Advanced Directives

What is an Advance Directive?

An Advance Directive is a way for you to say what you want when:

You are very sick
You have been in a serious accident
You can't make health care decisions for yourself

The oldest and most common Advance Directive is known as a Living Will. It is also a good idea to fill out a form called a Durable Power of Attorney for Health Care. This tells your doctors who has the right to make decisions for you when you can't. Some forms combine the Power of Attorney and Living Will together into one form and may have other questions to answer.

Why should you write down what you want?

A serious illness or accident is a scary time for anyone. Important decisions may need to be made quickly and it may be hard for those who know you and love you to remember what you said or how serious you were at the time. Writing down what you want and who you want to speak for you is the best way to help doctors know your wishes when you are too sick to talk. It is important that you do it so it is legal and can be used in making your medical decisions. The hospital has forms that can be filled out and made legal and people to help you get the forms completed for free. Ask your nurse for more information or assistance.

How can you decide today what you want if you don't know what is going to happen in the future?

An Advance Directive doesn't try to answer every question. But it will have questions for you to answer that will help those who have to make your decisions know some of your thoughts and ideas about life and death. It is the best way to tell others you care about what you want or don't want done to you and why.

Why fill out an Advance Directive now? Why not wait until you are older or become sick?

The best time to talk with the people you love about what you want and to write things down is when you are feeling good and thinking clearly. If you wait, it may be too late. Once you are sick, you may not be strong enough, able to think straight or be able to talk about what you want.

You said something about making the form legal. Does that mean you need to hire a lawyer to make out the form?

You do not need a lawyer to make out an Advance Directive. Many people will ask their lawyer to help them with this when they are making out their Will or other legal papers, but it is not necessary. All hospitals and nursing homes will have forms to use and may have people that can help fill out the form for free. Each state in the country has certain requirements they must meet in order for the form to be legal. In the state of Iowa, an Advance Directive must be notarized or witnessed by two (at least one non-related) persons who are not named on the front of the form or a part of the health care team providing care if it is to be legal.

So, you made out an Advance Directive, had it notarized or witnessed. Now, what will you do with it?

You need to make sure that everybody knows what you want. You will make copies for the hospital records, for your doctors' offices, and for anyone who you want to know your decisions. If you put the original form you signed in a safe place (like a bank box or safe), it is a good idea to have copies in your home and car. In case of an emergency, a copy will be available to let people know who to talk to and what medical procedures you wish to have carried out.

All right, I think I may want to fill out an Advance Directive. What should I do?

If you are a patient in the hospital, tell your nurse. They will find someone to talk with you about Advance Directives, answer your questions, help you fill out the form if you want to and make copies. Your family members can also make out their own Advance Directives at the same time. And, the help is always free!

Other places to look for Advance Directive information and forms:

"Five Wishes" booklet (Aging with Dignity PO Box 1661, Tallahassee, FL 32302)
"The Gift of Peace of Mind" booklet (Drake University, Des Moines, IA 50311)
"Advance Medical Directives" booklet (Staywell Co., 800-333-3032)