“Do you have an advance directive?” This is one of the first questions a patient is asked when admitted to a Kindred facility. “The goal of an advance directive is to make sure that patients are making informed decisions and that we’re following their wishes,” says Kathee Paradowski, Clinical Informaticist Consultant in Kindred’s Hospital Division. All patients who do not have an advance directive are educated/counseled on the importance of creating one. They are also encouraged to designate a power of attorney for health care who can speak for them if they become so sick they are unable to speak for themselves.

 Advance directives discussions, like the one pictured above, are vital to providing the proper care while keeping the patient's wishes a priority. Advance directives discussions, like the one pictured above, are vital to providing the proper care while keeping the patient's wishes a priority.

 

Kindred has developed a tool for staff members to help them with discussions about advance directives. “What we need to make clear to patients is that making their wishes known not only provides guidance to our staff, but also to their family members, who may not always agree,” says Paradowski. “And they can always change their minds if they decide on a different level of care based on changes in their condition.”

If a patient is unresponsive at admission, social services or case management staff immediately begin to attempt to contact the family to find out if an advance directive exists. “If the patient is unresponsive, we can’t reach the family, and there’s no indication that they have an advance directive, it’s Kindred policy that the patient be considered a full code until we can determine otherwise,” Paradowski says. “We also need to make sure we’re following state guidelines, which can vary.”

Once the patient’s wishes have been determined, the physician writes orders based on the patient’s desires and the advance directive is entered into the patient’s record. “Most of our records are electronic and there are PCs in all of our patient rooms, so it’s very easy for staff to access each patient’s information at the bedside,” says Paradowski.

Interested in reading more about advance directives? Click here for a list of frequently asked questions from Professional Healthcare at Home, an affiliate of PeopleFirst Homecare and Hospice.

Advance directives discussions, like the one above, are vital to providing the proper care while keeping patient's wishes a priority.