Advance care planning is the process of preparing for future care if the person becomes incapable of making their own decisions. It is suggested that any adult, no matter their age or state of health, develop their advanced care plan.
A living will gives directions about the health care that a person wishes to be provided or not provided in certain situations. A living will describes a patient's wishes regarding care during terminal conditions, persistent vegetative state, organ donation, or autopsy.
Life-sustaining treatments may be one of the areas outlined in a patient's living will. Life-sustaining treatments are any procedure, technology, and medication that suspends life. Some examples include ventilation, dialysis, diagnostic tests, antibiotics, artificial nutrition, transfusions, CPR.
A patient can include the level of comfort care they want to receive in their living will. They may wish to be as completely comfortable and free of pain even if it prolongs their death. Comfort care may include stopping any medications that do not support their comfort, stopping blood draws, lab work, therapies, and investigative studies, providing medication to relieve pain, and providing emotional support.
Artificial nutrition and hydration is another area that can be included in a living will. Artificial nutrition includes total parenteral nutrition, nasogastric tube, or a gastrostomy tube. A patient may wish to discontinue artificial nutrition and hydration if it is the primary treatment keeping them alive, or they may voice a desire to continue this treatment for this same reason.
A durable power of attorney is another kind of written advance directive. A durable power of attorney for health care allows someone the patient trusts to make choices should they become unable to make their own decisions.
Do not resuscitate is an order on the medical record of a patient who desires no resuscitative attempts to be made if their heart or breathing stops. This means that CPR should not be attempted, as well as other resuscitative measures such as electric shocks or artificial respirations.
Allow natural death is a term that may be used instead of DNR. Facilities may vary on which one they use; some may include both. Allow natural death may be implemented instead of DNR to help make the authorization easier for the family. Allow natural death sounds positive and peaceful as opposed to "do not resuscitate," which sounds like it is preventing care.
POLST are medical orders that must be completed and signed by a healthcare professional. A patient does not fill them out. A POLST form is a document that helps people with life-threatening medical conditions ensure that they get the kind of medical care they do, or do not want to receive.
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