Advance Directives – Rocky Mount Family Medical Center
Read on to find more about legal documents you might need for your healthcare decisions ahead of time. For more information, call us or schedule an appointment online! We are conveniently located at 804 English Road, Suite 100 Rocky Mount, NC 27804.
Family doctors concentrate on preventative medicine. However, we often see families and individuals frustrated because they are legally unable to properly care for/carry out a loved ones requests due to the lack of proper documentation. You may be asked by your Family Medical Center provider if you would like to choose an Advanced Directive. We are providing this list of advanced directives in an effort to educate our patients about their options. We encourage you to ask questions and discuss your options with your healthcare provider.
Thank you for being a Family Medical Center patient.
HPOA/Healthcare Power of Attorney:
A Healthcare Power of Attorney is not covered under a standard Power of Attorney (POA). By signing a HPOA, you are authorizing another individual of your choice (known as a healthcare agent) to make healthcare decisions for you when you are unable to make or communicate your own decisions. Unless you stipulate specific restrictions, your HPOA will have the ability to make any decisions for you concerning your physical and mental healthcare. A HPOA will also allow your healthcare agent access to your medical records. A copy of the HPOA must be presented or on file for the healthcare agent to make decisions on your behalf or have access to your medical records.
Click here for HPOA/Healthcare Power of Attorney Form
DND/Desire for Natural Death:
A DND states that you desire that your life not be prolonged by extraordinary means if your condition is determined to be terminal and incurable. By signing a DND, you are authorizing a physician to withhold or discontinue extraordinary means. DNDs are commonly called Living Wills. Typically, hospitals will ask if you have a living will during the admission process. Living Wills/DNDs may be revoked at any time, regardless of your mental or physical condition. Your revocation becomes effective once you, or somebody acting on your behalf notifies your doctor.
Click here for DND/Desire for Natural Death Form
DNR/Do Not Resuscitate:
A DNR states that no effort, such as Cardiopulmonary Resuscitation (CPR), should be made to save your life if your heart stops of if you stop breathing. A DNR order is usually written by a physician with the patients informed consent. The DNR tells the physician and other healthcare professionals that the patient is ready to accept death. DNRs are most common in cases of terminal illness. Without a DNR, it is the responsibility of the healthcare team to take all possible measures to save your life, even if you are clearly dying. In some patients there may be a risk of broken ribs due to CPR efforts. At times, patients who are terminally sick choose to die naturally rather than face other possible health complications.
Family Medical Center has provided a copy of the DNR form; however, this form must be an ORIGINAL. While you may review it from this site, an original form must be signed by your doctor. Original forms are available at Family Medical Center at no cost to the patient.
Click here for DNR/Do Not Resuscitate Form
FULL/Full Code: (No form required)
Full code means, if a patient has a cardiac or respiratory arrest, your healthcare provider is ethically and legally obliged to perform life-saving measures. Compressions, intubation, defibrillation, various push medications and infusions may be used to prolong life. If you choose Full Code, every means available to your healthcare team will be used to save your life. You do not need to sign a form for a Full Code.
DON/Donate Body to Medical Science:
You may choose to donate your body to medical science by signing an authorization to donate to medical science. This is different from an organ donor in which specific organs may be used for other individuals. A DON allows for your entire body to be used for medical science/research.
This is typically handled through an institution of the patients choice (such as Duke, UNC-Chapel Hill or East Carolina University). Please see the institution for all necessary forms and information.