Wellness Minute - Advanced Directives
In this segment of Wellness Minute, Tara Nalepinkski, Social Worker at Crossing Rivers Health, discusses advanced directives. Tara and Emily Wetter, also a Social Worker at Crossing Rivers Health, assist patients, their families, and community members in preparing advanced directives free of charge.
What are advanced directives?
Advanced 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.
For Wisconsin residents, it is very important to know that Wisconsin does not recognize the spouse, children, or other relatives as automatic decision-makers when an individual is incapacitated. Even though physicians and other health care providers may discuss treatment with relatives, and often take their decisions as consent, this is not explicitly protected by Wisconsin law. If the physician or hospital is unsure about a decision, or if your family disagrees about a decision, and these concerns cannot be resolved, they may have to turn to the courts for guidance.
Advanced directives contained several different documents, including:
- Power of Attorney for Health Care
- Declaration to Physicians - Living Will
- Power of Attorney for Finance
- Do Not Resuscitate (DNR order)
- Authorization for Final Disposition
The Patient Family Services team at Crossing Rivers Health can help with four of these five forms – all of them except Power of Attorney for Finance.
In Wisconsin, two very important advanced medical directives are the Power of Attorney for Health Care and the Declaration to Physicians (commonly referred to as a Living Will).
Attend an End of Life Planning Seminar on Tuesday, May 14, 2019 from 5:30 - 7:00 pm at Crossing Rivers Health to learn more about planning ahead for you and your family.
Power of Attorney for Health Care
A Power of Attorney for Health Care is 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.
At any age, a person can become incapacitated by an unexpected serious accident or illness which causes him or her to be unable to make decisions about health care. This is why it is recommended that anyone over the age of 18 complete an advance directive.
Hopefully, this will never happen to you. But in order to be prepared for that possibility, you may designate someone you know and trust to make health care decisions on your behalf. This person is called your "health care agent."
Health Care Agent FAQs
Q: What if my health care agent is unable or unwilling to serve for me when and if the time comes that I need help?
A: You may also designate an alternate health care agent to serve if the need arises. If you choose someone younger than you to be either your alternate or your health care agent you increase the likelihood that he or she will survive you.
Q: Can my health care agent make financial decisions for me?
A: No, not unless you use other forms and procedures to also give this person Power of Attorney for finance for you. You should consult a lawyer to discuss your options regarding financial matters.
Q: What kinds of decisions may my health care agent make?
A: First, according to Wisconsin Law, your agent can never admit you or commit you to an inpatient facility for mental diseases, an intermediate care facility for mental retardation or a state treatment facility. Your agent can never consent to experimental mental research or psychosurgery, electroconvulsive treatment or other drastic mental health treatment procedures. Under Wisconsin law, there are three areas on the Power of Attorney for Health Care form where you must specifically indicate whether or not you give decision-making authority to your health care agent:
- Admission to a nursing home or community-based residential facility for a purpose other than recuperative or respite care
- Having a feeding tube withheld or withdrawn
- Health care decisions for women who are pregnant
If you check the spaces on the form "no" or omit checking either "yes" or "no," your health care agent will not have the authority to decide these issues for you. Then, in all other areas your health care agent will be able to make decisions regarding your care. Your agent will also be able to sign a waiver or release of liability required by hospitals or doctors for you to receive treatment.
Be sure to discuss your wishes and desires carefully with your agent(s) so they will know how you feel and all of you are comfortable with the decisions to be made.
Declaration to Physicians - Living Will
A Declaration to Physicians – Living Will is 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.
To complete the form, two witnesses of at least 18 years of age that are not related to you by blood, marriage, or adoption and are not directly financially responsible for your health care are required.
The form itself contains multiple definitions that the Patient Family Services team can help you to understand to make sure your wishes are granted.