A competent older adult has a living will refusing resuscitation and heroic life support, but the family plans to contest it. Which nursing action is appropriate?

• A. Notify the hospital attorney.
• B. Contact the Social Services department.
• C. Place the document on the patient's medical record.
• D. Explain to the patient that the conflict could invalidate the document.

Answer: (C)

Respecting patient autonomy means ensuring that an advance directive like a living will is readily visible to all members of the care team so care aligns with the patient’s expressed wishes. Placing the living will in the medical record makes the document accessible at the point of care, guiding decisions about resuscitation and life-sustaining measures and reducing the risk of unwanted interventions even if family objects. It also supports legal and ethical practice by making the patient’s preferences clear to clinicians who may need to act if the patient cannot speak for themselves. After filing, confirm the document’s validity (signatures, witnesses as required) and ensure it’s clearly identified so staff can locate it quickly.

Involving an attorney or social services may be appropriate if disputes escalate or capacity questions arise, but they are not the immediate action needed to ensure the patient’s wishes are honored. Explaining to the patient that the document could be invalid would undermine the patient’s autonomy and is not a nursing action.