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Common Terminology for Advanced Care Directives

Ability – Mental and emotional intelligence that enables a person to sift through the evidence and make a decision aligned with the patient’s wishes

Admission to the hospital – Staying in the hospital as a patient in a room receiving care from the hospital doctors, nurses and therapists.

Adornments – An accessory or ornament worn to embellish, enhance, or distinguish the wearer, and to define cultural, social, or religious status within a specific community.

Advance directive – A general term that describes two kinds of legal documents, living wills and medical powers of attorney. These documents allow a person to give instructions about future medical care should he or she be unable to participate in medical decisions due to serious illness or incapacity. Each state regulates the use of advance directives differently.

Artificial breathing – A situation whereby a machine, usually called a ventilator, that will breathe in and out for you in the event that illness or injury causes you to not be able to do so on your own.

Artificial nutrition and hydration – Artificial nutrition and hydration supplements or replaces ordinary eating and drinking by giving a chemically balanced mix of nutrients and fluids through a tube placed directly into the stomach, the upper intestine or a vein.

Brain death – The irreversible loss of all brain function. Most states legally define death to include brain death.

Burial – A process by which a body is prepared for and ultimately buried in a casket in the ground after death.

Capacity – In relation to end-of-life decision-making, a patient has medical decision making capacity if he or she has the ability to understand the medical problem and the risks and benefits of the available treatment options. The patient’s ability to understand other unrelated concepts is not relevant. The term is frequently used interchangeably with competency but is not the same. Competency is a legal status imposed by the court.

Cardiopulmonary resuscitation – Cardiopulmonary resuscitation (CPR) is a group of treatments used when someone’s heart and/or breathing stops. CPR is used in an attempt to restart the heart and breathing. It may consist only of mouth-to-mouth breathing or it can include pressing on the chest to mimic the heart’s function and cause blood to circulate. Electric shock and drugs also are used frequently to stimulate the heart.

Central line – A special intravenous line, or lines, inserted through the chest wall for use in drawing blood or giving blood, medications, fluids, nutrition, etc.

Comfort measures – Any care designed to aid in comfort.

Cremation – A process by which a body is prepared for and then reduced to mineral fragments via high-temperature burning.  Cremated remains, which do not constitute a health risk, may be buried or interred in memorial sites or cemeteries, or they may be retained by relatives and dispersed in various ways.

Daily medications – Prescriptions you take every day or on a regular basis.

DNI (do not intubate) – A medical order signed by the patient and his or her physician stating that, in the event that the person stop breathing, a tube will not be inserted into their lungs to breathe mechanically.

Do-Not-Resuscitate (DNR) order – A DNR order is a physician’s written order instructing healthcare providers not to attempt cardiopulmonary resuscitation (CPR) in case of cardiac or respiratory arrest. A person with a valid DNR order will not be given CPR under these circumstances. Although the DNR order is written at the request of a person or his or her family, it must be signed by a physician to be valid. A non-hospital DNR order is written for individuals who are at home and do not want to receive CPR.

Emergency Medical Services (EMS) –  A group of governmental and private agencies that provide emergency care, usually to persons outside of healthcare facilities; EMS personnel generally include paramedics, first responders and other ambulance crew.

Feeding – How nutrition enters your body.

Health Care agent  The person named in an advance directive or as permitted under state law to make healthcare decisions on behalf of a person who is no longer able to make medical decisions. A named Individual with the documented right to make medical decisions about your healthcare when you are unable to do so.  For My Living Wishes we are using the term Health Care Agent.  Depending on where you live, you might see this same person identified by another term like Health Care Proxy, Health Care Surrogate, Health Care Representative, Health Care Attorney-In-Fact, Patient Advocate or Medical Power of Attorney.

Health Care Agent Backup – A named Individual with the documented right to make medical decisions about your healthcare when neither you or your HCA are able to do so.

