What is an Advance Directive?

It is any written instruction you give relating to the provision of health care in the event you become unable to make your own decisions. Examples of advance directives include: Living Wills; Durable Power of Attorney; and, Designation of a Health Care Surrogate. Using a directive you give specific instructions about your health care in certain situations, or designate a person to act on your behalf in decision making, or a combination of the two.

Is a Living Will the Same Thing as an Advance Directive?

A Living Will is one kind of advance directive; however, at the present time in Florida the standard Living Will only pertains to situations involving a terminal illness. Many conditions and situations may arise which do not involve a terminal illness. For example, in most cases a person who is in a “persistent vegetative state” is not considered terminally ill. The Advance Directive – Living Will is an expanded form addressing terminal illness and other conditions.

What is a Persistent Vegetative State?

The term refers to a condition caused by a brain injury. The victim is unable to respond to his or her surroundings and is not aware of anything, even though the eyes may open periodically. It is similar to a coma in that the person is unresponsive, but it is a permanent condition. A head injury, stroke or other events may result in this condition and a person may be kept alive indefinitely in this condition by artificial means.

Are Advance Directives just for Senior Citizens?

No. A severe illness or serious accident can happen to a person at any age. If you have strong feelings about what choices you would want in such a situation, regardless of your age, you are encouraged to consider an advance directive.

May I Change My Advance Directive?

Yes, you may do so at any time. If you do make changes to any advance directive, be sure to destroy all of the outdated copies and provide copies of the updated version to the appropriate people.

Will My Advance Directive Be Honored in an Emergency?

Usually it is not possible to determine the chance of survival in an emergency situation or to determine the outlook for recovery. After the initial emergency has passed and the prognosis for recovery is known, your advance directive will come into play if you are not able to express your wishes.

Is It Difficult to Stop a Treatment Once it Has Been Started?

No, not if you have an advance directive and your instructions are clear. Particularly in conditions with a sudden onset, it may take days or even weeks before the reasonable degree of certainty. During the time before the outlook is known, it is appropriate to use any treatments which might be beneficial. When the prognosis is established, if your instructions indicate you would not want continued treatment under the circumstances, treatment can be stopped.

What is a Health Care Surrogate?

A health care surrogate is a person you choose to make health care decisions for you if you are not able to do so for yourself. Your surrogate should be someone who knows your wishes and who will make decisions based on what he/she believes you would want, not based on his or her own preferences. You are encouraged to appoint a health care surrogate even if you have made other written expressions of your wishes, since it is difficult to address every situation in a directive.

May I request that I Not Be Given Food and Water Artificially?

Yes. It is believed your right to make choices includes the ability to choose not to be given food and water artificially, even if withholding this treatment shortens your life.

Are There Any Limitations on Carrying Out Instructions in My Directive if I Am Pregnant?

Yes. Most likely any instructions which would result in withholding or withdrawing life-prolonging treatments would not be honored during the time you are pregnant.

What About My Religious Beliefs?

Some choices you may make in filling out an advance directive may not be in keeping with the teachings of your religion. If this is a concern to you, discuss the matter with your minister, priest, rabbi or other spiritual mentor.

Do I need a Lawyer or a Notary to Complete an Advance Directive?

In most cases, no; the document need only be signed in the presence of two witnesses. One of the witnesses must be someone who is not your spouse, blood relative, heir, or person responsible for paying your medical bills. However, if you have legal effect of these documents or any other aspect of this matter, you should contact your attorney.

After I Complete an Advance Directive, What Do I Do With It?

Give copies to someone who would know if you became seriously ill. You may also want to consider giving a copy to your physician, minister, family members or close friends. Discuss with them the details of your directive and ask that they keep a copy to make available if it is ever needed. Of course you should give a copy to your health care surrogate, if you appoint one.

Can I schedule surgical services directly or do I have to go through my doctor?

You do need a referral from your doctor.  If you do not have a doctor, you can call the hospital 850-973-2271 for a list of providers in the area.  Patients are admitted to the OR through a referral from a primary care physician. The primary care physician consults with our surgeon to ensure each patient is a good candidate for our program. Once the surgeon approves a referral from your physician, a scheduler will contact you to set up an appointment. During the initial appointment, our team performs a thorough evaluation to better understand the patient’s medical history and condition to establish an individualized treatment plan that is tailored to your specific needs.

What type of insurance do you except for surgical procedures?

Everyone’s insurance policy is different and it is best to double check with your benefits coordinator or speak to one of our financial counselors.  However, the following is a sample of the commercial policies most widely accepted:

• Aetna
• Big Bend Hospice
• Blue Cross Blue Shield of Florida
• Clear Health Alliance
• Humana
• Medicare
• Molina Healthcare
• Prime Health Services
• United Healthcare Medicare
• Wellcare Medicare

Does Madison County Memorial have an Emergency Room (ER)?

