Advance Medical Directives

 

There are two kinds of advance directives in Wisconsin – the Power of Attorney for Health Care and the Declaration to Physicians (commonly referred to as a Living Will).

 

The Power of Attorney for Health Care allows you to name the person(s) that you want to make health care decisions for you, in the event that you are unable to express your wishes. Most often, this is a family member or close friend. The document can be helpful whenever you might be unable to communicate your wishes, whether short-term due to illness or injury, or at the end of life.

 

The Living Will allows you to state your care wishes if you have a terminal condition or you are in a vegetative state (permanent coma).

 

 

You may print a form on-line or request a copy from your Social Worker or Patient Relations.

 

Copies are available in Spanish, but are to be used as a guide only – state law requires the forms to be completed in English.

 

 

The documents must be witnessed by 2 people that are over 18, not related to the patient by blood or marriage, and is not a health care provider unless they are a Social Worker or Chaplain. They do not need to be notarized.

 

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, but they can not be joint decision makers. There must be a primary decision maker and there may be a back-up decision maker.

 

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 appointed decision maker(s) 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.

 

 

To use a Power of Attorney for Health Care, two physicians or a physician and a psychologist must sign a statement certifying you are unable to make medical decisions for yourself. This is called 'activation.' Until the document is officially activated, your health care agents do not have the authority to make health care decisions for you.

 

 

When patients don't have an Advance Medical Directive, we ask family members to make decisions on the patient's behalf. However, some decisions, such as whether to transfer the patient to another facility, may only be possible with a Power of Attorney for Health Care or a court-ordered Guardianship. Your family may also not all agree on what your wishes would be.

 

 

You should keep the original in a safe place that is accessible by others. You should give copies to your health care agent(s) – the person(s) you named to make health care decisions for you – to your primary care physician, and to the hospitals and clinics at which you receive care.

 

At UWHC, you may give a copy to your Social Worker or Nurse, or can mail a copy directly to:

 

Health Information Systems
Attn: Advance Directive Coordinator
8501 Excelsior Drive
Madison, WI 53717

 

A copy will be scanned into our electronic charting system.

 

 

Forms from other states are available through the Internet.

 

 

Please talk with your Social Worker or contact the Patient Relations Department.