Attorney-Approved Do Not Resuscitate Order Form for the State of Iowa

Detailed Guide for Writing Iowa Do Not Resuscitate Order

Completing the Iowa Do Not Resuscitate (DNR) Order form is a critical step for individuals wishing to make their end-of-life care wishes known in advance. This legally binding document instructs healthcare professionals not to perform cardiopulmonary resuscitation (CPR) in the event of cardiac or respiratory arrest. To ensure that your wishes are clearly expressed and legally recognized, it's important to fill out the form accurately and completely. Follow these steps to complete the Iowa DNR Order form.

1. Begin by reviewing the entire form to understand the scope and implications of the DNR order.
2. Enter the patient's full legal name to identify the individual to whom the DNR order applies.
3. Provide the patient's date of birth to further ensure there is no confusion regarding the patient's identity.
4. Fill in the patient's address, including city, state, and ZIP code, to have a record of where the patient resides.
5. Specify the patient's social security number, if available, to match the patient's identity with medical records.
6. If the patient is unable to sign the form, a legally authorized representative may do so on their behalf. Include the representative's name, relationship to the patient, and contact information.
Ensure that the patient or their authorized representative signs the form. A signature is necessary for the DNR order to be considered valid.
7. Witness signatures must also be obtained. The presence of witnesses or a notary public helps verify the authenticity of the document and the signatures on it.
8. Finally, the attending physician must sign and date the form, confirming their agreement with and understanding of the patient's wishes.

After completing these steps, it's crucial to keep the DNR order in an easily accessible place and to inform family members, caregivers, and healthcare providers of its existence and location. This document should accompany the patient if they are transferred to a new healthcare facility. By taking these actions, individuals can ensure their end-of-life care preferences are known and respected.

What is an Iowa Do Not Resuscitate Order form?

An Iowa Do Not Resuscitate (DNR) Order form is a legal document that tells medical personnel not to perform CPR (cardiopulmonary resuscitation) if a patient's breathing stops or if the patient's heart stops beating. It is used by individuals in Iowa who wish to refuse this specific type of life-saving treatment.

Who can request an Iowa DNR Order?

Individuals who are 18 years of age or older and of sound mind can request an Iowa DNR Order. This can also be requested by a legally authorized representative if the individual is unable to make such decisions due to medical conditions.

How can I get an Iowa DNR Order form?

The Iowa DNR Order form can be obtained from a healthcare provider, such as your doctor, a hospital, or it can be downloaded from certain authorized Iowa health websites. It's important to discuss your wishes with your healthcare provider to ensure the form is filled out accurately.

Does the Iowa DNR Order need to be signed by a doctor?

Yes, for the Iowa DNR Order to be valid, it must be signed by a licensed healthcare provider. This serves as an agreement that the healthcare provider will respect the patient's wishes as outlined in the DNR Order.

Where should I keep my signed Iowa DNR Order?

The signed Iowa DNR Order should be kept in a place where it can be easily found by healthcare professionals during an emergency, such as with your other important medical documents or on your refrigerator. Copies can also be given to close family members or your healthcare proxy.

Can I change my mind after creating an Iowa DNR Order?

Yes, you can change your mind at any time after creating an Iowa DNR Order. To do so, you should inform your healthcare provider and destroy all copies of the old DNR Order. A new DNR Order will need to be completed and signed if you decide you want different end-of-life care measures.

Is an Iowa DNR Order the same as a living will?

No, an Iowa DNR Order is not the same as a living will. A DNR Order specifically addresses the use of CPR in emergency situations where you cannot speak for yourself. A living will, on the other hand, provides a wider range of instructions about different types of medical treatments you wish to receive or refuse at the end of your life.

When completing the Iowa Do Not Resuscitate (DNR) Order form, individuals often aim for accuracy and clarity, recognizing the importance of this document in respecting their healthcare wishes. However, despite their best intentions, some common missteps can occur during this process. Understanding these mistakes can ensure that the form reflects the individual's true desires and is executed correctly.

1. Not consulting with a healthcare provider: Before filling out the DNR Order form, it is crucial to discuss this decision with a healthcare provider. This consultation ensures that the individual fully understands what the DNR order entails and the implications of their decision. Failure to have this conversation can lead to misunderstandings about the scope and consequences of a DNR order.
2. Incorrect or incomplete information: A common error is providing incorrect details or leaving sections of the form incomplete. Every field in the DNR form is vital for its legal and medical effectiveness. Accurate and complete information about the individual, including their full legal name, date of birth, and specific medical conditions, is crucial. Errors or omissions can invalidate the form or cause confusion in emergency situations.
3. Omitting the signature and date: The validity of the DNR Order hinges on appropriate signatures—that of the individual (or their authorized representative) and the supervising healthcare provider. Moreover, dating the document is equally essential as it shows when the order came into effect. Missing signatures or dates can render the document legally ineffective.
4. Failure to communicate the decision: After completing the DNR form, it's vital to communicate this decision to the relevant parties—family members, healthcare proxies, and primary care providers. Not sharing this critical information can lead to unwanted medical interventions in emergencies because healthcare professionals and loved ones are unaware of the individual's wishes. Keeping everyone informed ensures that the DNR order will be respected and followed.

