Medicare Sign Up pack sample

www.pnsystem.com page 9 POLICY ON ADVANCE DIRECTIVES Purpose: To provide an atmosphere of respect and caring to ensure a patient’s ability and right to participate in medical decision making, to ensure a patient’s wishes about his/her care, treatment and services are respected in accordance with acceptable standards of practice, ethics and applicable laws, to assure compliance with the Patient Self-Determination Act (PSDA), to expand patient, family, and staff knowledge base regarding advance directives and the process by which patient participation in their medical decision making is fostered by the Agency. POLICY: 1. At the time of Admission we will inform patients about the Agency’s written policies on implementation of Advance Directives. The Agency recognizes the right of the competent adult to make a verbal or written declaration regarding decisions about his /her own medical care. This would include deciding to have the medical or surgical means or procedures to prolong life provided, withheld or withdrawn. 2. The Agency will accept and act upon written advance directives received from the patient or patient's caregiver, to the extent permitted and required by Law. A "Do Not Resuscitate" (DNR) order or a "Do Not Intubate" (DNI) order will be accepted only if properly executed by the patient's physician. Appropriate actions to be taken will be discussed with the patient and/or patient's caregiver when such order is received. 3. Patients, patient caregivers, agency staff and the community will be educated on issues concerning advance directives. Patients and families/caregivers will be educated with printed material delivered at sign up date, containing all state mandatory regulations regarding Advance Directives that explain each topic such as living will, DNR orders, testaments, etc. 4. The presence or absence of Advance Directives will not influence the decision to provide health care. If an Advance Directive is not properly executed all staff will follow standard emergency procedures. Any change in the patient's Advance Directive will be communicated to all personnel. 5. When a patient is transferred or referred to any other provider of health care services, the information given will include whether the patient has Advance Directives or does not have Advance Directives. 6. Our Agency will provide services whether or not the patient has executed Advance Directives. INFORMATION ON 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. When a person becomes unable to make decisions due to a physical or mental change, such as being in a coma or developing dementia (like Alzheimer’s disease), they are considered incapacitated. To make sure that an incapacitated person’s decisions about health care will still be respected, the Florida legislature enacted legislation pertaining to health care advance directives (Chapter 765, Florida Statutes). The law recognizes the right of a competent adult to make an advance directive instructing his or her physician to provide, withhold, or withdraw life-prolonging procedures; to designate another individual to make treatment decisions if the person becomes unable to make his or her own decisions; and/or to indicate the desire to make an anatomical donation after death. By law hospitals, nursing homes, home health agencies, hospices, and health maintenance organizations (HMOs) are required to provide their patients with written information, such as this pamphlet, concerning health care advance directives. What is an advance directive? It is a written or oral statement about how you want medical decisions made should you not be able to make them yourself and/or it can express your wish to make an anatomical donation after death. Some people make advance directives when they are diagnosed with a life-threatening illness. Others put their wishes into writing while they are healthy, often as part of their estate planning. Three types of advance directives are: A Living Will , A Health Care Surrogate Designation , An Anatomical Donation. You might choose to complete one, two, or all three of these forms. What is a living will? It is a written or oral statement of the kind of medical care you want or do not want if you become unable to make your own decisions. It is called a living will because it takes effect while you are still living. You may wish to speak to your health care provider or attorney to be certain you have completed the living will in a way that your wishes will be understood. What is a health care surrogate designation? It is a document naming another person as your representative to make medical decisions for you if you are unable to make them yourself. You can include instructions about any treatment you want or do not want, similar to a living will. You can also designate an alternate surrogate. Which is best? Depending on your individual needs you may wish to complete any one or a combination of the three types of advance directives. What is an anatomical donation? It is a document that indicates your wish to donate, at death, all or part of your body. This can be an organ and tissue donation to persons in need, or donation of your body for training of health care workers. You can indicate your choice to be an organ donor by designating it on your driver’s license or state identification card (at your nearest driver’s license office), signing a uniform donor form (seen elsewhere in this pamphlet), or expressing your wish in a living will. Am I required to have an advance directive under Florida law? No, there is no legal requirement to complete an advance directive. However, if you have not made an advance directive, decisions about your health care or an anatomical donation may be made for you by a court-appointed guardian, your wife or husband, your adult child, your parent, your adult sibling, an adult relative, or a close friend. The person making decisions for you may or may not be aware of your wishes. When you make an advance directive, and discuss it with the significant people in your life, it will better assure that your wishes will be carried out the way you want. What is a do not resuscitate form: It is the mechanism used to inform emergency medical services personnel that the patient does not wish to have life-sustaining techniques performed in the event of respiratory or cardiac arrest. A properly completed form is signed by the patient’s physician to document that the patient is terminally ill. It must also be signed by the patient or patient’s health care surrogate and witnessed by two individuals. The form must be presented to the rescue staff. sample