Preparing for Advanced Directives

Preparing for Advanced DirectivesNameInstitutionInstructorCourseDate Preparing for Advanced DirectivesAdvanced directives involve planning for medical care that a person desires in a case where he/she is unconscious or unable to make medical decisions. This is meant to relieve other loved ones of the challenge of making such decisions due to certain challenges and oppositions from other members who may propose other recommendations that they deem effective (Peicius, Blazeviciene, & Kaminskas, 2017). Advance directives help in bringing peace by reducing confusion and disagreements between family members during a grieving moment. Due to unexpected situations that may happen to anyone, advance directives are not only for the elderly rather all individuals of any age can prepare advance directives (Peicius, Blazeviciene, & Kaminskas, 2017). Experience Completing an Advanced DirectiveCompleting an advanced directive is a complex process that involves taking certain considerations of certain aspects such as personal, cultural, and religious values. Talking about what may happen in such a situation was not comfortable at the first time since the idea of dying is disturbing (Pfirstinger et al., 2017). However, as the discussion continued, I was comfortable since this decision was meant to ensure that the right and effective treatment intervention is implemented. based on my wishes. Completing the form was difficult due to some of the decisions one has to make and requires the help of qualified healthcare personnel to advice on the treatment decisions (Pfirstinger et al., 2017). A person may fail to understand the most effective option to select given that there are diverse healthcare situations that may require different options depending on the desired outcome. Another factor that I had to consider was other family member’s wishes and how my decisions would impact my close family members financially and emotionally. This is because some interventions may take long before an individual regains his normal functioning that can incur huge costs as well as consume a large percentage of the family’s resources (Leanne & Kathryn, 2018). In discussing this decision with my family, the initial mood was a sad one. However, the family members understood the importance of an advance directive, as they would not have to worry about what to do incase such a situation occurs (Leanne & Kathryn, 2018). In fact, members of the family supported the plan with some providing other alternatives that are more effective in addressing certain situations. This is encouraging since no one knows about tomorrow and the best way is to plan effectively for any sudden events that may affect an individual’s health (Leanne & Kathryn, 2018).Insights Gained From This Activity That Might Help Me as a Social WorkerCompleting the advance directive and sharing it with my family helped me to understand some of the emotions and feelings that affect family members if a loved one makes such a decision (Rao, Anderson, Lin, & Laux, 2014). In making an advance directive, clients need to consider the wishes and of other family members as some family members may oppose certain advance directives due to certain reasons such as religious or cultural values. I also got to learn of the two types of advance directives which are the living will and a medical power of attorney (Rao et al., 2014). Healthcare practitioners should provide clients and family members with adequate information relating to the available healthcare interventions and the expected outcomes. This will enable the family members to make informed decisions since they may not be qualified or experienced to make certain healthcare decisions. Advance directives differ in different states and it is important to have an attorney prepare the advance directive to ensure that state regulations are followed (Rao et al., 2014). Specific Skills to Use When Talking To Clients about Advanced Directives, Assisting Clients in Completing an Advanced Directive, And Helping Families to Apply an Advanced DirectiveSocial workers need specific skills in talking to clients about advanced directives as well as helping them in competing advance directive. One of these skills is effective communication since healthcare providers need to educate clients on important aspects that may affect the decision-making process (Wang, Chan, & Chow, 2017). Healthcare providers also need to be competent to identify the learning needs of clients and carry out appropriate client education. It is also important for clients to understand healthcare proxies, state regulations, and the power of attorney. Healthcare staff should be familiar with state-designated advance directives where they are responsible for explaining the directives to clients in terms that can be understood by the client (Wang, Chan, & Chow, 2017). Nurses should also have a positive attitude when discussing end of life issues with clients. This means that they share the emotional fear of death with clients and be empathetic in discussing these issues with clients and family members. Advance directives should be implemented with honor and dignity (Wang, Chan, & Chow, 2017). Healthcare providers should be aware of their own feelings about death that will enable them to