This presentation discusses the importance of advance directives and provides information about them. It notes that the Patient Self Determination Act of 1990 requires certain healthcare facilities to provide information to patients about advance directives. An advance directive allows patients to communicate their treatment preferences if they become unable to make decisions. It can take the form of a healthcare proxy or living will. The presentation provides guidance on completing an advance directive form and sharing it with one's healthcare providers and agent. It also discusses POLST forms, which provide instructions for life-sustaining treatment.

1. Start the Discussion: The Importance
of Advance Directives
Presented by:
Rebecca A. Levy, Esq.
Mary M. Petti, MPA, RN
October 24, 2012

2. Please hold all questions until
the end of the slide
presentation. There will be
plenty of time for questions.

3. The Patient Self Determination Act
(PSDA)
• Passed by Congress in 1990
• Effective December 1, 1991
• Applies to Hospitals, Nursing Homes,
home health agencies, hospice
providers and HMOs
• Does not apply to individual doctors

4. PSDA Patients’ Rights Include
• The right to facilitate their own
healthcare decisions
• The right to accept or refuse
medical treatment
• The right to make an advance
healthcare directive

5. PSDA Requires Certain Facilities to:
• Inquire whether the patient already has an
advance healthcare directive and make note
of this in their medical records
• Give the patient written information about
preparing an advance directive (specifically
the patient’s rights under law)
• Provide education to their staff and affiliates
about advance healthcare directives

6. What is an Advance Directive?
• An advance directive is a legal
document that you can complete on
your own that can help ensure your
preferences for various medical
treatments are followed if you become
unable to make your own healthcare
decisions.

7. When does an Advance Directive go
into effect?
• An advance directive goes into effect when
you are unable to make medical/treatment
decisions on your own behalf.
• An advance directive is not effective for a
competent adult patient who is able to
communicate his/her own wishes for medical
care.

8. Types of Advance Directives
• Health Care Proxy
Directive/Power of
Attorney
 Allows you to choose
who will make
decisions on your
behalf if you become
incapacitated
• Instruction Directive
(“Living Will”)
 Provides specific
instructions for how
your representative
should make
decisions

9. Who can I appoint as my healthcare
representative?
• Spouse/Domestic Partner
• Family Member (adults only)
• Friends
• Religious/Spiritual Advisor
• Any adult EXCEPT your physician,
employees/administrator of a healthcare
institution where you are a patient/resident
unless they are related to you.

10. Where do I get an advance directive
form?
• WWW.state.nj.us/health/advancedirecti
ve/document
• Five Wishes booklet prepared by Aging
with Dignity

11. What do I need to do?
• Study and understand the terminology
used in discussing treatments and end-
of-life decisions
• Identify someone you would like to be
your healthcare agent/representative
and get their agreement to assume that
role if you become unable to make
decisions for yourself

12. Have the discussion…
• With your healthcare
agent/representative
• With your spouse/partner
• With your family members/loved ones
• Using the form, make your choices for
treatment clear

13. Complete the Form
• Sign the form
• Get signatures of two witnesses (may
not be witnessed by your healthcare
representative)
• New Jersey does not require
notarization (but may be notarized)

14. What do I do with my advance
directive?
• Keep the original in an easily accessible
place in your home (Not the safe deposit box)
• Give copies to:
 Your healthcare agent/representative
 Your Primary Care Physician or Summit Medical
Group
 The hospital or extended care facility if you are
admitted there
 Fill out the wallet card and carry it with you

15. Still have questions?
• Mary Petti, RN
• Patient Relations, 908-277-8928
• Spend some time preparing your
advance directive. It could become a
great gift to your loved ones in the
future.

16. What is POLST?
• Practitioner Orders for Life
Sustaining Treatment
• 12/21/2011 legislation that
enables patients to indicate
their preferences regarding
life-sustaining treatment

17. What is the POLST Form?
• Standardized form for practitioner
orders
• Signed by a physician or advanced
practice nurse
• Provides instructions for health care
personnel to follow for a range of life
prolonging interventions

18. Who Should Have a POLST Form?
• Seriously ill patients
• Medically frail persons with limited life
expectancy
• Those living in a nursing home or
hospice
• Those afraid of losing the capacity to
make their own healthcare decisions in
the near future

19. POLST
Questions?