St. Luke's Cornwall Hospital - Advanced Directives


	70 Dubois Street, Newburgh, NY 12550 (845) 561-4400 19 Laurel Avenue, Cornwall, NY 12518 (845) 534-7711

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Advanced Directives

Advance Directives are documents written by the patient to make their wishes about medical decisions known to the health care team in the event that the patient is not able to communicate these wishes. These documents give guidance to your family, guardians and the health care team about your treatment wishes. Patients should use these documents to express their wishes about end-of-life decisions as completely and specifically as possible.

When creating your advance directives you should consider what is important to you. Discuss your wishes with your family and physician and especially the person you have chosen to be your proxy.

There are three types of advance directives:

The Health Care Proxy is a document completed by the patient that allows them to choose someone to help make medical decisions for them in the event that they can no longer make medical decisions themselves. A blank Health Care Proxy form with detailed instructions is in the "Your Rights As A Patient In A Hospital In New York State" booklet that is distributed to all inpatients at the time of admission; you may also download a copy of the form now. A blank health care proxy form can also be obtained in the Admitting office.

A Living Will is written instructions that explain the patient's wishes regarding health care. The health care team will honor these instructions in the event the patient can no longer communicate their wishes. A blank Living Will may be obtained at a stationery or office supply store.
The Do Not Resuscitate (DNR) order is a document completed when you are in the hospital with the assistance of you physicians. This document instructs the health care team not to try to revive you if your breathing or heartbeat stops. The booklet "Do Not Resuscitate Orders -- A Guide for Patients and Families" is available through your nurse or in the Admitting office.

Use advance directives to help you express informed decisions about the care you wish to receive or refuse.

If you already have a completed advance directive please bring a copy with you when you are admitted to the hospital.

If you have questions or concerns about advance directives or end of life decisions please speak with your physician, nurse or by calling the Patient Relations office at (845) 568-2300.

Health Care Proxy Tips:

Section Two of the form indicates that you must discuss artificial nutrition and hydration with your proxy. We suggest that you do so and then write on the form “My proxy knows my wishes regarding artificial nutrition and hydration.”
After completion make copies and give to:
- All physicians involved in your care
- Your proxy and alternate (if you name one)
- Your lawyer
- Other relatives that you want to know who you are naming as your proxy
Always keep the ORIGINAL for your records. Place it where a relative or friend can locate it for you if you are unable to do so.
Take a copy of your Health Care Proxy form to the hospital for inclusion in the medical record for each visit. If you only have the original ask the staff to copy it for you and return the original to you.
Attach a list of everyone you gave a copy to. If you need to change your proxy, you may need a reminder of who has a copy. We suggest that you use a “post it” note for your list.

70 DUBOIS STREET, NEWBURGH, NY (845) 561-4400 • 19 LAUREL AVENUE, CORNWALL, NY (845) 534-7711