Yes, Madison County Memorial Hospital (MCMH) does have an Emergency Room (ER) that is open twenty four (24) hours a day and seven (7) days per week.  If you are sick please visit a local clinic or health care provider.  However, if you have a medical emergency please visit the ER.  If you are unable to drive please call 911 and Madison County Emergency Management will dispatch an ambulance.

What is the difference between an Acute Care Hospital and a Critical Access Hospital?

Acute Care Hospitals (ACH) are hospitals that provide short-term patient care, whereas Critical Access Hospitals (CAH) are small facilities that give limited outpatient and inpatient hospital services to people in rural areas.  Acute care is being a patient in a Hospital rather than an Urgent Care center.  Critical care is a unit for serious cases that need more one on one care and are normally part of emergency room care.

How many physicians are in Madison?

To date there are nine physician offices listed in Madison.  Please click here for a list of local providers who currently work with Madison County Memorial Hospital.

When will MCMH receive the vaccine?

MCMH received its first shipment of the Moderna vaccine December 23, 2020.  MCMH has a tiered distribution plan with priority going to those working in higher-risk areas.

Does MCMH have the right equipment, such as freezers, to store and distribute the vaccines?

MCMH established a working group who reviewed the Centers for Disease Control and Prevention (CDC) guidelines for vaccine distribution and developed a plan to administer the vaccine and report immunization records to Florida SHOTS.  Our plan is already in place and  includes having the right equipment on-hand to store and distribute the vaccines.

Who will receive the vaccine first?

Distribution guidelines have been established by the CDC to prioritize people in high-risk areas first.  Currently, we are in phase 1a of the vaccine distribution plan which includes healthcare workers and long-term care residents.

Will MCMH’s workforce be required to receive the vaccine?

MCMH employees and contract staff will be encouraged, but not required at this time, to receive the vaccine.

Can the general public receive the vaccine when it is released?

Due to limited supplies of vaccines, priority has been given to healthcare workers and long-term care residents as these groups have a high-risk of exposure to the virus.  Many experts expect the vaccine to be available for the general public in spring 2021.

Can I contract COVID-19 from the vaccine?

No. The vaccine does not contain the live virus that would cause COVID-19.  Instead, it is designed to help you develop antibodies to help recognize and prevent the virus from causing infection.  After receiving the vaccine, you may not feel well for a few days as the vaccination will trigger an immune response.  However, symptoms such as runny nose, cough, shortness of breath, sore throat, or loss of taste or smell are not consistent with post vaccination adverse effects and may indicate COVID-19 infection.

If I receive the vaccine, does that mean I cannot catch COVID-19?

These COVID-19 vaccines, as with all vaccines, are not 100% effective, but are an important part of managing the pandemic.  MCMH will still require masks, social distancing, and proper hand hygiene in our facility.

How is the vaccine given?

The two vaccines that have been currently approved require two doses.

Is the vaccine safe?

Vaccine safety is determined in terms of “adverse events”, or when a patient experiences a negative effect after receiving their dose.  Guidelines around this are very stringent, and too many or too severe events will cause a vaccine to be terminated during initial trials.  By the time a vaccine reaches consumers, the risk of a negative outcome is very low.

Does this vaccine use live or dead virus?

Both Pfizer and Moderna’s vaccines are mRNA vaccines, and AstraZeneca’s and Johnson & Johnson’s are non-replicating vectored vaccines.  None of the early vaccines being tested are live weakened versions of the virus.

Do we have knowledge of what products are in the vaccine? Some people have concerns if the vaccine has a blood product due to their religious beliefs.

Both Pfizer and Moderna’s vaccines are genetically manufactured and do not have a human or blood component.

When can I stop wearing a mask after I am vaccinated?

There is not enough information currently available to say if or when the CDC will stop recommending people wear masks and avoid close contact with others to help prevent the spread of the virus that causes COVID-19.  Experts need to understand more about the protection the COVID-19 vaccines provide before making that decision.  Other factors, including how many people get vaccinated and how the virus is spreading in communities, will also affect this decision.

Does immunity after getting COVID-19 last longer than protection from COVID-19 vaccines?

The protection someone gains from having an infection (called natural immunity) varies depending on the disease, and it varies from person to person. Since this virus is new, we do not know how long natural immunity might last.

Regarding vaccination, we will not know how long immunity lasts until we have more data on how well it works over a longer period of time.

Both natural immunity and vaccine-induced immunity are important aspects of COVID-19 that experts are trying to learn more about, and we continue to look to the CDC for guidance.

If I have had COVID-19, do I still need to get the vaccine?

The protection someone gains from having an infection (called natural immunity) varies depending on the disease, and it varies from person to person. Since this virus is new, we do not know how long natural immunity might last.  What we do know up to this point is that the reinfection rate appears to be very low.

What is the effective rate for Moderna,  AstraZeneca and Pfizer’s vaccines?

