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Living Wills

Rev. Anna Speiser, a spiritual care chaplain at Mercy Medical Center, holds Five Wishes, a popular living will that helps start and structure important conversations about end-of-life care.

SIOUX CITY -- A healthy person in his or her twenties probably isn't thinking about what kind of medical care he or she would like to receive in the event of an unexpected incapacitating accident, illness or injury, but Rev. Anna Speiser said that is in fact the perfect time to draft an advance directive.

"I once had a doctor tell me, 'Accidents are equal opportunity events,' so we never know what the future holds. It's not a decision to wait until you're in the midst of a critical situation to make," said Speiser, a spiritual care chaplain at Mercy Medical Center.

You can decide not to receive certain medical treatments that prolong the process of dying or you can choose to receive those treatments if you're terminally ill.

Advance directives, such as a living will and a durable power of attorney for health care, are legal documents that allow you to express your health care wishes in the event that you are unable to speak for yourself. Speiser said the vast majority of patients opt to complete both documents.

"I just see families draw so much comfort when they can say, 'I know this is what my mom would've wanted and we're following her wishes,'" she said. 

Before having a conversation with a relative or friend you'd like to designate as a durable power of attorney for health care, Speiser advises sitting down and thinking about the circumstances in which you'd like to receive life-support treatments. One or two people can be named as a power of attorney.

"I often encourage people just to think for themselves about how they feel about their own health and their own care and when time is short, what things are important to them," she said. "Thinking about it for ourselves makes it easier to talk to someone else about it."

Speiser said living will and power of attorney forms can be found on the Iowa Bar Association's website and printed off. She said patients have found Five Wishes, the most widely used living will in America, helpful in making and stating their end-of-life care wishes.

This advance directive, which is available at Mercy Medical Center, was created by the non-profit organization Aging with Dignity. The document, which acts as a living will for anyone over the age of 18, meets legal requirements in 42 states including Iowa, Nebraska and South Dakota.

Five Wishes asks patients in what circumstances they would like to receive life-support treatments, how they would like to be treated when they are near death and whom they would choose as their health care agent. For any of the forms to be legally binding, two witnesses or a notary are required.

"Here at the hospital, chaplains are notaries. We can notarize it and put it with the medical records," Speiser said. "People outside the hospital can also do it as well."

Speiser recommends making copies of living will and power of attorney forms and giving them to the people you've named as a durable power of attorney, as well as your primary care physician. Keep another copy in an easily accessible place, such as an unlocked desk drawer in your home. 

"We encourage people to have them in a place where people can find them," Speiser said of the forms. "Don't tuck them away in a safety deposit box. Have it there and accessible."

Down the road, if your end-of-life care plans change, Speiser said you can easily fill out new forms. The most recent forms are only used to make treatment decisions during the dying process.

"A lot people think, 'I'm only going to think about those things when I'm to that point -- when I'm older, when I'm sick, but really now is the time to think about it," she said.

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Health and Lifestyles reporter

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