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Idaho Advance Directive Form

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An Idaho advance directive, or ‘Living Will and Durable Power of Attorney for Health Care’, allows an individual to set forth their end-of-life treatment options and choose a medical agent. The instructions outlined in an advance directive are for health care planning in the event a person cannot think for themselves due to temporary or permanent incapacitation.

Table of Contents

Laws

StatuteTitle 39, Chapter 45 (The Medical Consent and Natural Death Act)

Signing Requirements (§ 39-4510) – Principal is the only person required to sign but the State of Idaho recommends it be witnessed or notarized.

State Definition – (§ 39-4502(8)) – “Directive,” “advance directive” or “health care directive” means a document that substantially meets the requirements of section 39-4510(1), Idaho Code, or is a “Physician Orders for Scope of Treatment” (POST) form or is another document which represents a competent person’s authentic expression of such person’s wishes concerning his or her health care.

Registring

If the principal, after completing the power of attorney document, would like to have it registered with the State of Idaho (at no cost) they may do so by completing the Registration Form and sending to:

Idaho Secretary of State Attn: Health Care Directive Registrar 700 West Jefferson, Room E205 PO Box 83720 Boise, ID 83720-0080.

Versions (4)


Honoring Choices

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Idaho.gov

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Intermountain Hospital

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Portneuf Medical Center

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How to Write

Download: Adobe PDF

Step 1 – Obtain The Idaho Living Will Abd Durable Power Of Attorney For Health Care

The “Adobe PDF” link in this area of the site, along with the “PDF” button on display, grant direct access to the Idaho Directive needed to issue a “Principal’s Living Will And Durable Power Of Attorney For Health Care.”

Step 2 – Attach The Appropriate Date To This Idaho Document

Open the file you have acquired then direct your attention to the upper left-hand area on the first page. The “Date Of Directive” line placed here requires that the month, calendar day, and the year of this Idaho paperwork’s issue. 

 

Step 3 – Name The Idaho Document’s Issuer

The next blank line makes a requirement of the “Name Of Person Executing Directive.” This Party will be the Idaho Resident who wishes to bestow the power to medical decisions over his or her health to a trusted Agent. Often referred to as the Principal behind this paperwork, input the full name of the Individual designating an Agent through this document.

 

Step 4 – Distribute The Idaho Principal’s Address

A couple of lines have been presented in this area so that the “Address Of Person Executing Directive” can be recorded. This should be the Principal’s home address as it is listed on his or her government-issued I.D. (i.e. a Driver’s License). Typically, this report will need to consist of the building number, street name, suite number on the first blank line then the city, state, and zip code on the next line. 

 

Step 5 – Discuss The Idaho Principal Preferences Regarding Nutrition And Hydration

The section titled “A Living Will A Directive To Withhold Or To Provide Treatment” introduces itself with a discourse on scenarios where the Principal suffers from a medical event, medical condition, or end-of-life event that has left him or her unconscious, incapacitated, uncommunicative, or otherwise unable to live independently. In such cases, this document can be used by the attending Medical Staff to discern and enact the Principal’s preferences. Read the Introduction to this section before proceeding. Locate the instructional statement, “Check One Box An Initial…” One of the first two boxed statements must have its contained checkbox selected. If the Principal desires to continue receiving “All Medical Treatment, Care, And Procedures” needed to sustain his or her life even when faced with imminent death or permanent incapacitation (as described in the introduction), then the first boxed statement should have its checkbox selected and the blank line preceding it initialed by the Principal.  If the Principal wishes to limit or restrict medical treatment when his or her ability to function or communicate have been rendered significantly handicapped, is in a long term com with little hope of waking, or when death is imminent, then the second boxed statement must be selected and initialed by the Principal. This statement will wish further definition as to whether the Principal wishes to continue receiving nutrients and liquids.  If the second statement has been selected, thus indicating the Principal’s objection to prolonging life in one of the introduction’s scenarios and is unable to drink water and other liquids independently, then he or she must also decide if “…Artificial Or Non-Artificial” liquids may be administered. If the Principal agrees to only receiving liquids when incapacitated permanently or during an end-of-life event, then item “A” of the second statement should be selected and initialed just before the words “Only Hydration…”  If the Principal wishes to be maintained by having his or her nutrients delivered artificially or otherwise (when unable to feed himself or herself) then item B’s checkbox should be selected. Additionally, the Principal must initial the blank line between the check box and “B. Only Nutrition…”A third item “C. Both Nutrition And Hydration” allows the Principal to insist that medical intervention and treatment be withheld during incapacitation or death but that he or she wishes to receive remain well-fed and hydrated.   The third boxed item declares that the Principal wishes to withhold all treatment, medical intervention, and the administration of both nutrients and liquids be withheld when he or she is unable to survive otherwise. Be advised that if selecting this as the Principal’s preference, then the previous choice (and its follow up questions should remain unmarked).  

