Advance Directives- Clinic Story of the Month

What are Advance Directives?

Advance Directives are legal documents that are completed by adults in advance of an illness or accident that would leave you unable to express your wishes. In Wisconsin, two important advance medical directives are the Power of Attorney for Health Care and the Declaration to Physicians (commonly referred to as a Living Will).’

What is a Declaration to Physicians (Living Will)?

• A document in which you can state your care wishes about life-support machines or feeding tubes if you become terminally ill or you lapse into a persistent vegetative state (permanent coma).
• A Living Will does not allow you to name someone to make decisions for you.

What is a Power of Attorney for Health Care?

• A document in which you can appoint a family member or friend (who is 18 years or older) you trust to make health care decisions for you if your doctors determine you can no longer make your own medical decisions.
• You may also name an alternate decision maker if the first decision maker is unwilling or unable to make decisions when needed.

Do I need both a Living Will and a Power of Attorney?

No. You may have one or both documents. The POA-HC is a broader document which allows you to name a decision maker in the event you can no longer make your own decisions. The Living Will is a place to answer three specific questions on end-of-life issues.

Why are these documents important?

• It is the best way for you to have control in making sure your health care wishes are followed when you are unable to speak for yourself.
• It may decrease disagreements between your family members.
• It may help your family avoid paying for guardianship.
• In the state of Wisconsin, once patients are under medical guardianship, their guardians are not allowed to withdraw or withhold life sustaining procedures unless they are in a persistent vegetative state or made an advance directive or other clear instructions that they would not want life support used.
• In the state of Wisconsin, patients that need to be transferred to a skilled nursing facility must be able to sign themselves in, have an activated power of attorney for health care, or a guardian.

If I am completing these forms myself, what are the most important things to know?

• A lawyer is not needed to complete these documents, and they do not need to be notarized.
• The documents must be witnessed by two people that are over 18, not related to the patient by blood or marriage, and are not health care providers unless they are social workers or chaplains.
• All of the dates must match – there is a date at the beginning of the document, after the signature of the patient and after the signatures of the witnesses.
• You can name up to two people to make decisions for you in the Wisconsin document. There must be a primary decision maker and there may be a back-up decision maker. You cannot have joint decision makers.
• Checking yes to the questions about nursing homes and community-based residential facilities does not mean you want to go to one of these facilities, it means you trust your decision maker to make this type of decision for you. If you check no, it means their authority is limited in this area, and  they may need to hire an attorney to apply for legal guardianship.
• The  section “Statement of Health Care Agent and Alternate Health Care Agent” is an optional section. If the person(s) you wish to name as your decision maker(s) are not available to sign the form when you complete it, the document is still valid.
• The section on organ donation is also optional. You may also register your decision to donate on-line at http://www.yesiwillwisconsin.org/.
• The page that explains “Notice to Person Making This Document” needs      to be attached to form for it to be valid.

What if I change my mind?

You can revoke your document or complete a new form. You cannot make changes to a document that has been witnessed.

Where do I get the forms?
You can pick up a copy of a Health Care Power of Attorney form from any of the Grande Health & Wellness Clinics.   The Grande Health & Wellness RN Case Manager or Clinic Supervisor would be happy to answer any questions you have on completion of this form.  They can be reached at 920-907-3922.

Alternatively, you can go to https://www.dhs.wisconsin.gov/forms/advdirectives/index.htm to print out the forms to complete.