Do your loved ones and medical providers know what type of medical treatment you prefer? By planning ahead, you can ensure you receive 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.
What Is an Advance Directive?
An advance directive is a legal document that explains how you want medical decisions to be made if you cannot make them yourself. This directive lets your healthcare team and loved ones know what kind of healthcare you want or who you want to make decisions for you when you can’t.
“Advance directives help you protect your right to make medical choices that can affect your life,” said Manning Regional Healthcare Center Education Coordinator Julie Hodne, RN. “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.”
Why Are Advance Directives Important?
All patients have rights, including privacy, informed consent, and access to information about their condition and treatment options. Advance directives help protect these rights if you become unable to communicate due to an injury or illness. They can also limit life-prolonging measures when there is little or no chance of recovery.
Under the Patient Self-Determination Act (PSDA), healthcare providers are required to inform patients of their rights regarding advance directives upon admission to a facility. This ensures that patients are aware of their options and can make informed decisions about their care. For example, advance directives can help patients decide if they want:
- Cardiopulmonary resuscitation (CPR)
- Artificial nutrition or hydration
- Intubation, ventilators, or dialysis
- Pain control and comfort care
Let Your Values Guide Your Decisions
When creating your advance directives, consider what is most important to you. Discuss your feelings with your family, physician, religious leader, or legal counsel to determine what is best for you. This might include:
- Avoiding pain and suffering
- Maintaining independence in decision-making
- Ensuring your family is not burdened with difficult choices
- Aligning your care with religious beliefs
- Being surrounded by loved ones at the end of life
Types of Advance Directives
The most common types of advance medical directives include:
- Living Will: Outlines your wishes regarding life-sustaining treatment.
- Durable Power of Attorney for Healthcare: Designates a person to make medical decisions on your behalf if you become unable to do so.
- Do Not Resuscitate (DNR) Order: Specifies that you do not want CPR if your heart stops, or you stop breathing.
- Health Care Instructions: Provides detailed guidance about specific treatments or interventions.
How to Obtain and Complete Advance Directives
Advance directive forms vary by state, so you should consult your state’s health department, legal resources, or healthcare provider for the appropriate documents. For example, in Iowa, you can obtain forms from the Iowa State Bar Association.
To receive the form by mail, send a self-addressed, stamped envelope to:
Iowa State Bar Association
625 E. Court Avenue, Des Moines, Iowa 50306
Include your full name, address, and date of birth. You can also print and download the form online. Once you have the forms:
- Put your wishes in writing and be as specific as possible.
- Review your advance directives with your family, physician, and power of attorney (POA).
- Sign, date, and have them witnessed and notarized as required by your state.
- Keep a copy in a safe place and provide a copy to your physician for your medical records.
- Ensure your POA and a trusted relative or friend have copies.
- Review and update your directives regularly, especially after major life events (e.g., marriage, divorce, or a change in health status). Inform your physician, family, and POA of any changes.
IPOST: An Additional Consideration
For individuals who are frail, elderly, or have a chronic critical medical condition or terminal illness, the Iowa Physician Orders for Scope of Treatment (IPOST) form may be beneficial. The original IPOST form should be kept with the person it applies to. You can discuss this option with your medical provider and find more information through the Iowa Department of Public Health.
Get Help with Advance Directives
“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 suggests. She reminds everyone, “Planning is the key to protecting your rights!”
Additionally, Medicare covers advance care planning discussions during annual wellness visits, so take advantage of this opportunity to discuss your wishes with your healthcare provider.
By taking these steps, you can ensure that your medical preferences are respected and that your loved ones are spared the burden of making difficult decisions on your behalf. Planning ahead is a gift to yourself and those who care about you.