 

Step 6 – Indicate If The Agent Has Been Informed Of The Principal’s Wishes

The next area requiring attention, item 4, also requests that the Principal choose between one of two boxed statements. The one he or she chooses will define this document’s relation to some other paperwork. A precautionary measure many Patients will take is to discuss their medical decision with a Physician while he or she completes the Physician Order For Scope Of Treatment or POST. If the Principal has worked with the Physician to fill out a POST that is compatible with this Directive, then he or she must check the first boxed statement and initial the blank space preceding the words “I Have Discussed These Decisions…”  If the Patient has not aided the Physician in completing the POST then when one is issued, the Principal must acknowledge that this living will may be “Modified To Be Compatible With The Terms Of The Post Form” my selecting the second checkbox statement and initialing the blank line corresponding to the statement “I Have Not Completed A Physician Orders For Scope Of Treatment…”   

 

Step 7 – Name The Elected Idaho Health Care Agent

The portion of this document titled “A Durable Power Of Attorney For Health Care” will enable the Idaho Principal to name a Health Care Agent to safeguard and communicate the Principal’s preferences and medical directives when incapacitated. Three lines in the first article “1. Designation Of Health Care Agent” have been reserved for a presentation of the Health Care Agent’s information. To begin document the full “Name Of Health Care Agent” on the first of these lines. 

 

Step 8 – Dispense The Idaho Agent’s Address And Contact Material

After a recording of the determined Idaho Health Care Agent’s Name has been completed, proceed to report the “Address Of Health Care Agent” on the next line down. Finally, locate the line following the label “Telephone Number Of Health Care Agent,” then product the home number, cell phone number, and/or work number where the Health Care Agent can be reached. Keep in mind the Health Care Agent must be reachable at any time in case a decision is needed in a relatively short amount of time. 

 

Step 9 – Include Direct Documentation Of The Principal’s Instructions, Restrictions, Or Grants Of Power

The language in the Idaho Directive and the Durable Power of Attorney is standard and set to comply with the Idaho Statute Title 39, Chapter 45 (The Medical Consent and Natural Death Act) therefore it should not be altered without the guidance of a qualified professional (i.e. a medical attorney). The Principal can still limit the power given to the Health Care Agent or even restrict it in some cases as well as document specific instructions and preferences to be followed by the Health Care Agent and the Medical Staff depending upon this document. This opportunity is presented in the text-box provided just below the words “Additional Statement Of Desires, Special Provisions, And Limitations” in article “4. Statement Of Desires, Special Provisions, And Limitations” 

 

Step 10 – Identify The Alternate Idaho Agent

Many Principals will be uncomfortable with the idea that the Health Care Agent named above may become unavailable or simply unwilling to act as his or her Representative. This worry can be alleviated by holding an Agent in reserve. Such an Entity will only assume principal authority if the Original Health Care Agent will (or can) no longer represent the Principal with authority. Article “7. Designation Of Alternate Agents” contains some structured areas where the Principal may name up to three Alternate Agents. The first Agent’s information should be produced starting with his or her “Name” on the first line in “A. Alternate Agent.” It is important that the Idaho Alternate Health Care Agent be easily found when necessary. Thus, report his or her entire home address to the two lines provided next to the “Address” label. The “A. Alternate Agent” section also seeks to document how this Party can be contacted directly and immediately.  To this end, supply the “Telephone Number” regularly monitored by the Idaho Alternate Health Care Agent on the final blank line of this section.

 

Step 11 – Reserve A Second And Third Alternate Idaho Agent

As mentioned earlier, up to three Alternate Agents can be named. Item “B. Second Alternate Agent” will accept the full “Name,” complete “Address,” and current “Telephone Number” of the Second Alternate Agent. It should be noted the Second Alternate Agent will not be able to wield authority in medical matters concerning the Principal unless the Original Health Cara Agent and “First Health Care Agent” cannot represent the Principal.  Item “C. Third Alternate Agent” will enable an Idaho Alternate Agent to be given the power to represent the Principal if the Original Health Care Agent, the First Alternate Health Care Agent, and the Second Alternate Agent no longer can or will. If a Third Alternate Agent is to be appointed then use the blank lines labeled “Name,” “Address,” and “Telephone Number” to document his or her full identity and current contact information.   

 

Step 12 – Revoke The Powers Of Previously Appointed Agents with The Principal’s Execution of this Directive

The next article seeking the Principal’s attention is titled “8. Prior Designations Revoked.” The Principal should review the entirety of this paperwork after it has been completed. If another document issuing power is to be revoked through this issue, then locate and delete the words “Date And Signature” of the Principal. The Principal must record the current date then sign his or her name to this area as a substitution for this label.  After reviewing this paperwork then dating and signing it the Principal must verify its authenticity by sling the blank line labeled “Signature” and documenting the city and state of the signing on the opposite end of this line.   

 

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