Healthcare Decisions

Advance Directives

In Colorado, a medical durable power of attorney, a do not resuscitate (DNR) order, the CPR (cardiopulmonary resuscitation) directive and a living will are the most common types of advance directives.
An advance directive is a written document that states your specific wishes for medical treatment or names a person to make choices for you in the event that you lose the ability to make decisions for yourself.
This booklet, Your Right to Make Health Care Decisions addresses naming of a medical durable power of attorney, accepting and refusing medical treatment, living wills, and resuscitation directives. This downloadable booklet is valid under the laws of Colorado once it is filled out and properly signed.


En español, Su derecho a tomar decisiones relativas a la atención médica
Medical Durable Power of Attorney for Health Care Decisions
This is a document that allows you to name someone else (agent) to make medical decisions for you when you are unable to make medical decisions. The agent is authorized to consent to or withdraw any treatment. The agent is charged with making decisions that you would want; therefore it is very important that you know this person well and tell them what your values are, what is important to you, what quality of life looks like to you, and what types of care you would want and not want. The agent must be 18 years or older. Every adult in Colorado should appoint an agent via an MDPOA, because unless you appoint an agent, you do not have someone to legally speak for you in a medical setting if you become incapacitated.

Living Will (Medical Declaration)
This is a document you create to tell physicians who are caring for you to stop or not start life-sustaining treatments if you are in a persistent vegetative state, or if you are unable to make your own decisions and you are in a terminal condition. A living will only goes into effect 48 hours after two physicians certify that you are in a persistent vegetative state or in a terminal condition and cannot make your own decisions.

Cardiopulmonary Resuscitation (CPR) Directive
A CPR Directive is a document that allows you – or your agent or guardian on your behalf – to refuse resuscitation. CPR is cardiopulmonary resuscitation which is an attempt to revive you if your heart stops or you stop breathing. CPR typically involves chest compressions, mechanical breathing, shock to the heart, and sometimes medications. If you wish to create a CPR directive, you should speak with your healthcare provider, as it is important to understand the process of CPR and your particular health circumstances and health goals.

Do Not Resuscitate (DNR) Order
A DNR is an order written in your medical chart by a physician while you are a patient in a healthcare facility. The physician will write the order only after consultation with you, or if you are unable to make your own decisions, with your agent. A DNR states that you do not want to be resuscitated if your heart stops or if you stop breathing. In a hospital setting, a DNR order is only valid for the hospital stay during which it was written.

Medical Orders for Scope of Treatment (MOST)

MOST serves as a translation of advance directives into medical orders. It establishes portability of orders to and from health care setting and providers. Because of these unique capabilities, it is designed only for use by individuals who are chronically ill and who are frequently hospitalized.

What is Community Hospital's Policy on Advance Directives?

Community Hospital recognizes and respects the rights of our patients to agree to or to refuse medical treatments. We encourage our patients, their families and physicians to clarify with one another both current and future treatment choices. We are happy to assist you by providing you with a copy of the Your Right to Make Health Care Decisions booklet.

This booklet can help you and your loved ones identify how you would like to be treated if you become seriously ill. It is an easy-to-complete form that lets you say exactly what you want. Once it is filled out and properly signed, it is valid as an advance directive under the laws of Colorado.

We will make every effort to assure that a patient’s wishes are respected as long as they are understood and can be carried out according to Colorado law. In general, we do not honor CPR directives in our outpatient settings, although exceptions may be made for surgical and other procedures in consultation with the patient and medical staff.

Where Should I Keep my Advance Directive?
Keep a copy in a safe place where you and family members or friends can locate it. It is a good idea to give copies to your physician and attorney, and to have a copy on hand in the event of an inpatient hospital admission.

How Can Community Hospital Help Me Complete an Advance Directive?
A number of Community Hospital professionals are available to assist you in answering your questions regarding this important issue. We are also happy to provide you with a copy of Your Right to Make Health Care Decisions and a medical power of attorney.

Questions?
Please feel free to talk with your nurse, a case manager, (970) 644-3130 or the Patient Advocate (970) 644-3154.

Colorado End-of-Life Options Act

Colorado West Healthcare Systems d.b.a. Community Hospital wishes to provide this notice to advise our patients that Community Hospital is opting out from facilitating patients with their rights under Colorado’s recently passed End-of-Life Options Act.

The Colorado End-of-Life Options Act authorizes medical aid in dying and allows a terminally ill adult to end his or her life in a peaceful manner. The patient must meet several requirements, including:
• A prognosis of six months or less;
• Mental capacity to make an informed decision;
• Residency in Colorado; and
• Has requested and obtained a prescription for medical aid-in-dying medication.

Colorado law recognizes certain rights and responsibilities of qualified patients and health care providers under the End-of-Life Options. Under the Act, a health care provider, including Community Hospital, is not required to assist a qualified patient in ending that patient’s life.

Community Hospital has chosen not to participate under the Act; any patient wishing to request medical aid-in-dying medication while a patient at this hospital will be assisted in transfer to another facility of the patient’s choice. Community Hospital allows physicians to participate in activities authorized by the Act, if they so choose, and other options including palliative care are also available for patients with serious illness.