Advance Directive
An advance directive is a legal document that allows individuals to specify their healthcare preferences and designate a decision-maker in case they become unable to communicate or make decisions for themselves. Common types include living wills and durable power of attorney for healthcare.
Exam Tip
Patient Self-Determination Act (1990) requires facilities to inform patients about advance directives. LPNs ask about and document advance directives but do NOT provide legal advice. Patients can revoke at any time while competent. Know living will vs. durable power of attorney for healthcare.
What Is an Advance Directive?
An advance directive is a legal document that communicates a person's wishes regarding medical treatment when they are no longer able to speak for themselves. It ensures patient autonomy is preserved even during incapacitation.
Types of Advance Directives
| Type | Purpose |
|---|---|
| Living Will | Specifies which treatments the person does or does not want (e.g., mechanical ventilation, tube feeding, CPR) |
| Durable Power of Attorney for Healthcare | Designates a trusted person (healthcare proxy) to make medical decisions on behalf of the patient |
| Do Not Resuscitate (DNR) | Instructs healthcare providers not to perform CPR if the heart stops |
| POLST/MOLST | Physician/Medical Orders for Life-Sustaining Treatment; a portable medical order for seriously ill patients |
Key Legal and Nursing Points
| Point | Detail |
|---|---|
| Patient Self-Determination Act (1990) | Requires healthcare facilities to inform patients of their right to advance directives upon admission |
| Competency | Must be mentally competent when creating the directive |
| Witness requirements | Vary by state; typically 2 witnesses who are not beneficiaries |
| Revocation | Can be revoked at any time while the patient is competent |
| Portability | Should be honored across healthcare settings, though state laws vary |
LPN/LVN Responsibilities
- Ask patients on admission if they have an advance directive
- Document the existence (or absence) of an advance directive in the medical record
- Notify the RN if the patient wants to create, change, or revoke an advance directive
- Do NOT provide legal advice or influence the patient's decisions
- Ensure the advance directive is accessible in the patient's chart
- Follow the directives as part of the care plan
Exam Alert
Advance directives fall under the Coordinated Care category on the NCLEX-PN. Know the Patient Self-Determination Act, the difference between a living will and durable power of attorney for healthcare, and that the LPN's role is to document and communicate, not to provide legal counsel.
Study This Term In
Related Terms
Patient Advocacy
Patient advocacy is the act of supporting and protecting patients' rights, safety, and best interests within the healthcare system. Nurses serve as patient advocates by ensuring informed consent, protecting patient rights, facilitating communication, and speaking up when patient safety is at risk.
Care Plan (Nursing)
A nursing care plan is a written document that outlines a patient's identified health problems, measurable goals, and specific nursing interventions. It is developed by the RN based on nursing assessment data and guides the entire nursing team in providing consistent, individualized care.
Scope of Practice (Nursing)
Scope of practice defines the legal boundaries of what a healthcare professional is authorized to do based on their education, licensure, and state Nurse Practice Act. For LPNs/LVNs, the scope includes basic nursing care, data collection, medication administration, and care plan implementation under RN or physician supervision.
10 free AI interactions per day
Stay Updated
Get free exam tips and study guides delivered to your inbox.