End of Life Care

Planning Ahead - Decisions That Can Affect Your Future Care

As an adult, you have the right to accept or refuse medical treatment. However, there may come a time when you are unable to make decisions about your own care, either because of illness or injury. An advance directive will help you communicate your desires about medical treatment to loved ones and health professionals, in the event that you cannot express your wishes yourself.

Download Pella Regional Health Center's Advance Directive by clicking here

What is an Advance Directive?

An advance directive is a legal document that adults can prepare at any time, which provides instructions about your preferences for medical treatment. It is an important tool that helps you determine the care you would receive in the future if you were unable to make a decision for yourself because of a serious illness, injury or unconsciousness. The advance directive gives your family, caregivers and physician specific information about how you would or would not want to be treated.

Who Needs an Advance Directive?

A competent adult of any age can create an advance directive. It’s a good idea to develop the advance directive before you need it – when you can think clearly about difficult decisions.

Who Benefits from an Advance Directive?

You, your family and your healthcare providers benefit when your care preferences are clearly defined. The advance directive enables you to protect your own best interests by letting you define the degree of care you do – or do not – want, or by designating a person you trust to make decisions on your behalf.
Your family and health providers have the peace of mind of knowing they are making decisions about your care based on your wishes.

What are Your Choices for an Advance Directive?

There are two types of advanced directives; Living Will and Durable Power of Attorney for Healthcare Decisions:

Durable Power of Attorney for Healthcare Decisions

This option enables you to designate a primary person/persons and secondary person/persons as (the "agent") to make healthcare decisions for you only when you cannot make those decisions yourself. Your agents must follow your instructions about care, treatment and extraordinary measures to be taken or withheld on your behalf. Many people select a close family member or trusted friend to be their agent. Your doctor or another healthcare provider cannot serve as your agent. Please speak with your doctor about this.

Living Will

A Living Will applies if you have a terminal condition illness or are permanently unconscious and are unable to state your wishes about care. For example, the Living Will might apply if you had severe brain injury from a car accident or were in a coma induced by a massive stroke. A Living Will lets your doctor know what, if any, life-sustaining procedures you agree to when death is imminent.
If you have both a Living Will and a Healthcare Power of Attorney, the Healthcare Power of Attorney will apply – unless your agent cannot make decisions for you. Please speak with your doctor about this.

Do You Need an Out-of-Hospital Do-Not-Resuscitate Order?

If you have a medical emergency and ambulance personnel arrive, they may look to see if you have an out-of-hospital do-not-resuscitate (DNR) order. An out-of-hospital DNR lets the paramedics know that you do not want cardiopulmonary resuscitation (CPR) or life-support treatment, such as a ventilator. If you wish to have an out-of-hospital DNR order, the State of Iowa requires that Iowa Department of Public Health  out-of-hospital DNR form be filled out by you and signed by your doctor. If the out-of-hospital DNR is something you desire, please speak with your doctor about it.

How Do You Make Your Wishes Known?

Although you may choose to create any of these advance directive documents, they cannot be followed if no one knows they exist. It’s important to communicate your wishes in advance to someone you trust: family members, a close friend, a clergy person and your physician. You may want to ask one of these people (except the physician) to act as your healthcare power of attorney. It is extremely important, once your Advance Directive is complete to give a copy to family members, friends who are listed as agents, clergy, physicians and other healthcare providers.

It’s also important to put your wishes in writing and sign the document. For more information about advance directive documents, contact Case Management at Pella Regional Health Center at 641.628.6749.