Advance DirectivesAdvance Directives

What Are They?What Are They?

Types of Advance DirectivesTypes of Advance Directives

Durable Power of Attorney for Health Durable Power of Attorney for Health Care/ Appointment of Health Care Care/ Appointment of Health Care AgentAgent

Living Will/ Advance Care PlanLiving Will/ Advance Care Plan

Appointment of Health Care Appointment of Health Care AgentAgent

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

Appointment of Health Care Appointment of Health Care AgentAgent

Who Can Do One?Who Can Do One?

Any competent adult or emancipated minorAny competent adult or emancipated minor

What Does it Take?What Does it Take? Must complete a form which is in Must complete a form which is in

substantial compliance with the lawsubstantial compliance with the law Must have witnessed by 2 adults, orMust have witnessed by 2 adults, or Must have notarized by a notary publicMust have notarized by a notary public

Living Will/ Advance Care Living Will/ Advance Care PlanPlan

Definition:Definition:

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

Living Will/ Advance Care Living Will/ Advance Care PlanPlan

Who Can Do One?Who Can Do One?

Any competent adult or emancipated minorAny competent adult or emancipated minor

What Does it take?What Does it take? Must complete a form which is in Must complete a form which is in

substantial compliance with the lawsubstantial compliance with the law Must be witnessed by 2 adults, orMust be witnessed by 2 adults, or Must be notarized by a notary publicMust be notarized by a notary public

WitnessesWitnesses

A Witness May Not Be….A Witness May Not Be…. Person being appointedPerson being appointed At least one witness may not be related by At least one witness may not be related by

blood/ marriage or adoption or entitled to blood/ marriage or adoption or entitled to any portion of estateany portion of estate

Financially responsible for individual’s Financially responsible for individual’s medical caremedical care

SurrogateSurrogate Attending physicianAttending physician

When Does the Advance When Does the Advance Directive Become Effective?Directive Become Effective?

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

How Is An Advance Directive How Is An Advance Directive Revoked?Revoked?

Health Care Agent (Durable Power of Attorney for Health Health Care Agent (Durable Power of Attorney for Health Care):Care):

An individual having capacity may revoke the designation An individual having capacity may revoke the designation of an health care agent only in a written statement which of an health care agent only in a written statement which must be signed by the individual or by the individual must be signed by the individual or by the individual personally informing the supervising health care providerpersonally informing the supervising health care provider

Decrees of annulment, divorce, dissolution of marriage, or Decrees of annulment, divorce, dissolution of marriage, or legal separation revokes a designation of a spouse as the legal separation revokes a designation of a spouse as the Health Care Agent unless otherwise specified in the decree Health Care Agent unless otherwise specified in the decree or in an Advanced Care Planor in an Advanced Care Plan

An designation of a Health Care Agent that conflicts with an An designation of a Health Care Agent that conflicts with an earlier designation of a Health Care Agent revokes the earlier designation of a Health Care Agent revokes the earlier directiveearlier directive

How Is An Advance Directive How Is An Advance Directive Revoked? (continued)Revoked? (continued)

Advance Care Plan (Living Will):Advance Care Plan (Living Will): An individual having capacity may An individual having capacity may

revoke all or part of the Advance revoke all or part of the Advance Care Plan at any time and in any Care Plan at any time and in any manner that communicates an intent manner that communicates an intent to revoketo revoke

An Advance Care Plan that conflicts An Advance Care Plan that conflicts with an earlier Advance Care Plan with an earlier Advance Care Plan revokes the earlier directiverevokes the earlier directive

ReciprocityReciprocity

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

Letting Others Know….Letting Others Know….

Patient/representative’s responsibility to notify Patient/representative’s responsibility to notify MD and health care providers of existence of MD and health care providers of existence of Advance DirectiveAdvance Directive

Patient/representative’s responsibility to notify Patient/representative’s responsibility to notify MD and health care providers when Advance MD and health care providers when Advance Directive is revokedDirective is revoked

Patient/representative’s responsibility to provide Patient/representative’s responsibility to provide copy of new Advance Directive and/or revocation copy of new Advance Directive and/or revocation for medical recordsfor medical records

When MD/employees receive, facility staff When MD/employees receive, facility staff responsibly to ensure Advance Directive gets on responsibly to ensure Advance Directive gets on medical recordmedical record