Healthcare providers – The people who take care of you when you are sick or injured.

Hospice – Considered to be the model for quality, compassionate care for people facing a life-limiting illness or injury, hospice and palliative care involve a team-oriented approach to expert medical care, pain management, and emotional and spiritual support expressly tailored to the person’s needs and wishes. Support is provided to the persons loved ones as well.

Hydration – How water enters your body.

Intravenous line – A line inserted into a vein via a needle that leaves a tube into the vein for use in drawing blood or giving blood, medications, fluids, nutrition, etc.

Intubation– Refers to “endotracheal intubation” the insertion of a tube through the mouth or nose into the trachea (windpipe) to create and maintain an open airway to assist breathing.

Life-sustaining treatment – Treatments (medical procedures) that replace or support an essential bodily function (may also be called life support treatments). Life-sustaining treatments include cardiopulmonary resuscitation, mechanical ventilation, artificial nutrition and hydration, dialysis, and other treatments.

Living will – A type of advance directive in which an individual documents his or her wishes about medical treatment should he or she be at the end of life and unable to communicate. It may also be called a “directive to physicians”, “healthcare declaration,” or “medical directive.”

Meaningful recovery – Defined by the person completing My Living Wishes, meaningful recovery is the set of standards you believe to be the restoration of health and strength after an illness or injury.

Mechanical ventilation – Mechanical ventilation is used to support or replace the function of the lungs. A machine called a ventilator (or respirator) forces air into the lungs. The ventilator is attached to a tube inserted in the nose or mouth and down into the windpipe (or trachea).

Medical power of attorney – A document that allows an individual to appoint someone else to make decisions about his or her medical care if he or she is unable to communicate. This type of advance directive may also be called a healthcare proxy, durable power of attorney for healthcare or appointment of a healthcare agent. The person appointed may be called a healthcare agent, surrogate, attorney-in-fact or proxy.

My Living Wishes – A technology program that enables an individual to document who, what, when and how another person should handle medical decisions if the individual is unable to do so.

Organ donation – After death, the donation of organs and/or tissue to another person who needs them.

Pain medicine – Prescriptions given to a patient to treat pain.

Palliative care – A comprehensive approach to treating serious illness that focuses on the physical, psychological, spiritual, and existential needs of the patient. Its goal is to achieve the best quality of life available to the patient by relieving suffering, and controlling pain and symptoms.

Patient/Individual – The person who uses My Living Wishes to control future, personal medical situations.

PICC line – PICC stands for peripherally inserted central catheter and is a special intravenous line usually inserted into the upper arm for use in drawing blood or giving blood, medications, fluids, nutrition, etc.

Power of attorney – A legal document allowing one person to act in a legal matter on another’s behalf regarding to financial or real estate transactions.

Respiratory arrest –  The cessation of breathing – an event in which an individual stops breathing. If breathing is not restored, an individual’s heart eventually will stop beating, resulting in cardiac arrest.

Right – Legally authenticated decision-making power relevant to individual’s health care decisions when individual is unable to make decisions.

Short-term medications – Prescriptions you take for a new condition or health status.

Surrogate decision-making – Surrogate decision-making laws allow an individual or group of individuals (usually family members) to make decisions about medical treatments for a patient who has lost decision-making capacity and did not prepare an advance directive. A majority of states have passed statutes that permit surrogate decision making for patients without advance directives.

The ability to think and communicate – A situation that, by all available medical tests, you are aware of the world around you, have the ability to have thoughts and are able to interact with others.

Ventilator – A ventilator, also known as a respirator, is a machine that pushes air into the lungs through a tube placed in the trachea (breathing tube). Ventilators are used when a person cannot breathe on his or her own or cannot breathe effectively enough to provide adequate oxygen to the cells of the body or rid the body of carbon dioxide.

Withholding or withdrawing treatment – Forgoing life-sustaining measures or discontinuing them after they have been used for a certain period of time.