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Advance Directives

Advance Directive is a general term that refers to your verbal and written instructions about your medical care and decisions in the future, should you be unable to speak for yourself. When individuals are admitted to the hospital, they (or their family members) are asked if the individual has health care advance directives. If so and if a copy is available, it is made part of the patient’s hospital record.

Iowa law provides two types of advance directives:

  • the Declaration Relating to the Use of Life-Sustaining Procedures, known as a Living Will, and
  • the Durable Power of Attorney for Health Care.

Advance directives are important because they help ensure that a person's wishes are honored if they become too sick or unconscious to make their wishes known. They can also help to eliminate confusion and provide peace of mind for the patient and their family.

Living Will

A living will is a written declaration 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, are permanently unconscious, or 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 In a Living Will, you may specify that certain life-sustaining procedures be withheld or withdrawn if you are in a terminal condition and unable to decide for yourself.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 people who know you well but are not related to you or your potential heirs or your healthcare providers. Witnesses cannot be:

  • Your doctor or other treating healthcare provider.
  • An employee of your treating healthcare provider.
  • The person you named as your healthcare attorney.
  • An individual who is less than 18 years of age.

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

Durable Power of Attorney for HEALTHCARE

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 can also include instructions about specific possible choices to be made. In creating a Durable Power of Attorney for Health Care, you will choose a person to make health care decisions for you in case you are unable to do so, in accordance with your wishes. The person named 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. A DPOA must be witnessed. In Iowa, your DPOA can be signed in front of two witnesses or by a notary public. The same rule applies to the living will.

IPOST​

What is IPOST?

  • The Iowa Physician Orders for Scope of Treatment, known as IPOST, is a double-sided, one-page document, salmon in color.
  • It allows a person to communicate their preferences for key life-sustaining treatments.
  • The IPOST form allows for treatment communications when or if an individual is unable to express their preferences in an emergent situation.

IPOST Key Points:

  • IPOST form belongs to the patient

  • IPOST form is valid as a medical order statewide regardless of where the patient resides

  • IPOST is appropriate for any individual who is frail and elderly or who has a chronic, critical medical condition, regardless of age

How is the IPOST Used?

  • In a medical situation, IPOST directs emergency staff, such as First Responders, EMTs, Paramedics, and Physicians to the type of care you do or do not want.

  • IPOST orders show what treatments you want now, in your current state of health.

What Does the IPOST Ask?

  • Your preference for CPR

  • Medical conditions

  • The use of antibiotics

  • Artificially administered fluids and nutrition (tube feeding)

Who Completes the IPOST?

  • You and your health care provider will talk about choices you have. Together, you will complete your IPOST form. A physician, nurse practitioner, or physician assistant must sign the IPOST form.

  • You may discuss your wishes with a social worker, nurse or trained facilitator who will help you complete the form and then have it signed later by your health care provider.

  • If you are unable to speak for yourself, your health care agent or representative can speak on your behalf.

What If I Change My Mind?

  • The IPOST can be changed or voided at any time.

  • Talk with your health care provider at any time if you want to make changes to your IPOST.

  • This is a process that can be reviewed and changed at any time.

Where Do I Keep My IPOST Form?

  • The IPOST form goes where you go - at home, the hospital, or long-term care facility.

  • At home - keep on the refrigerator. EMS personnel are trained to look for it there.

  • At health care facilities it’s kept on the medical chart. The IPOST form will travel with you.

  • You will be given a clear plastic sleeve and a sticker to keep your IPOST at home.

Is an IPOST Required?

No. Completing the IPOST is always voluntary.

Advance Directive information and forms are available from the Iowa State Bar Association by clicking here.

See the list of web resources for links to other websites with information to help you write your Advance Directives, answer frequently asked questions, and discuss Advance Directives and choices with your family.

For more information about advance directives, ask your healthcare provider.