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Advance Medical Directives (Power of Attorney/Living Will)

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.
  • Wisconsin Declaration to Physicians / Living Will 

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.
  • Wisconsin Power of Attorney for Health Care
    • A Spanish version is available from Patient Relations (608-263-8009). This is to be used as a guide only, as state law requires the form to be completed in English.

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.

What happens if I don't have an advance medical directive? 

  • Some people choose not to have advance directives.  When there is no advance directive, doctors often turn to adult family members to make decisions. 
  • However, being a family member does not automatically make someone a health care agent.  
  • Sometimes family members don't agree about what should happen. When this happens, a guardian may need to be appointed. This is done by a judge which takes both time and money. The guardian may or may not be the person you would want to make decisions for you.

How are Advance Directives different from Guardianship?

  • Guardianship is a legal process in which a person is appointed by a court to make medical decisions for a patient after they become unable to make their own decisions. Petitioning the court for guardianship can cost thousands of dollars.
  • An Advance Directive is a statement of your wishes that is completed in advance and later used if you become unable to communicate those wishes. There is no cost to completing an Advance Directive when completed through your hospital or clinic.

Does UW Health offer help in completing Advance Directives?

 

UW Hospital and Clinics

  • Many clinics have social workers available. Ask your clinic.
  • Information and assistance is available on a monthly basis at both UW Hospital and the West Clinic:
    • UW Hospital 
      • Date: second Wednesday of each month
      • Time: 11am-1pm
      • Location: H Elevator Lobby on the first floor (near the cafeteria)
    • West Clinic
      • Date: fourth Tuesday of each month
      • Time: 9am-Noon
      • Location: Clinic lobby, across from clinic registration

UW Medical Foundation and Department of Family Medicine Clinics: UW Medical Foundation and Department of Family Medicine Patient Resources social workers can be reached at (608) 821-4819.

 

Inpatients: Patients should let their nurse know they’d like to speak with a social worker or chaplain.

 
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.
 
Who should I give copies to?
  • 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 UW Hospital, you may give a copy to your social worker or nurse, or can mail a copy directly to:

    Health Information Management
    Attn: Advance Directive Coordinator
    8501 Excelsior Drive
    Madison, Wisconsin 53717
Contact Information
  • Inpatient social workers: (608) 263-8667
  • Outpatient social workers: (608) 263-8667
  • Chaplains: (608) 263-8574
  • UW Medical Foundation and Department of Family Medicine patient resources/social workers: (608) 821-4819
  • UW Hospital and Clinics Patient Relations: (608) 263-8009

Little Known Facts About Your POA Document:

  • If you name a domestic partner as your health care agent, and that person works in the medical setting where your POA is on file, you must be registered in the Wisconsin Domestic Partner Registry for the POA document to be valid.
  • If you name your spouse as your health care agent, and you are divorced or your marriage is dissolved later, the POA document is no longer valid and you will have to do a new one. You may name an ex-spouse as your primary agent, but the form has to be redone post-divorce.