It’s Your Life, It’s Your Plan
Imagine that you are critically ill or seriously injured and cannot communicate.
Would your loved ones know what is important to you? Would they know what
medical options and interventions you would choose and which ones you
would not want?
“It always seems too early, until it’s too late.”
No matter how young or old you are, one important way you can take care
of yourself is to complete an Advance Directive. An Advance Directive
is for everyone, not just patients facing a life-limiting illness or serious injury.
It’s what matters to you, not what’s the matter with you
By completing an Advance Directive you make your wishes known. An Advance
Directive is a gift you give your loved ones so that they are confident
in helping guide your medical care if you are unable to do so. It alleviates
some of the fear and anxiety from an already stressful situation and allows
them to make decisions about your medical treatment that you want. By
choosing a healthcare agent (or surrogate), you designate the person whom
you trust to carry out your wishes if you are unable.
Our commitment to patient-centered care
At Frederick Health, we are committed to providing the highest quality
medical care and supporting you in creating your Advance Directive is
one way in which we accomplish that.
Our staff provides support to you in completing your Advance Directive.
An Advance Directive simply states what medical interventions you would
want and which ones you would not want if you are in an end stage condition,
terminal condition or persistent vegetative state – an unable to
communicate your wishes.
So there’s nothing to be afraid of. We are with you every step of
the way – you are not alone. For assistance in completing an advance
please ask for or contact a social worker or case manager at 240-651-4541.
Conversation Starter Kit
Conversation Starter Kit
is designed to help you think about what your wishes are and how to have
conversations with your family about your wishes.
Adults (ages 18 or older) who are mentally competent have the right to
make healthcare decisions in advance. For your convenience, we have included
this form to
complete your Advance Directive. There are two sections when one is completing an advance directive. It’s
best to complete both but it’s not required:
Living Will or Healthcare Instructions - This part of your written advance directive asks you to state what kind
of care you want to receive if you are suffering from a terminal, persistent
vegetative state, or an end-stage condition and are unable to communicate
your wishes. Written Healthcare Instructions allow you to say whether
or not you want to receive life-sustaining treatment in each of these
circumstances. A life-sustaining procedure is defined as any medical procedure,
treatment, or intervention that uses mechanical or other artificial means
to sustain, restore, or replace a spontaneous vital function. You may
also indicate whether or not you would want to receive artificially administered
sustenance (nutrition and hydration given through an IV or feeding tube).
These conditions are described below:
- A terminal condition is an incurable condition caused by injury, disease,
or illness which makes death imminent. Even if life-sustaining procedures
are used when an individual is close to death, there is no reasonable
expectation of recovery.
- A persistent vegetative state is a condition in which a person is permanently
unconscious, unaware of his or her environment, and is unable to interact
with others. There is no reasonable expectation of recovery. A persistent
vegetative state is not the same as a temporary coma.
- An end-stage condition is a progressive condition caused by injury, disease
or illness in which a person suffers severe and permanent deterioration
which can be accompanied by incompetence and complete physical dependency.
To a reasonable degree of medical certainty, treatment of this irreversible
condition would be medically ineffective.
Healthcare Agent/Medical Power of Attorney - This part of your written advance directives is a legal document that
allows you to name someone you know and trust as your agent to make healthcare
decisions. Your agent must be 18 years of age or older.
Choose your healthcare agent carefully, and make sure he or she knows
what you want. Your agent can then follow your wishes, even if your friends
or family disagree.
In order for your Healthcare Instructions and Appointment of Healthcare
Agent to be effective in Maryland, both documents must be:
- voluntarily executed and made in writing;
- dated and signed by you;
- witnessed by two adults, 18 or older, one of whom will not financially
benefit from your death;
- your appointed healthcare agent cannot serve as a witness.
Advance Care Planning Checklist is a quick reminder of things to complete in the advance directive process. The
Comparison of Maryland State Forms explains the differences between the forms used in Maryland for advance
Oral Advance Directive
Adults often make healthcare decisions during discussions with their physicians.
The physician describes the options and explains the pros and cons of
each, but you make the final decision. For example, you might decide in
this way about the use of CPR (cardiopulmonary resuscitation). An oral
advance directive is legally effective and is to be honored by your healthcare
providers. You must communicate your decision to your doctor in front
of a witness, and your decision must be written in your medical record
at the time it is made and signed by the witness. You should read what
is written to make sure it reflects your wishes.
Medical Orders for Life-Sustaining Treatment (MOLST)
While the Advance Directive is for future medical treatment at the end
of life, the MOLST form is for current medical treatment you wish to receive.
This order form makes your treatment wishes known to health care professionals
and has to be signed by a physician, nurse practitioner or physician assistant.
If you do not have a Do Not Resuscitate (DNR) order on your MOLST form,
medics (ambulance personnel) and other healthcare team members in Maryland
must attempt resuscitation. This form does not expire and it goes where
you go, to the hospital, rehab, assisted living, and back home. It consolidates
important information into orders that are valid across the continuum
of care. For your convenience,
we have included this form to complete.