Avoiding these mistakes requires careful attention to detail, open communication with medical professionals, and ensuring that one's healthcare wishes are known to those who may need to act on them. By navigating these steps thoughtfully, individuals can achieve peace of mind, knowing their preferences are clearly documented and will be honored.

When preparing for situations that involve serious health care decisions, it's essential to be thoroughly prepared. Alongside the Iowa Do Not Resuscitate (DNR) Order form, there are several other forms and documents that individuals may need to consider. These documents can play a crucial role in ensuring one's health care preferences are known and respected. Here is a list of documents often used in tandem with the Iowa DNR form:

• Advance Directive: This document outlines what medical actions should be taken if someone is no longer able to make decisions for themselves due to illness or incapacity. It includes a living will and health care power of attorney.
• Health Care Power of Attorney: A form that designates another individual to make healthcare decisions on your behalf should you become unable to do so. It's an essential component of planning for future health care needs.
• Living Will: A living will declares your wishes regarding the use of life-sustaining measures in the event that you become terminally ill or permanently unconscious.
• POLST (Physician Orders for Life-Sustaining Treatment): A physician's order that outlines what types of life-sustaining treatment a patient prefers in their current health condition. It is more detailed than a DNR and can include preferences on treatments like intubation, IV fluids, and feeding tubes.
• HIPAA Authorization Form: This form allows designated persons to access your protected health information. This can be crucial in situations where family members need to make informed decisions about your health care.
• Medical Records Release Form: A document that authorizes the release of medical records to individuals or entities specified by you. This is especially important for ensuring that all care providers have access to your complete health history.
• Last Will and Testament: While not directly related to health care, a Last Will and Testament is crucial for specifying how you want your property and assets to be distributed after your death. It can also appoint a guardian for minor children.
• Funeral Planning Declaration: This document allows individuals to specify their preferences for funeral arrangements ahead of time, relieving loved ones of the burden of making these decisions during a difficult time.

Ensuring that all relevant forms and documents are in place is a critical step in preparing for the future. Each of these documents serves a unique purpose and, when used together with a DNR order, provides a comprehensive approach to planning for one's health care. It's always advisable to consult with a healthcare professional or a legal advisor to make sure these documents are correctly filled out and filed.

The Iowa Do Not Resuscitate (DNR) order form bears similarity to an Advance Directive, though there are notable differences. An Advance Directive is a document that speaks to a person's healthcare preferences, including treatments they do or do not want, should they become unable to communicate those decisions themselves. Like a DNR, it provides guidance for healthcare professionals and loved ones regarding care preferences, but it is broader, covering more types of medical decisions besides resuscitation.

Similarly, a Living Will is another document akin to the DNR order form. It specifically outlines what life-sustaining treatments an individual wishes to refuse or receive if they are in a permanent unconscious state or if death is imminent and they cannot make decisions for themselves. While a Living Will can specify desires about resuscitation, it goes further to address other procedures such as mechanical ventilation, feeding tubes, and more, making it more comprehensive than a DNR.

A Health Care Power of Attorney (HCPOA) document also aligns closely with the intentions behind a DNR order. By designating a health care agent, this document grants an individual the authority to make health care decisions on behalf of someone who is incapacitated or otherwise unable to make their own decisions. Though it doesn't directly command medical teams to withhold life-saving treatments like a DNR, it allows the agent to make such decisions based on their understanding of the incapacitated person's wishes.

The POLST form (Physician Orders for Life-Sustaining Treatment) is another medical directive closely related to the DNR order. It is designed for people facing serious illness or frailty when their health care professionals expect that they might encounter a medical crisis. A POLST form turns specific wishes about life-sustaining treatment into medical orders, including whether or not to administer CPR, just like a DNR. However, POLST forms are more detailed, covering other interventions like hospitalization, intensive care, and feeding tubes.

When filling out the Iowa Do Not Resuscitate (DNR) Order form, it's critical to follow certain guidelines to ensure the document is legally valid and effectively communicates the individual's wishes. Below are the essential dos and don'ts to consider:

Things You Should Do

1. Review the form thoroughly with a healthcare provider to fully understand the implications of a DNR order and ensure that it aligns with the patient's wishes.
2. Ensure that all required fields are completed accurately, including personal information, medical details, and any specific instructions or limitations related to the DNR order.
3. Have the form signed and dated by the required parties, which typically include the patient (or their legally authorized representative) and the attending physician.
4. Keep the original DNR order in an easily accessible place and inform close family members or caregivers of its location.
5. Distribute copies of the completed DNR order to relevant parties, including the patient's primary care physician, hospital, and any home care providers.

