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I'm making the Advanced Healthcare Directive POA for my mother. Any of you guys have any pointers to add in the form that has been helpful for your loved ones in any institutions?


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Perhaps you need an elder law attorney.
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By the way a POLST or DNR should be carried at all times. If in an emergency if a person is taken to the hospital they will do what is necessary to save your life, as will paramedics on the scene if the POLST or DNR is not available. Even if you say the person has either document if it is not there it "does not exist" until presented.
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Follow your state's guidelines. Make sure that the facility,local hospital,ambulance company,local ambulance company, and her primary care physician have copies. Keep one for yourself. Make sure the completed document honors your mother's wishes. I found out when my mother was dying that the E.R physician reviewed her advanced directive to ensure that I didn't wish to override it. It is important that the surrogate understand and honor their loved one's wishes even if they do not agree. If your mother dies not wish to be resuscitated, the primary care physician must write a DNR order to place in her chart. If a person is person is unable to execute an advanced directive due to dementia, an advance directive document can not be executed for them.
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each state is different.
You can go to your states statutes and codes and pull up the form and fill it out yourself
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We live in AZ and had an attorney draw up Advanced Directive, which is called a Living Will here. But there was quite a bit of confusion about what is really needed by different agencies, so here is what I was told by our attorney...
1. A DNR is for the paramedics. We got it from the fire department and kept it by the front door of ALF. The facility also had a copy as did hospice.
2. The LW is a general document that the hospital and medical personnel will honor. When mom fell and went to hospital, we had to get them a copy ASAP, so they knew her wishes. Hospice also had a copy as did all of her doctors prior to hospice stepping in.
3. A hospital will require their form filled out if you go in for a procedure. It is only good for that procedure.

Crazy, huh?

Also, PLEASE have a list of all of your LO doctors and phone numbers printed up. When my mom broke her hip, and before we could get all the forms to the hospital (paramedics would not take them), they had scheduled mom for surgery. Due to Covid19, we could not go to hospital. Anyway, when we got the forms there by FAX, which the ALF did for us, the hospitalist called me. She then called the pulmonologist who told them mom was too high risk for surgery. Amazingly, I had updated all the information the day before mom fell and had emailed it to my dad. It turned out to be critical to moms care and for following her wishes.
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OneBlueMoon May 2020
Would you please explain your abbreviations. I'm not familiar with these since I'm new at all of these.
Thanks.
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The MOLST form (Medical Orders For Life Sustaining Treatment) is used in New York State. The person is supposed to carry this form with them whenever they leave their residence. The social worker at my mother’s AL facility completed the form with my mother. It was then witnessed by two people and notarized.
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I think it is very important to have the statement that any measures outside of what is specifically allowed is to be not allowed. Mthr's AD states that on the first page of the document, but hospice just kept the check boxes in her medical chart. It would have been nice to have that statement on the check box page.
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jacobsonbob May 2020
Excellent point, surprise! A document that says "Yes, I approve of the use of A, B and C, but nothing else" is the best approach.
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A document called a POLST is much more detailed than a DNR.
there is a pamphlet you can get on line called Five Wishes and it has a lot of good information and it is pretty easy to complete.
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Shirley7 May 2020
I tried to get a Five Wishes form online but it directed me to a class I must take first. So, I have not pursued it further with the Covid 19 problem.
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If you use any online forms, be sure that they are approved by your state's Bar Association, but I would recommend retaining an attorney anyway - that way, you are sure to have documents that are appropriate for your mom's particular situation. The Advance Directive can be confusing.

I had an attorney draw up my mother's Advance Directive, Health Care Power of Attorney and Durable POA just before she started on opioid pain medication. In the absence of a Last Will and Testament (Mom had nothing of value to warrant one), he also drew up a brief document giving me the sole rights to her personal letters and papers, as I was getting ready to publish a book that contained them.

The cost for these documents, including the recording fees, was $300. That may seem like a lot, but it gave me great peace of mind. The attorney carefully questioned her on each item to ensure that her wishes were indeed being stated clearly, and he explained every clause before she signed anything.

Having a disinterested third party create and witness everything also provides a "stamp of legitimacy" that could prove valuable later on.
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OneBlueMoon May 2020
Thank you. I have consulted with an elder law attorney. She helped me to fill it up since mom dosen't know English.
But my concern is, I need to know if anyone has had any bad experiences in some institutions, despite having the AHD and if they wished they had that detail mentioned in the POA. I like to have it notarized but want to make sure before signing, that I have considered any possibilities to make her experience as comfortable as possible, in any institution.
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my advice is to have a lawyer prepare the document. Do not use an online form or book to create one. A lawyer will be familiar with local provincial/state laws and can be an ongoing resource.

Make sure the Will and POA are up to date too.
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Some states require 2 witnesses. If you ever consider moving to another state with the documents, consider this 2 witness document just in case. If you are doing a POA a lot of states require 2 signatures and some documents need to be filed in probate to be certified. This can be a do it yourself. Call the probate office to answer those questions. You can find out about the HPOA and the POA.
For the HPOA, you can ask specifics such as short term vs.no long term feeding tube, yes to ventilator but not for long term such as greater than 30 days, administer free water. I will recheck my living will and might check into your post again

Without a paper, my brother and I sat down with our parents and gave them some scenarios including decisions for burial. My dad verbally informed us that if he could no longer drive that he would not want to be kept alive. Guess who had a stroke? Even his wife with mild cognitive imparement made the decision making easy

Mom now has full blown dementia. A few years ago as she was starting CKD I spoke with her in front of her doctor and asked about dialysis. She was still able to give an answer of no. I at least have her verbal answer so I am comfortable with her decision.
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I would say that AHD and a living will are the same. My Moms was so I chose not to do a living will.

I agree about the diagnosis of ALZ.
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Your profile says Mom has Dementia/ALZ. Depending on how far into her Dementia she is, she may not be able to assign POA. She has to be of sound mind. Health directives are based on the wishes of the person having them written up.

My Moms medical POA read like a living will. She didn't want extraordinary measures. No feeding tube. She had a Do Not Resuscitate Order signed by her doctor. The lawyer asked her a list of questions and she answered yes or no.
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OneBlueMoon May 2020
She is still aware and can answer questions as well as communicate her wants. Her diagnosis is more towards cognitive decline due to her age and last neuro told me her case is not alzhiemer but some sort of dementia or age related decline. By the way the CAN NOT
diagnose alzhiemer before an autopsy of the brain. He said most doctors jump into diagnosing it incorrectly(like ADHD)! Hers is given to us by an attorney. Living will and AHD are the same. Correct? At least that's what I heard.
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When my Mom did her medical POA it read like a living will. What her wishes
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OBM - here are some links to info that might interest you.

Advance Care Planning: Healthcare Directives

What Is Advance Care Planning?
Advance Care Planning Decisions
Getting Started with Advance Care Planning
Making Your Advance Care Wishes Known
How to Choose Your Healthcare Proxy
Making Your Healthcare Directives Official
What to Do After You Set Up Your Advance Directive
Be Prepared

https://www.nia.nih.gov/health/advance-care-planning-healthcare-directives

https://www.everplans.com/articles/checklist-creating-an-advance-health-care-directive

For those who want even more control over their final exit, there's an organization call Final Exit Network that advocates for right to die and peaceful ways to end one's life. If it's not for you, disregard it.

https://finalexitnetwork.org/about/mission-and-vision/
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OneBlueMoon May 2020
Thank you....very helpful 🙏
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