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Review your advance directive periodically to make sure it still expresses your intent, then initial and date your review.

Advance Directive Document

Advance Directive Glossary

Here are some common terms to help you understand.

Advance Directive – A document giving instructions as to how health care should be administered in the event the patient becomes unable to make particular health care decisions. The attending physician then must make the determination of the patient's lack of capacity in writing, stating the specific nature, cause, extent and duration of the condition, and unless the patient's lack of decision-making capacity is clearly apparent to both the physician and the health care representative, it must be confirmed by a second physician, N.J. Stat. Ann. § 26:2H-60, and in the case of mental illness a psychiatrist is necessary. In re A.A., 381 N.J. Super. 334, 885 A.2d 974, 2005 N.J. Super.

Allow Natural Death – A physician’s order, which directs that, if a patient suffers a cardiac or pulmonary arrest, defibrillation, cardiac massage, artificial ventilation and/or pharmacologic agents intended to reverse the patient’s death will not be administered.

Artificial nutrition and hydration – Artificial nutrition and hydration supplements or replaces ordinary eating and drinking by giving a chemically balanced mix of nutrients and fluids through a tube placed directly into the stomach.

Brain Death – Brain Death is defined as the permanent and irreversible loss of all brain function.

Decision-Making Capacity – means a patient’s ability to understand and appreciate the nature and consequences of health care decisions, including the benefits and risk of each, and alternatives to any proposed health care, and to reach an informed decision. A patient’s decision making capacity is evaluated relative to the demands of a particular health care decision.

Cardiopulmonary resuscitation – Cardiopulmonary resuscitation (CPR) is a group of treatments used when someone’s heart and/or breathing stops. CPR is used in an attempt to restart the heart and breathing. It may consist only of mouth-to-mouth breathing or it can include pressing on the chest to mimic the heart’s function and cause blood to circulate. Electric shock and drugs also are used frequently to stimulate the heart.

Do-Not-Hospitalize - A DNH order is a physician’s written order instructing healthcare providers not to send a patient to a hospital. A DNH order is requested by a patient and/or family when the patient wants to remain in their residence and receive palliative and comfort care only. All nursing and medical treatment currently in place will be continued.

Emergency Medical Services (EMS) – A group of governmental and private agencies that provide emergency care, usually to persons outside of healthcare facilities; EMS personnel generally include paramedics, first responders and other ambulance crew.

Futile Treatment: Medical treatment that is ineffective in treating a terminal condition or merely prolonging an imminent dying process.

Healthcare Representative (Proxy): The person named in an advance directive or as permitted under state law to make healthcare decisions on behalf of a person who is no longer able to make medical decisions.

Hospice – Considered being the model for quality, compassionate care for people facing a life-limiting illness or injury, hospice and palliative care involve a team-oriented approach to expert medical care, pain management, and emotional and spiritual support expressly tailored to the person’s needs and wishes. Support is provided to the person’s loved ones as well.

Intubation – Refers to “endotracheal intubation” the insertion of a tube through the mouth or nose into the trachea (windpipe) to create and maintain an open airway to assist breathing.

Life-sustaining treatment – Treatments (medical procedures) that replace or support an essential bodily functions (may also be called life support treatments), Life-sustaining treatments include cardiopulmonary resuscitation, mechanical ventilation, artificial nutrition and hydration, dialysis, and other treatments.

Living will – A document which becomes valid when a person is no longer able to make decisions regarding his or her medical treatment, and that governs the withholding or withdrawing of life-sustaining treatment from an individual in the event of an incurable or irreversible condition that will cause death within a relatively short time.

Mechanical ventilation – Mechanical ventilation is used to support or replace the function of the lungs. A machine called a ventilator (or respirator) forces air into the lungs. The ventilator is attached to a tube inserted in the nose or mouth and down into the trachea (windpipe).

Palliative care – A comprehensive approach to treating serious illness that focuses on the physical, psychological and spiritual needs of the patient. Its goal is to achieve the best quality of life available to the patient by relieving suffering, and controlling pain and symptoms.

Power of Attorney – An instrument in writing whereby one person appoints another as his agent and confers authority to perform certain specific acts or kinds of acts on behalf of that person such as banking, financial decisions.

Respiratory arrest – The cessation of breathing – an event in which an individual stops breathing. If breathing is not restored, an individual’s heart eventually will stop beating, resulting in cardiac arrest.

Ventilator – A ventilator, also known as a respirator, is a machine that pushes air into the lungs through a tube placed in the trachea (windpipe). Ventilators are used when a person cannot breathe on his or her own or cannot breathe effectively enough to provide adequate oxygen to the cells of the body or rid the body of carbon dioxide.

Withholding or withdrawing treatment – Foregoing life-sustaining measures or discontinuing them after they have been used for a certain period of time.

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