Things You Shouldn't Do

• Do not fill out the DNR order without consulting a healthcare provider, as misunderstanding the form's contents can lead to unintended consequences.
• Do not leave any required fields blank or partially filled. Incomplete forms may not be legally valid and could be disregarded in an emergency.
• Do not rely on verbal communication of DNR wishes without having a completed and signed form, as healthcare providers may be legally required to attempt resuscitation in the absence of valid written directives.
• Do not forget to review and update the DNR order as the patient's health status or wishes change. An outdated DNR order may not reflect current preferences.
• Do not fail to provide copies of the DNR order to all necessary parties. Ensuring that the patient's healthcare team is aware of the DNR status is critical for it to be honored.

When discussing the Iowa Do Not Resuscitate (DNR) Order form, there are several misconceptions that frequently arise. Understanding these misconceptions is crucial in ensuring that individuals make well-informed decisions regarding their healthcare preferences, especially in emergency or life-threatening situations. Below, you'll find a detailed explanation of common misunderstandings surrounding Iowa's DNR Order form.

• Misconception 1: A DNR order applies to all medical treatments. In reality, a DNR order specifically addresses the use of cardiopulmonary resuscitation (CPR) in the event of heart or respiratory failure. It does not affect other treatments or interventions a patient might receive, such as pain management, antibiotics, or nutrition.

• Misconception 2: Only elderly patients can request a DNR order. This is inaccurate; patients of any age with serious health conditions, who wish to avoid aggressive life-saving measures like CPR, can request a DNR order. Age is not a determining factor for eligibility.

• Misconception 3: DNR orders are permanent and cannot be changed. Patients or their legal decision-makers can revoke or modify a DNR order at any time based on changing health circumstances or preferences.

• Misconception 4: A DNR order must be requested by a patient. While the preference of the patient is paramount, a legal guardian, healthcare proxy, or family members, in accordance with Iowa laws, may also be involved in the decision-making process, especially when the patient is unable to make decisions on their own.

• Misconception 5: DNR orders are only for terminally ill patients. While it's common for terminally ill patients to opt for a DNR order, it's also relevant for individuals with chronic illnesses, severe physical impairments, or those who wish to avoid aggressive resuscitation efforts due to personal or religious beliefs.

• Misconception 6: Having a DNR order means you will not get emergency services. This is not true. A DNR order specifically instructs healthcare providers not to perform CPR. It does not prevent the individual from receiving other forms of emergency care or interventions that can provide comfort and support in a critical situation.

• Misconception 7: DNR orders are the same in every state. Each state has its own legal requirements and documentation for DNR orders. The Iowa DNR order may have different requirements or forms compared to those from another state. It's important to understand the specific guidelines within Iowa to ensure the order is legally recognized.

• Misconception 8: A living will is the same as a DNR order. A living will is a broader document that can outline various end-of-life care preferences, such as the use of ventilators or feeding tubes. A DNR order is more specific and solely focuses on the use of CPR in emergency situations.

• Misconception 9: Doctors and emergency responders may ignore a DNR order. In Iowa, healthcare providers and emergency personnel are legally obligated to honor a valid DNR order. It's crucial, however, for the DNR order to be properly documented and readily accessible in an emergency to ensure it is followed.

Clarifying these misconceptions can help individuals and their families make informed decisions that align closely with their health care preferences and values. It's also beneficial to consult healthcare providers or legal advisors to understand the implications fully and to ensure that wishes regarding resuscitation and end-of-life care are clearly documented and respected.

Understanding and completing the Iowa Do Not Resuscitate (DNR) Order form is an important process for those wishing to make clear their preferences for emergency medical treatments. Here are key takeaways to guide you through filling out and using the form:

• Consent is crucial: The individual for whom the DNR order is intended must give their consent, provided they are competent to do so. If unable, a legally recognized health care proxy or power of attorney can consent on their behalf.
• Physician’s signature: A licensed physician must sign the DNR order for it to be considered valid. This confirms that the physician has discussed the DNR order with the patient or their designated decision-maker.
• Clear identification: The form must clearly identify the individual it pertains to. This includes full legal name, date of birth, and any other identifiers to prevent confusion during emergency situations.
• Documentation is essential: Once completed and signed, the DNR order should be documented in the patient's medical records. Keeping it accessible and visible to health professionals is crucial, especially in an emergency.
• Distribute copies: Copies of the DNR order should be given to the patient, the patient's family or decision-maker, and any caregiving facilities, such as nursing homes or hospice care, where the patient resides.
• Understand its limitations: The DNR order specifically pertains to not initiating cardiopulmonary resuscitation (CPR) in the event of a cardiac or respiratory arrest. It does not affect other forms of medical treatments or interventions.
• Expiration: In Iowa, the DNR order does not expire. However, it can be revoked at any time by the patient or their designated proxy, should they change their mind.
• Emergency Services Notification: Make sure that emergency personnel are aware of the DNR order. Consider placing a copy in a visible location within the patient’s home or informing emergency services directly if the patient resides at home.
• Review and discuss: It's important to periodically review the DNR order with your healthcare provider and family members or decision-makers to ensure it still reflects your current wishes.

Following these guidelines will ensure that the DNR order is correctly filled out and implemented, respecting the individual’s healthcare preferences during critical moments.