNEY NAME DATE BHS 80000246 v1 11/13 baptisthealthsystem.com That s Baptist Care. Page 1 of 5 INFORMATION CONCERNING THE MEDICAL POWER OF ATTORNEY THIS IS AN IMPORTANT LEGAL
LOUISIANA Advance Directive Planning for Important Healthcare Decisions
LOUISIANA Advance Directive Planning for Important Healthcare Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National Hospice
Advance Directives: Planning for Future Health Care Decisions
CONNECTICUT Advance Directives: Planning for Future Health Care Decisions Your Rights to Make Health Care Decisions and Frequently Asked Questions A Summary of Connecticut Law Directions for Completing
NOTICE TO THE INDIVIDUAL SIGNING THE POWER OF ATTORNEY FOR HEALTH CARE
NOTICE TO THE INDIVIDUAL SIGNING THE POWER OF ATTORNEY FOR HEALTH CARE No one can predict when a serious illness or accident might occur. When it does, you may need someone else to speak or make health
Advance Health Care Directives
Business Name An Informational Booklet on Health Care Decisions for Individuals who have Developmental Disabilities, their Families, Services Providers and Advocates on Health Care Decisions Advance Advance
Patient and Family Guide to Advance Directives. Information on Health Care Proxies and Living Wills 50611701 (8/04)
Patient and Family Guide to Advance Directives Information on Health Care Proxies and Living Wills Member of the HealthCare System 50611701 (8/04) Introduction Advances in modern medical care have not
ADVANCE DIRECTIVE FOR HEALTH CARE FORM
ADVANCE DIRECTIVE FOR HEALTH CARE FORM GEORGIA S ADVANCE DIRECTIVE FOR HEALTH CARE The Georgia General Assembly has long recognized the right of individuals to control all aspects of their personal care
How to Complete This Power of Attorney for Healthcare
How to Complete This Power of Attorney for Healthcare Overview The attached Power of Attorney for Healthcare form is a legal document, developed to meet the legal requirements of Wisconsin. This document
Ohio s Health Care Power of Attorney
Ohio s Health Care Power of Attorney Provided by COLLEEN M. SWEDYK Medina County Recorder 144 N. Broadway, Room 117, Medina OH 44256 (330) 725-9782 What you should know about a Health Care Power of Attorney:
Information for Patients. Advance Health Care Directive Kit A guide to help you express your health care wishes
Information for Patients Advance Health Care Directive Kit A guide to help you express your health care wishes Table of contents PART I - REQUIRED Selection of a decision maker Who will make health care
The Right to Decide. to the health care professionals who provide the care? All persons have the fundamental right to
The Right to Decide We have the right to make health care decisions, but how do we communicate them clearly to the health care professionals who provide the care? All persons have the fundamental right
Why and how to have end-of-life discussions with your patients:
Why and how to have end-of-life discussions with your patients: A guide with a suggested script and some basic questions to use The medical literature consistently shows that physicians can enhance end-of-life
DPower of Attorney for Health Cared
State of Illinois Illinois Department of Public Health Illinois Statutory Short Form DPower of Attorney for Health Cared NOTICE TO THE INDIVIDUAL SIGNING THE POWER OF ATTORNEY FOR HEALTH CARE No one can
Cardio-Pulmonary Resuscitation (CPR): A Decision Aid For. KGH Patients And Their Families
Cardio-Pulmonary Resuscitation (CPR): A Decision Aid For KGH Patients And Their Families The goal of this pamphlet is to provide information about cardiopulmonary resuscitation (CPR) so you can be adequately
GEORGIA ADVANCE DIRECTIVE FOR HEALTH CARE
GEORGIA ADVANCE DIRECTIVE FOR HEALTH CARE Revised April 2012 Purpose: In recognizing the right of individuals to (1) control all aspects of his or her personal care and medical treatment, (2) insist upon
Simplified Advance Care Plan and Living Will (Optional)
Simplified Advance Care Plan and Living Will (Optional) Basic information for patients and families This handout helps you say how you want to be treated if you get very sick and cannot make decisions.
ADVANCE CARE PLANNING GUIDE
ADVANCE CARE PLANNING GUIDE A process to think about, talk about and plan for end-of-life care New Hampshire Advance Directives: Durable Power of Attorney for Health Care (DPOAH) Living Will www.healthynh.com
MAKING HEALTH CARE DECISIONS. Colorado Advance Directive Guide
MAKING HEALTH CARE DECISIONS Colorado Advance Directive Guide COLORADO ADVANCE HEALTH CARE DIRECTIVE Give your loved ones peace of mind; make your wishes known now. These forms let you communicate your
UTAH Advance Directive Planning for Important Health Care Decisions
UTAH Advance Directive Planning for Important Health Care Decisions Caring Connections 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program of the
ADVANCE HEALTH DIRECTIVE
Form 4 Queensland Powers of Attorney Act 1998 (Section 44(2)) ADVANCE HEALTH DIRECTIVE This form deals with your future health care. The time may come when you cannot speak for yourself. By completing
ILLINOIS Advance Directive Planning for Important Health Care Decisions
ILLINOIS Advance Directive Planning for Important Health Care Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National Hospice
Health Care Advance Directives
Health Care Advance Directives The Patient s Right to Decide Every competent adult has the right to make decisions concerning his or her own health, including the right to choose or refuse medical treatment.
