Consider the following options and fill in the corresponding portions of your advance directive form.
1) I want my agent to be able to receive any information about my health, verbal or written, and release this information to others involved in my health care.
Note: if you do not give your agent this power, he or she will probably not be able to make informed decisions about your health care.
YES/NO
2) I want my agent to be able to hire and fire my health care providers.
YES/NO
3) I want my agent to be able to approve my admission to or discharge from any hospital, hospice, nursing home, assisted living facility or other medical care facility.
Note: This does NOT include mental health facilities which are covered later.
YES/NO
4) I want my agent to be able to consent to pain-relieving medication even if I need more than what is usually given.
Sometimes, especially at the end of life, people may need medications at a higher dose than normal to keep him or her out of pain. Higher doses of pain medications can lead to addiction and can speed up the dying process for those people who are already quite ill because pain medications tend to slow our breathing. However, people at the end of life who are experiencing extreme pain may not worry about either of these risks. Assisted suicide is not legal in Virginia, so your agent cannot consent to high enough doses to cause death.
YES/NO
NEXT - Screen 10: Admissions to Facilities
BACK - Screen 8: Agent Powers
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