Advance Directives

If you become unable to express your wishes, how will you have a say in your medical care? The answer is advance care planning. Advance care planning is both a conversation and the creation of legal documents about what is most important to you and how you want your medical care to look. The creation of advance care planning documents is the best way to communicate your wishes.

Why Advance Care Planning Is Important

• You have the right to make decisions about your health care.
• You have the right to plan and direct the types of health care you may receive in the future.

It is recommended that every person over the age of 18 complete a Health Care Power of Attorney document. It is important to choose a person to express your wishes and make health care decisions in the event that you are unable to do so for yourself.

There are two recognized advance care planning documents in Wisconsin.

1. Power of Attorney for Health Care
2. Living Will

Health Care Power of Attorney

It is important to have a Health Care Power of Attorney document. This allows you to formally choose a health care agent to make decisions for you in the event you are unable to make decisions for yourself. A lawyer or notary is not required to complete these forms.

Getting Started on Your Health Care Power of Attorney

The forms require the information listed below:

• Your legal name, address and date of birth
• Choose one or two people to be named as your health care agents. Include their current address and phone number(s).
• You will answer questions about giving your agent(s) the ability to make decisions for you in specific situations that may or may not happen in the future. These situations are specific to the State of Wisconsin Health Care Power of Attorney. If you do not give your agent(s) permission, their ability to make decisions may be limited in certain situations.
• You will need two witnesses who are not your health care agents or related to you by blood, marriage, domestic partnership or adoption.

The Difference Between a Living Will and Power of Attorney for Health Care

A Living Will is a legal document that lets you share your wishes for medical care or life-sustaining treatments if you are ever in a vegetative state or have a terminal condition. It does not name a health care agent.

When there is a conflict between what you direct in a Living Will and what you direct in a Power of Attorney, the Power of Attorney takes precedence.

If you have questions about the Health Care Power of Attorney form or need assistance to complete a document, please contact the Enterprise Care Coordination Department to speak with a social worker at 414-454-4747. There is no cost involved.

If you already have a completed document, you can:

• Bring this to your next appointment.
• Upload the document to MyChart.

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Advance Directive Topics to Discuss

Before having your health care agent sign any forms, you should discuss your beliefs and wishes with him or her. When you become incapacitated and they need to make health care decisions, however we suggest you consider the following questions. We suggest no particular answers. Each person should answer these questions based on his or her own beliefs and convey those beliefs and wishes to their health care agent. Any other wishes or desires that you feel your health care agent should know, should also be given to them so that they can carry out their responsibilities.

25 Suggested Topics to Discuss With Your Health Care Agent

1. Do you think it is a good idea to sign a legal document that says what medical treatments you want and do not want when you are dying? (This is called a "Living Will.")
2. Do you think you would want to have any of the following medical treatments performed on you?
   • Kidney dialysis (used if your kidneys stop working).
   • Cardiopulmonary resuscitation, also called CPR (used if your heart stops beating).
   • Respirator (used if you are unable to breath on your own).
   • Artificial nutrition (used if you are unable to eat food).
   • Artificial hydration (used if you are unable to eat fluids).
3. Do you want to donate parts of you body to someone else at the time of your death? (This is called "organ donation.")
4. How would you describe your current health status? If you currently have any medical problems, how would you describe them?
5. If you have any current medical problems, in what ways, if any do they affect your ability to function?
6. How do you feel about your current health status?
7. If you have a doctor, do you like him or her? Why?
8. Do you think your doctor should make the final decision about any medical treatments you might need?
9. How important is independence and self-sufficiency in your life?
10. If your physical and mental abilities were decreased, how would that affect your attitude toward independence and self-sufficiency?
11. Do you wish to make any general comments about the value of independence and control in your life?
12. Do you expect that your friends, family and/or others will support your decisions regarding medical treatment you may need now or in the future?
13. What will be important to you when you are dying (e.g., physical comfort, no pain, family members present, etc.)?
14. Where would you prefer to die?
15. What is your attitude toward death?
16. How do you feel about the use of life-sustaining measures in the face of terminal illness?
17. How do you feel about the use of life-sustaining measures in the face of permanent coma?
18. How to do you feel about the use of life-sustaining measures in the face of irreversible chronic illness (e.g., Alzheimer's disease)?
19. Do you wish to make any general comments about your attitude toward illness, dying and death?
20. What is your religious background?
21. How do your religious beliefs affect your attitude toward serious or terminal illness?
22. Does your attitude toward death find support in your religion?
23. How does your faith community, church or synagogue view the role of prayer or religious sacraments in an illness?
24. Do you wish to make any general comments about your religious background and beliefs?
25. What else do you feel is important for your agent to know?

If, over time, your beliefs or attitudes in any area change, you should inform your health care agent. It is also wise to inform your health care agent of the status of your health when there are changes such as new diagnoses. In the event you are informed of a terminal illness, this, as well as the ramifications of it, should be discussed with him or her.

Resources

• State of Wisconsin Health Care Power of Attorney Document
• State of Wisconsin Living Will Document

National Healthcare Decision Day

National Healthcare Decision Day (NHDD) is observed on April 16 each year. Events on the day are held across the country to raise awareness about the importance of advance care planning. NHDD events provide educational resources about advance directives and organizers can assist people with creating and filling out the form.