Understanding Advance Directives

Advance directives are legal documents that outline a client’s healthcare preferences if they become unable to make decisions. These documents help ensure their wishes are respected during critical moments.

Key Details to Know:

• Be aware of whether a client has advance directives.
• Know the location of these documents.
• Provide the documents to emergency responders when necessary.

Physician’s Orders for Life-Sustaining Treatment (POLST).

The POLST form is a physician-authorized directive designed for individuals with life-threatening illnesses. It clearly states the person’s preferences regarding life-sustaining treatments.

POLST Form Highlights:

• Signed by the client (or surrogate) and medical provider.
• Provides specific instructions for emergency situations, including:

1. Whether to administer CPR.
2. Preferred levels of medical intervention (e.g., full treatment, limited intervention, or comfort-focused care).

• Functions as physician orders and must be followed accordingly.

Recognizing Medical Emergencies

Common examples of medical emergencies include when a client:

• Experiences severe difficulty breathing.
• Loses consciousness and cannot be awakened.
• Suffers a serious fall or injury.
• Experiences a drug overdose or serious medication reaction.
• Shows sudden, serious health changes (e.g., chest pain, seizures).

Emergency Response Protocols

• Assess the Situation: Determine the nature and severity of the emergency.

• Call for Help: Contact emergency services (911) immediately or notify the designated responder as per workplace policy.

• Follow POLST Instructions: If the client has a POLST form, comply with the documented wishes regarding resuscitation or interventions.

• Provide Basic Support: Offer first aid or CPR (if permitted by the POLST or advance directives) until help arrives.

• Communicate with Responders: Provide clear details about the situation, including the advance directives or POLST form.

• Report and Document: After the emergency is under control, report the incident and document actions taken.

Advance directives ensure clients’ wishes are honored. Long Term Care workers must be knowledgeable about these forms and prepared to act decisively in emergencies while respecting clients’ preferences.