Advance Care Planning & End of Life Decisions
Life can be unpredictable, which is why having an advance care directive is a good idea. An advance directive can help guide important decisions should you face a serious health concern. Directives are strong advised for elderly people, or anyone facing a chronic or terminal illness. In general, though, anyone over the age of 18 should consider having an advance directive in place.
Making your Decisions Clear
New rules have made it easier for patients and their families to communicate end-of-life care decisions through a form called IPOST.
Iowa Physician's Orders for Scope of Treatment, or IPOST, is a form that details a patient's end-of-life treatment choices. As a patient's care may move between home, clinic, hospital, nursing home, and hospice care, the IPOST form is designed to be portable and honored in any treatment setting.
IPOST is meant to enhance advance directive planning. Advance directive planning should include a durable power of medical attorney, a person chosen by the patient to make those decisions in their stead.
End-of-Life Care Decision Guidelines
- Communicate often and thoroughly. Talk to your family members about what you would want should you be unable to make medical care decisions for yourself. High profile news stories like the Terri Schiavo case provide a good platform for discussing how to avoid painful family decisions later on. Talk to your physician about the medical aspects of your wishes.
- Be specific. Don't assume anything. Consider different scenarios. Do you want to be on life support? For how long? Do you want a feeding tube, or not? Do you want a do-not-resuscitate order? Don't leave tough decisions to your loved ones. The more detailed you can make your living will, the less burden you place on your family later when you can no longer speak for yourself.
- Choose one person wisely. The person chosen to be your medical power of attorney should be someone who is familiar with your wishes and is willing to carry them out for you should the need arise. Someone who expresses doubts or discomfort about it isn't the right person. It should only be one person with one alternate, not a group of people. Family members making medical decisions by committee often leads to disagreements and in the worst case scenarios, court cases and permanent family discord.
For more information about advanced directives or IPOST, speak with your physician. A free living will and medical power of attorney form (advance directive) is available from the Iowa State Bar Association.
You can download an IPOST, get one from your primary care physician or Mary Greeley Hospice. More information is also available from the Iowa Department of Public Health.
Watch the video
Dr. Larry Otteman, an oncologist with McFarland Clinic and co-medical director for HOMEWARD Hospice, is featured in this video that provides important details about advance directives.