Advance Directive and Code Status Discussions

This chapter provides guidance and sample language that can be used to conduct advance directive and code status discussions with patients and families. It stresses the importance of initiating these conversations when patients become adults and revisiting them with any change in health status or major life circumstances. The chapter highlights the significance of helping patients choose a surrogate medical decision-maker who can make decisions objectively and keep their values and preferences in mind. It provides guidance for discussing advance directive documents, including a living will and POLST form, which specifies code status wishes, preferences for medical care in the hospital or at home, and feeding tube preferences. The chapter concludes with a brief overview of legal considerations that include durable power of attorney, guardianship, conservatorship, competence, and capacity.