Advanced directives are legal documents provided under the federal Patient Self-Determination Act (PSDA) of 1990, giving clients the right to have and prepare advanced directives by all federally funded healthcare facilities
These legal documents give the clients an opportunity to state their wishes in advance for life-sustaining treatment if, at some time, they are unable to make those informed decisions.
a. Describe the similarities and differences between a living will and a durable power of attorney (DPOA).
b. If the living will on the client's chart states "do not resuscitate" but there is no physician's order in the chart, does the DNR preference on the living will stand when the person is in a code situation? Why or why not?
Students' answers should include the following:
a. A living will gives specifics about what the client wants for treatment when he or she is no longer able to make decisions on his or her own. DPOA gives a designated person the right to make the decisions when the client is not able to make decisions himself or herself.
Discussion can be on different instances where a living will and a DPOA might give a different option for care.
b. Discussion on a "do-not-resuscitate" order is always controversial. Different healthcare workers have different opinions as to what a DNR order means. Typically, the order has to be in the chart as a written order to be honored. The DPOA can say what they want in an emergency code situation and the physician can order it, but the living will must be read and then ordered, which may not be looked for in time of an emergency, therefore often overlooked. This could be a good discussion, depending on what client example would be given.
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