Pfizer has indicated their vaccine has an efficacy rate of 95%, Moderna has announced its vaccine is 94.5% effective. AstraZeneca’s vaccine efficacy has yet to be clearly stated, but it ranges between 60- 90%.

How many doses of a COVID-19 vaccine will I need? What is the time period between the initial vaccine and the 2nd vaccine shot/booster?

Both vaccines will require two doses.  An initial vaccination and then a second dose either three or four weeks later. The Pfizer vaccine requires a booster 21 days later and the Moderna vaccine requires a second dose 28 days later.  The different vaccine products are not to be interchangeable. The second dose must be completed with the same vaccine brand as the first dose.  Both doses are important to ensure full protection.

What if I miss my second dose of the vaccine?

These two COVID-19 vaccines do not reach their maximum effectiveness unless you receive the two doses.  Your second dose will be scheduled after you get your first shot.

How long will it take for the vaccine to begin protecting me?

It normally takes about two to three weeks for immunity to develop.  In the Pfizer vaccine clinical trial, the drop in infection rate between the vaccine group and the placebo group started around 14 days after the first dose.

What are the side effects of the COVID-19 vaccine?

Pfizer has said that some Phase III clinical trial participants experienced mild-to-moderate side effects with its investigational COVID-19 vaccine candidate.  Scientists anticipate the shots may cause mild flu-like side effects — including sore arms, muscle aches and fever.

Will COVID-19 vaccines cause me to test positive on COVID-19 viral tests?

No. These vaccines will not cause you to test positive on viral tests, which are used to see if you have a current infection. If your body develops an immune response, which is the goal of vaccination, there is a possibility you may test positive on some antibody tests.  Antibody tests indicate you had a previous infection or vaccination and that you may have some level of protection against the virus.

Experts are currently looking at how COVID-19 vaccination may affect antibody testing results.

Will I have to get a COVID-19 shot every year?

Scientists are still studying this and will determine this once the vaccine is distributed and more data is available.

After I receive both doses of the vaccine, am I still required to wear a mask at work?  

Yes.  We continue to follow CDC guidance on this subject.

The vaccines preliminary data shows it is 60-95% effective so there is a subset of the population that will not gain immunity from the vaccine.  Furthermore, the protective effect of the vaccine may take at least one month.  While experts learn more about the protection that COVID-19 vaccines provide under real-life conditions, it will be important for everyone to continue using all the tools available to us to help stop this pandemic, like covering your mouth and nose with a mask, washing hands often, and staying at least 6 feet away from others.

Unfortunately, the vaccine is not the proverbial “light switch” to turn off the COVID-19 pandemic.  It will take some time.

What is the criteria for U65 Population?

What is the criteria for U65 Population?

We are planning to follow the guidelines presented by AHCA that outlines key at-risk conditions such as:

  • Clinically extremely vulnerable
    • Solid Organ Transplant and Bone Marrow Transplant Patients
    • Cancer patients undergoing active treatment
    • Cystic fibrosis
    • Sickle Cell Disease
    • Adults with Down Syndrome
  • Vulnerable
    • COPD (Chronic Obstructive Pulmonary Disease
    • Chronic Kidney Disease
    • Chronic Liver Disease
    • Chronic Heart Disease, such as severe heart failure
    • BMI > 40
    • HIV/AIDS
    • Chronic Neurological Conditions, such as Multiple Sclerosis, Cerebral Palsy
What kind of documentation do we need to provide to get the vaccine if we are under 65?
  • Current prescription and picture ID.
  • Diagnosis and/or care plan from your primary care physician or specialist.
How do I sign up to get a vaccine if I think I fit into one of these categories?

Go to our website:  www.mcmh.us/COVID.  You will find a scheduling form that allows you to give us your information and then one of our logistics coordinators will contact you to schedule and appointment.

Do I have to have an appointment or do you all accept drop-in?

Yes, you do need a scheduled appointment.  Each bottle holds a total of 10 vaccines, therefore it is critical for us to have the exact number of people as vaccines.  There are very strict storage and administration guidelines.  The vaccine must remain frozen until time to do the shot.  Once it is thawed we have a six hour window to give the shot.  Once we pull the medicine up into a vial, we have two hours to administer the shot, so appointments are critical.

Where do I go to get the shot?

We administer the shots through a drive thru system.  You pull to the front of the hospital, we get all of the appropriate documentation and signatures, administer the shot, and then each person waits in the car for 15 minutes to make sure there is no reaction and then you are allowed to leave.

What if I have additional questions?

You can contact the public relations department at 850-253-1961 or email levans@mcmh.us most importantly, go online and provide your information and you will be added to the communication list to stay up to date with the latest information.  www.mcmh.us/blog or follow us on Facebook @madisoncountymemorialhospitalMCMH.

Contact Us

We're not around right now. But you can send us an email and we'll get back to you, asap. You can also send us a message through our Facebook page. Please do not include personal health information in your communications through social media.

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