Understand and complete your Advance Directives

Start the conversation about your healthcare decisions.

What is an Advance Directive?
An Advance Directive is a document that allows a person to outline their healthcare goals and choose a medical agent to act on their behalf in case they become unable to make decisions for themselves. The form must be notarized or signed with at least two (2) witnesses present. A completion, a copy of the advance directive should be shared with your healthcare provider, and stored in a safe and accessible place for use in the event of an emergency. This document is only used if you are not able to speak for yourself.
*Each state has its own advance directives law(s).

How does a Living Will differ from a Durable Power of Attorney?
A Living Will applies only if it is your intention to have life-sustaining procedures withheld or withdrawn and you have a terminal condition. It is a directive to your physician. A Durable Power of Attorney for Health Care lets you name an agent to make health care decisions in accordance with your wishes. In this document, you may specify the health care treatments you want or do not want. This document is not restricted to patients with a terminal condition or to decisions about life-sustaining procedures.

Contact Information
Orange City Area Health System
1000 Lincoln Circle • Orange City, IA 51041
712-737-2000 • 712-737-4984
Social Work Department: 712-737-5343

Overview
A healthcare advance directive does not give your agent permission to make your financial or other business
decisions. As stated by Iowa law, “health care” means any care, treatment, service, or procedures to maintain, diagnose, or treat your physical or mental condition.
Though this can be a hard topic to talk about, it is often helpful for you to have these plans in place long before decisions need to be made. Make decisions and fill
out these papers before you are very ill. It is very important to talk about your views, values, and the advance directive form with your Health Care Agent.
If you do not closely involve your agent, your views and values may not be fully respected because they may not be understood.

Living Wills
A Living Will is a document directing your physician that certain life-sustaining procedures should be withheld or withdrawn if you are in a terminal condition and unable to decide for yourself.

Durable Power of Attorney for Health Care
A Durable Power of Attorney for Health Care is a document through which you name another person known as your agent to make health care decisions for you if you are unable to make them.

What is a life-sustaining procedure?
A life-sustaining procedure is any mechanical or artificial means, which sustains, restores, or replaces a vital body function that would only prolong the dying process for a terminal patient. A mechanical respirator is an example of this. In addition, medication or medical procedures necessary to provide comfort, or ease pain, are not
considered life-sustaining procedures and would not be withheld under a living will.

What is a terminal condition?
A terminal condition is an irreversible condition that, without life-sustaining procedures will result in death in a relatively short time or a state of permanent unconsciousness from which there is no likelihood of recovery. The attending physician following consultation with another physician must make the determination of a terminal condition.

Who should I choose to be my Health Care Agent?
A family member or friend who:
• Is at least 18 years old
• Knows you well
• Can be there for you when you need them
• Is willing to learn about your goals and values for health care decisions
• You trust will do what is best for you, and will follow your wishes
• Can make decisions under sometimes stressful situations

What kind of choices can my Health Care Agent make?
Your agent can decide:
• Which doctors, nurses, social workers or other health care team members may provide you care
• Which hospitals or clinics will treat your conditions
• The types of medicines, immunizations/ vaccinations, tests, or treatments you get

Completing the Documents
Through a Durable Power of Attorney for Health Care, your agent can make all your health care decisions, including decisions that would be covered by a Living Will.
If you know you want life-sustaining procedures withheld or withdrawn when you are in a terminal condition, you may also want to sign a Living Will. This will provide direction to your physician and you will not have to rely on an agent to communicate those wishes. If you are uncertain about which documents would be best for you, contact the hospital social worker, your physician, or attorney for additional guidance.

Where can I get a Living Will or Durable Power of Attorney for Health Care form?
Contact the Social Worker at Orange City Area Health System and they will be able to provide you with the correct documents you need. You may
also request an appointment to get assistance in completing your documents, or to obtain additional information on Advance Directives.

What if I decide to cancel my Durable Power of Attorney for Health Care form?
You have the right to cancel your Durable Power of Attorney for Health Care form at any time. You can do this by telling your Health Care Agent or anyone else at any time. You should tell your health care provider and anyone else know who may have received a copy. Your current and valid form will cancel out any older versions. If your spouse is your health care agent, and you get divorced, the power granted to your spouse by this form is revoked. If you would remarry your spouse, this power is reinstated unless you cancel it.

When does a living will take effect?
A living will takes effect only when you have a terminal condition and are unable to make decisions.

How will my agent know my wishes?
It is important to discuss your wishes with the person who will be your agent. You may also state your specific wishes on your Durable Power of Attorney for Health Care form. If your agent does not know your wishes, he or she has a duty to act in your best interest considering your condition and prognosis.

What if my agent is unable to serve?
It is advisable to name an alternate agent in case the person you appoint becomes unable or unwilling to act on your behalf.

Do I need to consult an attorney before filling out my Advance Directive documents?
While it is not necessary to consult an attorney for your Advance Directive to be a legally binding document, it may be helpful. Advance Directive forms do not need additional signatures other than the patient, two witnesses, or a notary. Contacting an attorney may help you get gain more clarity on the documents.

How will I know if I am making the right choices about my treatment decisions?
These are important personal health care decisions, which require careful consideration. You should talk to your medical provider about the effects of withholding or withdrawing certain treatments in certain situations. Additionally, it is also very important to discuss your decisions with your family, friends, as well as other
advisors, such as spiritual or legal.