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Planning for your loved one's future with advanced directives

Your family has made the decision. After much contemplation, you have decided that it's best that your mom be placed in a nursing home. Having reviewed our suggestions for locating an optimal retirement facility, you have found a home that provides the care your mom needs. You are impressed with the staff-to-patient ratio, facility conditions and food quality. While you have completed your research and have been granted approval by your loved one, however, there are still steps you will need to take to ensure she receives the care she desires.

Upon admission into the nursing home, residents are recommended to document the type of medical intervention they desire. Known as an advanced directive, this record establishes what type of future medical involvement patients deem appropriate.

While discussing end-of-life care may lead to other uncomfortable conversations, completing advanced directive forms can actually serve to dispel future anxieties. Please remind your loved one that the purpose of this documentation is to empower the patient by making manifest her current and future wishes. In Illinois, these are the four types that can be completed to protect the health wishes of the patient:

1. Health care power of attorney

This record designates the patient's "agent," the name given one who acts on behalf of the patient. The agent will be given control over the patient's health plan only when the patient becomes incapacitated. Although the agent may make decisions in the future, he must follow guidelines the patient has established. In order to have as much control as possible over future medical care, your loved one should identify not only an agent but also the conditions for treatment to make sure her wishes are followed.

2. Living will

The living will is used for patients suffering from a terminal illness. It stipulates the end-of-life care the individual desires. While this document can be drawn up when the patient is of sound mind, the plans are not put into effect until the patient is determined to have an incurable condition. There are many options to consider when drawing up a living will, and it is very helpful to prepare for a conversation by drafting a list of questions that can spur discussion on treatment options.

3. Mental health treatment preference declaration

Another document designed to protect the wishes of the aged is the mental health treatment preference declaration. As the name suggests, this form allows a patient to identify the type of treatment she would like to receive should she become incapacitated in the future. Unlike the two previous contracts discussed, this declaration expires in 3 years if the patient does not require intervention for mental health issues. If the patient is undergoing mental health treatment, the agreement will not expire until the patient is treated successfully.

4. Do-not-resuscitate order

While the three previous documents may be most applicable for elderly patients, those choosing to sign a DNR range widely in age. The DNR establishes that, should the need for CPR arise, the individual does not want cardiopulmonary resuscitation to be used. For those desiring that no medical intervention occur when the heart or breathing stops, the required forms and signatures must be recorded with a doctor in order for the DNR to be placed in the medical file.

You have taken the appropriate steps to secure a safe environment for your loved one in a nursing home. Be certain to follow through with the appropriate documentation to ensure that she receives the medical care she wants now and in the future.

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