Buchanan County Health Center and Lexington Estate respects the right of patients and residents to make decisions regarding their own health care, including the right to accept or reject certain recommended care.  BCHC will recognize and honor a person’s right under Iowa Law to execute a Living Will and/or Durable Power of Attorney for Healthcare.

Advanced Directive is the legal term used to describe a plan of action for medical providers to take in the event an individual needing treatment is no longer able to make his/her own decisions due to illness or injury. An Advanced Directive can take out the guess work of making a difficult decision for family members who are faced with such extreme and stressful circumstances.

Advanced Directives are especially important in this day and age where technology has given medical providers several options for life-sustaining measures. Life sustaining measures can be defined as, “Any medical treatment in which the primary goal is to prolong life rather than treat the underlying condition.” Some examples include feeding tubes, ventilators, dialysis, etc. In cases where life-sustaining measures are explored, the individual’s own body is not capable of sustaining proper functioning on its own without medical intervention.

Iowa law provides four types of advance directives: The Declaration Relating to Use of Life-Sustaining Procedures, known as a Living Will, Durable Power of Attorney for Health Care, Out-of-Hospital Do-Not- Resuscitate, and IPOST.

Living Will

A living will is a written statement that lets medical personnel know what kind of life-prolonging medical care you want to receive if you become ill with no hope of recovery, if you are permanently unconscious, or if you are in a vegetative state and unable to make your own decisions. In a Living Will, you may specify that certain life-sustaining procedures be withheld or withdrawn if you are in a terminal condition and unable to decide for yourself. However, medication or medical procedures that provide comfort or ease pain are not considered life-sustaining and are not withheld under a Living Will. A living will should be signed, dated, and witnessed by two people – preferably those who know you well, are over the age of 18, and people who are not related to you or your potential heirs or healthcare providers.

In Iowa, your living will can be signed in front of two witnesses or by a notary public. There are notary publics available at Buchanan County Health Center and at your local bank.

Durable Power of Attorney for Health Care

A Durable Power of Attorney is a written directive which names someone else to make your healthcare decisions if you become unable to make them. This document can also include instructions on what decisions you would like to be made in certain situations. The person provided with your Durable Power of Attorney (DPOA) should be someone you trust and who is willing to act in this capacity. It is also important to discuss your wishes with this person. In Iowa, your DPOA can be signed in front of two witnesses or by a notary public.

Out-of-Hospital Do-Not-Resuscitate

This allows emergency care providers and others in settings outside the hospital to rely upon a physician-issued, do-not-resuscitate (DNR) order for an adult individual in a terminal condition. Rules of the Iowa Department of Public Health further detail the out-of-hospital do-not-resuscitate (OOH-DNR) process. Immunities for acting consistent with the statute and rules are provided.

IPOST

The Iowa Physician Orders for Scope of Treatment, known as IPOST, is a double-sided, one-page document that allows a person to communicate their preferences for key life-sustaining treatments including: resuscitation, general scope of treatment, artificial nutrition and more.  IPOST is appropriate for an individual who is frail elderly, who has a chronic, critical medical condition, or terminal illness.  Appropriate individuals are those whose life expectancy is less than a year or in a long-term care facility.   An IPOST form is as valid as a medical order.  This has been in effect as Iowa law since July 1^st, 2012.

For more information about Advanced Directives options, please contact your family attorney, physician, or Kelly Palmer, LBSW, Social Worker/Case Management at BCHC by calling (319) 332-0999. For more information, please visit www.bchealth.org