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Advance Directives in Long Term Care

Advance Directives in Long Term Care. Julie Bayly, LNHA julie.bayly@rivhs.com October 22, 2009. Long Term Care Providers. Nursing Home Assisted Living Continuing Care Retirement Community Adult Day Care PACE – Program for the all inclusive care for the elderly Hospice

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Advance Directives in Long Term Care

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  1. Advance Directives in Long Term Care Julie Bayly, LNHA julie.bayly@rivhs.com October 22, 2009

  2. Long Term Care Providers • Nursing Home • Assisted Living • Continuing Care Retirement Community • Adult Day Care • PACE – Program for the all inclusive care for the elderly • Hospice • Home Health Care

  3. Right To Be Informed • Virginia State Law requires Nursing Home residents upon admission to be informed of their right to make decisions about medical care. • LTC Providers will discuss Advance Directives and individual preferences when enrolling in a new LTC service.

  4. Best Practice • All Long Term Care Providers have an assessment tool completed on a routine schedule. This may be quarterly, monthly, bi-annually- varies depending on the service. • The assessment will include the interdisciplinary care team, the individual receiving care and in some cases the resident responsible party. • Advance Directives should be discussed during this assessment and the documentation should reflect the discussion. • “Your Right to Decide” a publication from the Virginia Department of Health and Department of the Aging. • Include the physician in the discussion.

  5. Durable Do Not Resuscitate Order • Written by a physician • May be verbally revoked • Durable Do Not Resuscitate Order • Yellow Form Provided by Virginia Department of Health

  6. Family in Crisis – No Advance Directive Planning

  7. The Crisis • Weight loss/Refusal to Eat -Feeding Tubes • Provide education on feeding tubes and the relationship with hydration. • Palliative Care over Hospitalization or frequent Hospitalizations • Provide education on the dying process. Consider Hospice staff as a resource.

  8. Difference of Opinion in the Family • Follow the Advance Directive • If no Advance Directive, follow statute hierarchy (guardian, spouse, adult child, parent, adult sibling, blood relative) • Work for consensus that is best for the resident • Include the Physician in the discussion.

  9. What Can You Do? • Write a Letter to the Editor of your local paper for National Advance Directives Day (April 16th) • Offer to give a presentation on Advance Directives at a Resident Council Meeting • Partner with a long term care provider to do a community education seminar on Advance Directives

  10. Questions? Julie Bayly (804) 758-2363 julie.bayly@rivhs.com

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