understand and be sensitive to clients. This require nurses to have knowledge on diverse worldviews as the issue of religion and cultural differences may come up in completing the advance directive (Wang, Chan, & Chow, 2017). Ethical Issue to a Medical Advanced DirectiveOne ethical issue that is relevant to a medical advanced directive is respect for individual autonomy that requires healthcare practitioners to respect patient’s decisions. Although some clients may have made ineffective decisions, a healthcare practitioner has to respect the patient’s wishes regardless of the outcomes (Porteri, 2018). This is because advance directives are legally binding instruments where a healthcare practitioner may face legal prosecution in the case that he/she fails to observe the patient’s treatment preferences. Healthcare practitioners should not impose their decisions on patients regardless of their effectiveness (Porteri, 2018). This becomes a challenge for healthcare practitioners whose main role is to enhance the health status of patients. However, in such situations, healthcare providers should understand the implications of going against the client’s treatment interventions and respect the patient’s wishes (Porteri, 2018). Two Sides of the Ethical IssueOne challenge faced by healthcare providers is dealing with patients who cannot make their own decisions. This brings about an ethical dilemma and healthcare providers may not know how to proceed (Scher & Kozlowska, 2018). Some of the issues that may affect respect for patient autonomy is implementing some of the interventions covered by the directive. This is because clients may not adequately specify what forms of medical interventions should be implemented. This brings about a challenge for healthcare practitioners in discerning a client’s intended preference affecting the application of the advance directive (Scher & Kozlowska, 2018). Problems of not adhering to the ethical guideline of respect for patient autonomy may also arise in cases where healthcare providers misinterpret the patient’s treatment preferences leading to the implementation of ineffective treatment interventions. The parents or close relatives may also choose to override the client’s advance directive leaving the healthcare provider in an ethical dilemma (Scher & Kozlowska, 2018).Addressing the Ethical Issue and the Benefits of This Decision to the Patient and the FamilyWhen healthcare providers are faced with an ethical issue, the most obvious way is to adhere to the ethical guidelines provided by the American Nurses Association’s Code of Ethics. In the case of advance directives, a nurse can present an ethical dilemma to multidisciplinary ethics committee that is responsible for resolving ethical dilemmas (Enguidanos & Ailshire, 2017). This will lead to the development of a more effective solution protecting the nurse from legal procedures. The nurse in collaboration with the family members can also determine the best possible treatment intervention that will enhance the life of the client (Enguidanos & Ailshire, 2017). Although this may be going against the principle of respect for patient autonomy, the nurse has the ability to override an advance directive in special situations to ensure that the principles of beneficence and nonmaleficence are observed. This will enhance the health status of the patient as well as give peace to the family in that they made the most effective decision that would help one of their family members (Enguidanos & Ailshire, 2017). However, overlooking advance directives requires serious justification.ReferencesEnguidanos, S., & Ailshire, J. (2017). Timing of Advance Directive Completion and Relationship to Care Preferences. Journal of pain and symptom management, 53(1), 49–56. doi:10.1016/j.jpainsymman.2016.08.008Leanne, C. L., & Kathryn, M. S. (2018) Things to Consider When Completing an Advance Directive. Journal of Pain & Palliative Care Pharmacotherapy, 32(2-3), 175-177, DOI: 10.1080/15360288.2018.1534922 Peicius, E., Blazeviciene, A., & Kaminskas, R. (2017). Are advance directives helpful for good end of life decision making: a cross sectional survey of health professionals. BMC medical ethics, 18(1), 40. doi:10.1186/s12910-017-0197-6Pfirstinger, J., Bleyer, B., Blum, C., Rechenmacher, M., Wiese, C., & Gruber, H. (2017). Determinants of completion of advance directives: a cross-sectional comparison of 649 outpatients from private practices versus 2158 outpatients from a university clinicBMJ Open, 7(12), 2017;7:e015708. doi: 10.1136/bmjopen-2016-015708 Porteri, C. (2018). Advance directives as a tool to respect patients’ values and preferences: discussion on the case of Alzheimer’s disease. BMC medical ethics, 19(1), 9. doi:10.1186/s12910-018-0249-6Rao, J. K., Anderson, L. A., Lin, F. C., & Laux, J. P. (2014). Completion of advance directives among U.S. consumers. American journal of preventive medicine, 46(1), 65–70. doi:10.1016/j.amepre.2013.09.008Scher, S. R., & Kozlowska, K. (2018). Rethinking health care ethics. Singapore: Palgrave Macmillan.Wang, C. W., Chan, C., & Chow, A. (2017). Social workers’ involvement in advance care planning: a systematic narrative review. BMC palliative care, 17(1), 5. doi:10.1186/s12904-017-0218-8

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