Advance Directives

1
Advance Directives

• What Are They?

2
Types of Advance Directives

• Durable Power of Attorney for Health Care/
  Appointment of Health Care Agent
• Living Will/ Advance Care Plan

3
Appointment of Health Care Agent

• Definition
• An adult or emancipated minor who is appointed
  by another person to make health care decisions
  for the person.

4
Appointment of Health Care Agent

• Who Can Do One?
• Any competent adult or emancipated minor
• What Does it Take?
• Must complete a form which is in substantial
  compliance with the law
• Must have witnessed by 2 adults, or
• Must have notarized by a notary public

5
Living Will/ Advance Care Plan

• Definition
• An individual instruction or a written
  statement, witnessed, and governing the
  withholding or withdrawing of life-prolonging
  intervention, voluntarily executed by a person

6
Living Will/ Advance Care Plan

• Who Can Do One?
• Any competent adult or emancipated minor
• What Does it take?
• Must complete a form which is in substantial
  compliance with the law
• Must be witnessed by 2 adults, or
• Must be notarized by a notary public

7
Witnesses

• A Witness May Not Be.
• Person being appointed
• At least one witness may not be related by blood/
  marriage or adoption or entitled to any portion
  of estate
• Financially responsible for individuals medical
  care
• Surrogate
• Attending physician

8
When Does the Advance Directive Become Effective?

• Unless otherwise specified in the advance
  directive, the authority of an agent becomes
  effective only upon determination the individual
  lacks capacity, and ceases to be effective upon a
  determination the individual has recovered
  capacity.

9
How Is An Advance Directive Revoked?

• Health Care Agent (Durable Power of Attorney for
  Health Care)
• An individual having capacity may revoke the
  designation of an health care agent only in a
  written statement which must be signed by the
  individual or by the individual personally
  informing the supervising health care provider
• Decrees of annulment, divorce, dissolution of
  marriage, or legal separation revokes a
  designation of a spouse as the Health Care Agent
  unless otherwise specified in the decree or in an
  Advanced Care Plan
• An designation of a Health Care Agent that
  conflicts with an earlier designation of a Health
  Care Agent revokes the earlier directive

10
How Is An Advance Directive Revoked? (continued)

• Advance Care Plan (Living Will)
• An individual having capacity may revoke all or
  part of the Advance Care Plan at any time and in
  any manner that communicates an intent to revoke
• An Advance Care Plan that conflicts with an
  earlier Advance Care Plan revokes the earlier
  directive

11
Reciprocity

• An Advance Directive executed outside of this
  state by a nonresident of this state is valid as
  long as executed in compliance with the laws of
  Tennessee or with laws of the state where executed

12
Letting Others Know.

• Patient/representatives responsibility to notify
  MD and health care providers of existence of
  Advance Directive
• Patient/representatives responsibility to notify
  MD and health care providers when Advance
  Directive is revoked
• Patient/representatives responsibility to
  provide copy of new Advance Directive and/or
  revocation for medical records
• When MD/employees receive, facility staff
  responsibly to ensure Advance Directive gets on
  medical record