Five Wishes Advance Directive

Five Wishes Advance Directive
An advance directive is a legal document that defines a patient’s wishes for medical care. This document is a way for patients to share their wishes with family members and health care providers when their illness or mental capacity prevents them from making decisions. As an advanced practice nurse who has care discussions with patients and their families, you need to be familiar with the process of completing an advance directive. In this Discussion, you complete the Five Wishes advance directive and consider how it might help you communicate with patients in your nursing practice.

To prepare:

•Review the Alfonso, Casey, and Watson articles in this week’s Learning Resources.
•Review the Five Wishes website. Reflect on the questions presented and complete your Five Wishes.
•Research advance directives in your state. Consider whether your Five Wishes can be turned into a formal document based on your state’s requirements.
•Reflect on how your experience of completing your Five Wishes advance directive will help you guide discussions with patients and their families.
•Think about how you could apply the Five Wishes advance directives to your nursing practice. Consider how this advance directive might benefit patients in decision making for specialized areas of care.
Write an explanation of your state’s requirements for advance directives including whether your Five Wishes can be turned into a formal document. Then, explain how your experience of completing your Five Wishes advance directive will help you guide discussions with patients and their families. Finally, explain how you could apply the Five Wishes advance directives to your nursing practice. Include how this advance directive might benefit patients in decision making for specialized areas of care.

Readings
•Flaherty, E., & Resnick, B. (Eds.). (2011). Geriatric nursing review syllabus: A core curriculum in advanced practice geriatric nursing (3rd ed.). New York, NY: American Geriatrics Society.
?Chapter 50, “Kidney Diseases and Disorders” (pp. 404–414)

This chapter describes changes in kidney function related to aging. It also presents guidelines for diagnosing, treating, and managing kidney diseases and disorders including electrolyte disorders, acute renal failure, chronic kidney disease, and end-stage kidney disease.
?Chapter 51, “Gynecologic Diseases and Disorders” (pp. 415–420)

This chapter presents guidelines for gynecologic examinations for older adult females. It also examines strategies for diagnosing, treating, and managing gynecologic diseases and disorders such as menopausal symptoms, urogenital symptoms, disorders of the vulva, disorders of pelvic floor support, and postmenopausal vaginal bleeding.
?Chapter 52, “Prostate Disease" (pp. 420–430)

This chapter examines treatment and management strategies for benign prostatic hyperplasia, prostate cancer, and chronic prostatitis. It also describes the controversy surrounding prostate cancer screening.
?Chapter 57, “Neurologic Diseases and Disorders” (pp. 464–479)

This chapter examines treatment and management strategies for neurologic conditions such as cerebrovascular disease, headaches, movement disorders, and epilepsy.
?Chapter 62, “Oncology” (pp. 521–532)

This chapter explores risk factors for developing cancer and the increased prevalence of cancer in older adults. It also describes treatment options, such as surgery, radiation, chemotherapy, and biology therapy, for a variety of specific cancers including breast and colon cancer.
•Alfonso, H. (2009). The importance of living wills and advance directives. Journal of Gerontological Nursing, 35(10), 42–45.
Retrieved from the Walden Library databases.

This article emphasizes the importance of creating a living will and advance directive, focusing on the impact of not having a living will and potential barriers to creating living wills. It also examines the nurse’s role in educating patients about living wills.
•Casey, D. A., & Walker, D. M. (2011). The clinical realities of advance directives. Widener Law Review, 17(2), 429–442.
Retrieved from the Walden Library databases.

This article examines federal law regarding advance directives and issues related to advance directives. It also provides recommendations for implementing advance directives in clinical settings.
•Watson, E. (2010). Advance directives: Self-determination, legislation, and litigation issues. Journal of Legal Nurse Consulting, 21(1), 9–14.
Retrieved from the Walden Library databases.

This article examines types of advance directives including the living will and do-not-resuscitate orders. It examines reasons for nonimplementation of an advance directive and common causes of action claims for nonimplementation of advance directives by health care providers.
•Aging with Dignity. (2011). Five wishes. Retrieved from http://www.agingwithdignity.org/five-wishes.php/