Importance of Advance Directives for End-of-Life Medical Care Skip to content

Importance of Advance Directives for End-of-Life Medical Care

Do your loved ones and medical providers know what type of medical treatment you prefer? By planning ahead, you can get the medical care you want, avoid unnecessary suffering, and relieve caregivers of decision-making burdens during moments of crisis or grief. You can also help reduce confusion or disagreement about the choices you would want people to make on your behalf.

An advanced directive is a legal document that explains how you want medical decisions to be made if you cannot make the decisions yourself. This directive lets your healthcare team and loved ones know what kind of health care you want or who you want to make decisions for you when you can’t. An advance directive can help you think ahead about what kind of care you want to receive as well as help guide your loved ones and healthcare team in making clear decisions about your health care when you can’t do it yourself.

“Advance directives help you protect your right to make medical choices that can affect your life,” said Julie Hodne, R.N., Education Coordinator at Manning Regional Healthcare Center. “They help your family avoid the responsibility and stress of making difficult decisions on your behalf. Advance directives also help your physician by providing guidelines for your care.”

All patients have rights that include privacy, informed consent, information about your condition, and information about advance directives. Advance directives can protect these rights if you ever become mentally or physically unable to choose or communicate your wishes due to an injury or illness. Advance directives can also limit life-prolonging measures when there is little or no chance of recovery. For example, advance directives may help patients decide if they want cardiopulmonary resuscitation (CPR), artificial nutrition or hydration, intubation, ventilators, or dialysis. They can also address your feelings about pain control and comfort care.

Let your values be your guide when creating your advance directives. Consider what is important to you. That may include passing on without pain and suffering, being able to make your own decisions, leaving your family with good memories and not burdening them with difficult decisions, acting according to your religious beliefs, or to be with your loved ones at your time of passing. Discuss your feelings with your family, friends, physician, religious leader, or your lawyer to consider what is best for you.

Advance medical directives are most commonly in the form of a living will or a durable power of attorney for healthcare. Both documents allow you to give directions about your future medical care. To get a durable power of attorney for health care or a living will, you will need to complete a form available from the Iowa State Bar Association.

To receive the form in the mail, send a self-addressed, stamped envelope to:  Iowa State Bar Association, 625 E. Court Avenue, Des Moines, Iowa 50306, with the following information in the envelope: your full name, address, and date of birth. You can also print and download the selected form here.

Once you have the forms, put your wishes in writing and be as specific as possible. Review your advance directives with your family, friends, physician, and power of attorney (POA). You will need to sign and date your advance directives and have them witnessed and notarized.

Keep a copy in a safe and secure place and provide a copy to your physician to be kept as part of your medical records. Your Durable Power of Attorney for Healthcare will also need a copy. Give copies to a relative or friend who is likely to be notified in an emergency. Review your advance directives regularly and make changes when necessary. Inform you physician, family, and POA of any changes.

Another document to be considered for any individual who is frail and elderly or who has a chronic critical medical condition, or a terminal illness is the IPOST form. IPOST stands for the IOWA PHYSICIAN ORDERS for SCOPE OF TREATMENT. The original form is strongly encouraged to be accompanied by the person it is written for. You can discuss this with your medical provider and find more information about IPOST from the Iowa Department of Public Health here.

Hodne suggests that “if you need help preparing your advance directives or if you would like more information, contact your legal counsel, healthcare provider, or any hospital, hospice, home health agency, or long-term care facility.” Hodne reminds everyone that “planning is the key to protecting your rights!”

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