Question

1.When should a person execute a durable power of attorney?
2. What preferences does an advance directive establish?
3.When is CPR indicated and when is it not?
4.How would you explain the statement that CPR should not be the standard of care for the chronically ill resident of a long term care facility?
5.Explain the difference between starvation and the malnutrition/dehydration of the dying?

Answer 1

QUESTION NO :- 1

POWER OF ATTORNEY

The term power of attorney is a legal document giving one person ( the aget or attorney in fact) the power to act for other person.The agent can have broad legal authority or limited authority to make legal decisions about the principal's property,finances or medical care. A power of attorney can be end by many reasons such as

• Death of principal
• Principal revokes it
• A court invalidate it
• The principal dvorces their spouse
• The agent can no longer carryout the outlined responsibilities.

DURABLE POWER OF ATTORNEY

• A person can execute a Durabe Power of Attorney when he is in sa state that he can't take a dicission in some of the circumstances.
• The durable power of attorney will help the person to plan for medical emergencies and declines in mental funtioning and can ensure that his or her finances are taken care of.

Durable power of Attorney in health care

• It will be usful when a medical emergency leaves a person unconscious or otherwise unable to make choices about his or her care.
• It appoints someone else to communicate with the doctors and make medical decisions for the person.

QUESTION NO :- 2

ADVANCE DIRECTIVE ESTABLISH

• Advance directives refers to the treatment preferences and placing a surrogate desicion maker when the person is unabe to make the medical decisions.
• An Advance directive lets the person's  health care team and loved ones know what kind of health care the person want when he or she can't able to take a decision about his or her health care.

QUESTION NO :- 3

CPR (CARDIO PULMONARY RESUSCITATION)

It is an emergencr life saving procedure performed when the heart stops it's funtion by giving the chest compression and artificial ventilation.

INDICATIONS	CONTRA-INDICATIONS
Ventricular fibrillation	(DNR)do-not-resuscitate order or other advanced directive indicating a persons's desire not to be resuscitated in the event of cardiac arrest.
Pulseless Ventricular Tachycardia	Clinician justifiably feels that the intervention would be medically futile(useless)
Pulseless Electrical Acivity
Asystole
Pulseless Bradycardia

QUESTION NO :- 4

CPR should not be the standard of care for the chronically ill resident of a long term care facility because the long term care facility for a chronic illness means providing critical daily support to the patient who might not have the ability to take care by himself or herself which provides a homley atmosphere for the patient. So CPR is not a standard care here.

QUESTION NO :- 5

Differene between starvation and malnutrition or dehydration of the dying.

Starvation

• Fatal starvation is the deliberate withholding of the food,especially in infants.
• The cause of death due to the starvation can be understand by an expert's opinion about the degree and duration of the starvation.

Malnutrition

Fatal malnutrition can be described as the patient is not recied an adeduate nutritions due to physical neglect. It can be identified by the muscle wasing or weight loss.

Dehydration

It may be also seen in young children due to physical neglect.In addition to classical autopsy findings such as

• Poor skin turger
• sunken eyes
• Vitreous - humor chemistry may be helpful in making the diagnosis.