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 individual’s 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/representative’s responsibility to notify MD and health care providers of existence of Advance Directive • Patient/representative’s responsibility to notify MD and health care providers when Advance Directive is revoked • Patient/representative’s 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