Created for a noon conference presentation to introduce a resident-led QI project. The specific instructions about next of kin are specific to Ohio.

1. Q u a l i t y i m pr o v e m e n t p r o j e c t
JE W IS H C L I N I C
Go a L : D i sc u s s h C P OA f o rm s w i t h e v e r y
pa t i e n t > 5 0 y e a r s o L D
HCPOAHealth Care Power Of Attorney

2. Medical Advanced Directives
1. HCPOA
2.Living Will
3.DNR Form

3. HCPOA
Ohio HCPOA lets the patient name someone
(doesn’t have to be family) to make decisions about
your medical care.
 ONLY comes into effect when the patient can no longer
make their own decisions

4. Next of Kin in Ohio
The order of next of kin:
1. Legal Spouse
2. Adult children
3. Parents
4. Siblings
5. Other blood relatives
If someone does not have a HCPOA form, this is the order of people
we would go to.
 For children, we need a majority, 2 of 2, 2 of 3, 3 of 4, 3 of 5.
 “When’s the last time the majority of your children decided on one thing? If you
think that will be an issue, do the form!”

5. How to Approach Patients?
Some phrases you could use…
“Sometimes when patients come into the hospital, they may be
unconscious or hooked up to a ventilator. In that case, we don’t
know what the patient would or would not want.”
If that happens, we can contact your healthcare power of attorney
(it can be anyone, family or friend) and ask them.
It’s important to think about who you would want as your power
of attorney – someone you know will carry out your wishes
Just as important to have a conversation with your HCPOA about
what you would and wouldn’t be ok with, so they know.

6. How to Approach Patients?
Somethings to think about and talk to your HCPOA about:
 How aggressive would you want medical therapy to be if it wasn’t
likely to bring you back to where you’re at now?
 Would you want to be hooked up to a ventilator for long time? Would
you want a breathing tube in your throat if you couldn’t bring on your
own. (like in smoking commercials)
 Would you want a feeding tube in your stomach?
“I know this is hard to think about because
you’re ok right now, but better safe than sorry.
We’d like to be prepared rather than wish we can
done this before.”

7. Frequently Asked Questions
Who should complete the HCPOA?
 Anyone over age 18.
If I state that I don’t want to be hooked up to life
support equipment, will I still be given medication for
pain?
 Yes.
If I’m DNR, will I get all other treatments necessary up
to the point that I die?
 Yes.

8. Frequently Asked Questions
Which is better to have? HCPOA or Living Will?
 HCPOA is a person. Good to talk to them about what you would want and they can
make decisions that they think YOU would want.
 Living will is a document. You can write exactly what you would want and that
trumps a HCPOA.
If I name someone in my HCPOA to make decision for me, how much
authority does that person have?
 Their power only comes into play if you can’t make your decisions.
What if I want to say exactly what I would and would not want?
 That’s where the living will comes into play. That acts likes your voice and that
trumps a power of attorney. So if you say something in your living will and the power
of attorney says something else, we go by what you told us in the living will.

9. Frequently Asked Questions
What’s the most important step?
 Make sure you give us a copy of the HCPOA and any
other advanced directives!
 It doesn’t do any good if you have it at home. We need it for
our records. So whenever you go into the hospital – we have it
and we know what to do!

10. Thank you!