OHIO Advance Directive Planning for Important Health Care Decisions
OHIO Advance Directive Planning for Important Health Care Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National Organization
GEORGIA ADVANCE DIRECTIVE FOR HEALTH CARE
Purpose: GEORGIA ADVANCE DIRECTIVE FOR HEALTH CARE In recognizing the right of individuals to (1) control all aspects of his or her personal care and medical treatment, (2) insist upon medical treatment,
10 LC 38 1047 A BILL TO BE ENTITLED AN ACT
House Bill 1178 By: Representatives Scott of the 2 nd, Bearden of the 68 th, and Butler of the 18 th A BILL TO BE ENTITLED AN ACT 1 2 3 4 5 6 7 To amend Chapter 9 of Title 31 of the Official Code of Georgia
NEW YORK Advance Directive Planning for Important Healthcare Decisions
NEW YORK Advance Directive Planning for Important Healthcare Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National Hospice
Advance Care Planning Guide
Advance Care Planning Guide How to think about, talk about and plan for serious illness or injuries which may keep you from making your own health care decision. New Hampshire Advance Directives: Durable
OKLAHOMA Advance Directive Planning for Important Health Care Decisions
OKLAHOMA Advance Directive Planning for Important Health Care Decisions Caring Connections 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 Caring Connections, a program of
MASSACHUSETTS Advance Directive Planning for Important Health Care Decisions
MASSACHUSETTS Advance Directive Planning for Important Health Care Decisions CaringInfo 1731 King St. Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National
Put it in Writing. Questions and Answers on Advance QDirectives. www.aha.org July 1998, Revised December 2012, Item No. 166909
Put it in Writing uestions and nswers on dvance Directives www.aha.org July 1998, Revised December 2012, Item No. 166909 ii Many people today are worried about the medical care they would receive if they
The Living Will: What Do I Need to Know?
What is a Living Will? The Living Will: What Do I Need to Know? Simply put, a Living Will is a legal document that tells the doctor that you don t want to be put on a life-support machine when it won t
Combined Living Will & Health Care Power of Attorney PART I
Combined Living Will & Health Care Power of Attorney Example Form from Pennsylvania Act 169 of 2006 PART I Introductory Remarks on Health Care Decision Making You have the right to decide the type of health
WEST VIRGINIA Advance Directive Planning for Important Health Care Decisions
WEST VIRGINIA Advance Directive Planning for Important Health Care Decisions CaringInfo 1731 King St., Suite 100, Alexandria, VA 22314 www.caringinfo.org 800/658-8898 CaringInfo, a program of the National
DOWNLOAD COVERSHEET:
DOWNLOAD COVERSHEET: This is a standard advance directive for your state, made available to you as a courtesy by Lifecare Directives, LLC. You should be aware that extensive research has demonstrated that
Deciding About. Health Care A GUIDE FOR PATIENTS AND FAMILIES. New York State Department of Health
Deciding About Health Care A GUIDE FOR PATIENTS AND FAMILIES New York State Department of Health 1 A GUIDE FOR PATIENTS AND FAMILIES Introduction Who should read this guide? This guide is for New York
H e a lt h C a r e A d v a n c e D i r e c t i v e s
H e a lt h C a r e A d v a n c e D i r e c t i v e s Y o u r R i g h t t o D e c i d e a n d M a k e Y o u r W i s h e s K n o w n STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION www.fdhc.state.fl.us
M ARYLAND A DVANCE D IRECTIVE: P LANNING FOR F UTURE H EALTH C ARE D ECISIONS
M ARYLAND A DVANCE D IRECTIVE: P LANNING FOR F UTURE H EALTH C ARE D ECISIONS A Guide to Maryland Law on Health Care Decisions (Forms Included) STATE OF MARYLAND OFFICE OF THE ATTORNEY GENERAL Douglas
You know them well They know you well You trust them to do what you desire And, you trust them to do what is best for you.
Advanced Directive Act of Texas Part III Medical Power of Attorney and Content of a DNR By James L. Holly, MD Your Life Your Health The Examiner April 21, 2005 There are many decisions which are made in
SUGGESTIONS & REQUIREMENTS For Medical Power of Attorney & Completing the Texas Will to Live Form
SUGGESTIONS & REQUIREMENTS For Medical Power of Attorney & Completing the Texas Will to Live Form 1. This Medical Power of Attorney (also known as the Health Care Agent Designation Form) allows you to
Advance Directives and Durable Power of Attorney for Health Care
Advance Directives and Durable Power of Attorney for Health Care This form lets you have a say about how you want to be treated if you get very sick. Adapted with approval from the Creative Commons Attribution-Non
Advance Health Care Directive Form Instructions
Advance Health Care Directive Form Instructions You have the right to give instructions about your own health care. You also have the right to name someone else to make health care decisions for you. The
ADVANCE DIRECTIVE FORMS and MY RIGHTS TO GUIDE MY HEALTH CARE
ADVANCE DIRECTIVE FORMS and MY RIGHTS TO GUIDE MY HEALTH CARE NAME: DATE OF BIRTH: SSN: XXX - XX - (last 4 digits only) I am at least 18 years old, and of sound mind. I have received information regarding
End-of-Life Decisions
End-of-Life Decisions This booklet addresses issues that matter to us all, because we will all face the end of life. Advance directives living wills and healthcare powers of attorney are valuable tools
