Advance Directives
Many people today are worried about the medical care they would be given should they become terminally ill or are unable to communicate. They may not want to spend months or years dependent on life-support machines, or they may want every measure to be taken to sustain their life. A growing number of people are taking action before they become seriously ill. You may now state your healthcare preferences in writing, while you are still healthy and able to make such decisions.
Under federal law, this health care organization is required to provide you, the patient, and explanation of your rights under Ohio law to make personal decisions regarding your own medical care. We are also required to ask you whether you have written down your wishes.
Durable Power of Attorney for Healthcare
This form allows you to appoint someone as your agent to make all health care decisions for you, should you become terminally ill and unable to communicate, or temporarily or permanently unable to make decisions for yourself. (If you are temporarily impaired, once you can make decisions for yourself, you will be the decision maker)
Living Will
This form allows you to give advance written directions about all your health care decisions when you are terminally ill and unable to communicate or you are in a permanently unconscious state.
(Taken from the CCF pamphlet "You Have the Right: Stating Your Wishes Regarding Medical Treatment")
These websites have forms available:
National Hospice and Palliative Care Organization --you can download any state's advance directive, click on advance directive in the upper right corner of the home page
PODER DE CUIDADO DE SALUD DE--Power of Attorney for Healthcare in Spanish
DECLARATION DE TESTAMENTO ED VIDA AVISO AL DECLARANTE--Living Will in Spanish
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If you have done a living will or durable attorney for healthcare and have not given us a copy, please make a copy and return it to us so that we can best honor your wishes:
Include your name and your Cleveland Clinic # (patient number).
Mail to:
Advance Directive
Department of Social Work
Desk P-87
9500 Euclid Ave.
Cleveland, OH 44195-9905
Return to the Social Work Home Page
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