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Health Care Directives

Michigan Handbook for Health Care Decisions for Residents in Long Term Care
Source: Michigan Long Term Care Ombudsman Program
Content Type: PDF (472KB)
Sample handbook on rights and health care decisions for residents in long term care.

In the Matter of Northern Manhattan Nursing Home
Source: Supreme Court, New York County
Content Type: Case law on advance directives
The Vera Institute of Justice, Inc., Guardianship Project (Vera), moves for an order authorizing it, as guardian of the person and property of the above-named incapacitated person, A. M., to act on his behalf in withholding consent to his intubation with a Percutaneous Endoscopic Gastronomy (PEG) feeding tube, to diagnostic testing, and to medical treatment of a metastasized cancer; and, further, authorizing Vera to act on Mr. M.'s behalf in granting consent to palliative and/or hospice care, and in executing orders of Do Not Resuscitate (DNR) and Do Not Intubate (DNI). This case is an example of the court appointed guardianship at work. The case also stands to demonstrate the risk individuals face at the end of life when they have opted not to execute advance directives.

Terry v. Red River Center Corp
Source: Court of Appeal of Louisiana, Second Circuit
Content Type: Case law on advance directives
Veda Beth Terry and Carol Ann Flowers, appeal the trial court's denial of their action against Riverview Care Center for its alleged failure to follow the advance directive of their mother Doris Lee, who died while in the care of Riverview. This case is an example of poor document execution being one of the reasons why advance directives are often not followed in the way it was intended to.

CDC - Advance Care Planning online training
Source: CDC
Content Type: Interactive Web Site Course Description
This course will prepare and encourage public health and aging services professionals to accept their vital role in assisting older Americans plan and document what should be done in the event they become seriously ill or lose decision-making capacity. Three course modules cover

  • What advance care planning is and why it's needed.
  • How to initiate difficult but essential conversations and document personal values and preferences.
  • What public health and aging services professionals can do to leverage their unique position in the community to assist clients and constituents with advance care planning.
  • Where to find reliable guidance and resources.

Coping with End-of-Life Decisions
Source: Pew Research Center
Content Type: Article
Medical care at the end of life has gained more attention in the past few years. There are mixed thoughts on who has the right to make decisions when someone's life is ending, but we have laws for these concerns. The article discusses various issues regarding end of life care and how to plan ahead.

Living Wills and Advance Directives for Medical Decisions
Source: Mayo Clinic
Content Type: Article
Documents such as living wills and other advance directives allow individuals to be prepared if something happens where they are not able to make a decision (serious accident or illness). Furthermore, these documents are not just for older adults, as end of life can be unexpected. This article explains what these documents are and how they work.

POLST Physicians Orders on Life Sustaining Care
Source: AARP Public Policy Institute
Content Type: Website
Physician Orders for Life-Sustaining Treatment (POLST) is a promising program to elicit and honor the treatment goals of people with advanced progressive illness or frailty. Research shows that POLST effectively communicates patient treatment choices, whatever they may be, without sacrificing comfort care. This report documents the evolution of POLST in 12 states and highlights lessons learned for states developing and implementing new programs.

Lawyers Toolkit for Healthcare Advance Planning, 2005
Source: American Bar Association Commission on Law and Aging
Content Type: Manual
This tool-kit is designed to help lawyers guide clients through an extended discussion to encourage effective health care advance planning.

Consumer's Toolkit for Health Care Advance Planning, 2005
Source: American Bar Association Commission on Law and Aging
Content Type: Manual
A consumer focused tool-kit that assists consumers in healthcare advance planning and understanding the process (does not include forms for creating advance directives).

Health Care Decision-Making Authority: Health Care Agents vs. Court Appointed Guardians (50-state chart)
Source: American Bar Association Commission on Law and Aging
Content Type: State Law
State Law Chart comparing roles of health care agents vs. Court-Appointed Guardians.

For more information

More information on this topic might be found in the following areas of the Legal Issues library:
Capacity Requirements

Advanced Directives for Health Care

American Indian and Alaska Native End of Life Care
Source: CDC
Content Type: Study Report as a Word Document
“Moving Beyond Paradigm Paralysis: American Indian End-of-Life Care” is the latest in the series of Issue Briefs on aging from the Centers for Disease Control and Prevention's (CDC) Healthy Aging Program. This one, a collaboration with the National Association of Chronic Disease Directors, was prepared by staff of the International Association for Indigenous Aging (IAIA) and Health Benefits ABCs, where longtime Washington journalist on aging, Nancy Aldrich, served as principal writer. Focusing on end-of-life beliefs of American Indian and Alaska Native (AI/AN) elders, the Issue Brief concludes that health care and social services professionals may need to re-examine their assumptions about end-of-life care. According to the IAIA website, “Conventional wisdom has long held that Indian elders - especially those couched in traditional belief systems - will not openly discuss issues related to death and dying. But, in light of changing culture and demographics and recent successes with new end-of-life care models for AI/AN populations, these long-held but increasingly unjustified assumptions may no longer apply.”

In Your Hands: Legal Tools for Preserving Personal Autonomy [English] [Spanish Subtitles]
Source: ABA Commission on Law and Aging
Content Type: YouTube video
Created by the American Bar Association Commission on Law and Aging, this video is narrated by the late Helen Hayes, with an epilogue by her son, James MacArthur. It addresses the legal aspects of planning for incapacity in a clear and positive way, and introduces four legal tools: durable powers of attorney, medical powers of attorney, living wills and trusts.

Having Your Say: Advance Directives
Source: American Health Care Association – National Center for Assisted Living
This website contains a consumer guide to planning for incapacity

Caring Connections: Planning Ahead
Source: National Hospice and Palliative Care Organization
This website contains links to information on Advance Care Planning,Advance Directives and Financial information.

Legal and Financial Planning for People with Alzheimer's Disease
Source: National Institute on Aging
The site contains a free printable consumer guide to legal and financial planning for persons with Alzheimer’s disease.

Advance Directives: Interpreting Written Instructions Regarding: End of Life for Medical Care
Source: National Elder Law Network
Content Type: Bibliography
An advocate focused overview of advance directives and bibliography of relevant State Statutes, Articles, Websites and other resources on Advance Directives.

Myths and Facts about Health Care Advance Directives
Source: American Bar Association Commission on Law and Aging
Content Type: Article
This consumer focused fact sheet includes common misperceptions about advance directives.

National Disability Rights Network Advance Directive Resources
Source: Protection and Advocacy
Content Type: Website
Resources on advance directives from P & A organizations across the country.

Surrogate Decision Makers

Default Surrogate Consent Statutes, 2008
Source: American Bar Association Commission on Law and Aging
Content Type: State Law
State Law Chart with citation, priority of surrogates, limitations on decision, standard for decision making and disagreement among surrogates.

Health Care Decision-Making Authority: Health Care Agents vs. Court Appointed Guardians (50-state chart)
Source: American Bar Association Commission on Law and Aging
Content Type: State Law
State Law Chart comparing roles of health care agents vs. Court-Appointed Guardians.