Advanced Directives: By: Marquez, T.M & Credito, E.G

ADVANCED DIRECTIVES
BY: MARQUEZ, T.M &

CREDITO, E.G
ADVANCED DIRECTIVES
• Advanced directives are legal documents that state the
patient’s wishes when the patient’s become unable to
speak for themselves.
• Advanced directives are created ahead of any medical
incapacitation in order to ensure that the patient has the
ability to make their own decisions when they are unable
to do so.
TYPES OF ADVANCED DIRECTIVES
POLST
(Physician
LIVING Order for life-
WILL Sustaining
Treatment
DURABLE
POWER OF
ATTORNEY
LIVING WILL
• The living will is a legal
document used to state certain
future health care decisions
only when a person becomes
unable to make the decisions
and choices on their own.
(only used at the end of life if
a person is terminally ill (can't
be cured) or permanently
unconscious.
THINGS TO THINK ABOUT WHEN WRITING A
LIVING WILL:
 Cardiopulmonary • Antibiotics or Anti-viral
Resuscitation (CPR) Medications
 Mechanical Ventilation  Comfort Care (Palliative
 Tube Feeding Care)
 Dialysis • Organ and tissue

donations.
• Donating your body
How long are living wills good for?
Your living will remains effective for

as long as you live, unless you
intentionally revoke it or the courts get
involved.
DO NOT RESUSCITATE &
DO NOT INTUBATE
You don’t need to have Advance Directive or Living will to
have a DNR or DNI orders. You can establish DNR & DNI
orders by telling to your doctor and she/he can put them
in your medical record
DURABLE
POWER OF
ATTORNEY FOR
HEALTH CARE
DURABLE POWER OF ATTORNEY
FOR HEALTH CARE
• A durable power of attorney for health care, also known as a medical power
of attorney, is a legal document in which you name a person to be a proxy
(agent) to make all your health care decisions if you become unable to do
so.
• Before a medical power of attorney can be used to guide medical decisions,

a person's physician must certify that the person is unable to make their
own medical decisions.
What happens if I do not have a
Durable Power of Attorney for Health
Care?
The following people are in order of priority, they are legally
authorized to make your health care decisions for you:
• Your court-appointed guardian or conservator;

• Your spouse or domestic partner;
• Your adult child;
• Your adult sibling;
• A close friend; or
• Your nearest living relative.
Can I appoint more than one agent?
• Yes. The law allows you to appoint co-agents
(two people who will serve together as equals)
or successive agents (a second person who will
serve in case the first agent is unable to do so).
Is my agent legally liable for what he
or she does?
• No. As long as the agent is acting in "good

faith" and in accordance with your
instructions, the law protects him or her
from being sued for his or her actions.
PHYSICIAN ORDERS
FOR LIFE-
SUSTAINING
TREATMENT
(POLST)
PHYSICIAN ORDERS FOR LIFE-
SUSTAINING TREATMENT (POLST)
• The document may also be called provider orders for life-
sustaining treatment (POLST) or medical orders for life-
sustaining treatment (MOLST).
• A POLST is intended for people who have already been

diagnosed with a serious illness.
• This form does not replace your other directives. Instead, it serves as
doctor-ordered instructions — not unlike a prescription — to ensure
that, in case of an emergency, you receive the treatment you prefer.
Your doctor will fill out the form based on the contents of your
advance directives.
• POLST enables your doctor to include details about what treatments

not to use, under what conditions certain treatments can be used,
how long treatments may be used and when treatments should be
withdrawn.
Issues covered in a POLST may include:
• Resuscitation
• Mechanical ventilation
• Tube feeding
• Use of antibiotics
• Requests not to transfer to an emergency room
• Requests not to be admitted to the hospital
• Pain management
CREATING ADVANCED
DIRECTIVES:
Advance directives need to be in writing. Each state has
different forms and requirements for creating legal
documents.
When you have completed your documents,
you need to do the following:
•Keep the originals in a safe but • Talk to family members and
easily accessible place. other important people in
•Give a copy to your doctor. your life about your advance
•Give a copy to your health care directives and your health
agent and any alternate agents. care wishes
•Keep a record of who has your • Carry a wallet-sized card that
advance directives. indicates you have advance
directives
• Keep a copy with you when
you are traveling
REVIEWING AND CHANGING
ADVANCED DIRECTIVES:
• You can change your directives at any time. If you want to make
changes, you must create a new form, distribute new copies and
destroy all old copies.
Consider reviewing your directives and creating new ones in the

following situations:
• New diagnosis.
• Change of marital status.
• About every 10 years.
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ADVANCED DIRECTIVES

BY: MARQUEZ, T.M &

 Dialysis • Organ and tissue

Your living will remains effective for

• Before a medical power of attorney can be used to guide medical decisions,

• Your court-appointed guardian or conservator;

• No. As long as the agent is acting in "good

• A POLST is intended for people who have already been

• POLST enables your doctor to include details about what treatments

Consider reviewing your directives and creating new ones in the

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