The Conversation We All Need: Discussing Advance Directives
I wanted to talk to you about something that we don’t often discuss—Advance Directives.
This conversation can be tough to initiate, but it’s one I encourage everyone to have.
Avoiding it can greatly impact not only your life but also the lives of others, especially your patients.
What are Advance Directives?
Advance Directives are legal documents that spell out how a patient wants their medical care to be handled if they become unable to communicate or make decisions.
These documents guide healthcare providers and loved ones on whether to continue life-sustaining treatment, and they provide clarity during emotionally difficult times.
They’re crucial for ensuring that your personal wishes are honored when you can no longer speak for yourself.
Why Is This So Important?
I’ve seen firsthand how family dynamics can complicate these situations.
When there’s no Advance Directive, families are often left to make decisions that may conflict with what the patient/resident would have wanted.
I've watched families struggle, arguing in the hallways, filled with doubt and guilt over what the "right" choice is.
Having this document in place removes the burden from loved ones and allows them to focus on what matters most—supporting their family member through the end of life, not making impossible decisions.
If you haven’t had this conversation with your loved ones, I highly encourage you to do so. It might feel uncomfortable, but it will make a world of difference when the time comes.
As a leader of the facility, I want to emphasize how important this conversation is in healthcare settings.
Under regulation 483.24, Advance Directives are defined as written instructions like a living will or a durable power of attorney for healthcare, recognized under state law, guiding care when an individual becomes incapacitated.
These documents are designed to honor the resident’s rights, ensuring that their wishes regarding medical treatment are respected.
How Does This Impact Care?
Advance Directives empower the resident to remain in control, even when they can no longer actively make decisions.
For this reason, I urge you to discuss these preferences with the resident and their families during quarterly care plan meetings.
Circumstances and feelings about life-sustaining treatment may change as quality-of-life shifts, and regular check-ins allow families to adjust plans as needed.
It’s not just about completing the paperwork—it’s about initiating the conversation so that, when the time comes, you know you’ve done everything possible to honor your patient’s wishes.
Encourage these conversations.
It’s one of the most compassionate things we can do to ensure that, no matter what, our residents rights and dignity are upheld.
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