What Is an Advance Directive?
Who Can Make an Advance Directive?
What if I Change my Mind?
Where Can I Get an Advance Directive Form?
Asking Questions/Making Decisions
In Conclusion
We at St. Nicholas Hospital want you to know you have the right to make decisions about your healthcare. This includes the right to accept or refuse medical or surgical treatment and the right to direct future healthcare decisions if you become unable to express your wishes. You can do this by completing an Advance Directive.
What Is an Advance Directive?
Advance Directives are instructions given to healthcare providers that describe the type of care you would like to receive if you should be unable to make your own medical decisions. An Advance Directive expresses to your Physician, your personal wishes. It is based upon your beliefs and values. When you complete an Advance Directive, you will consider issues about death, living as long as possible, being kept alive by machines, being independent, and the quality of your life. The advance directive will be able to communicate to your Physician the treatment you want to receive and also, treatment you do not want to receive. During your hospitalization someone from the hospital will ask you about advance directives.
The two forms of Advance Directives the State of Wisconsin recognizes are Living Will and Durable Power of Attorney for Healthcare.
Living Will
A Declaration to Physicians, more commonly known as a Living Will, describes the kind of life-sustaining care you would want only if you had a terminal condition or were in a persistent vegetative state. The declaration directs your physician whether to withhold or withdraw life-sustaining treatment or a feeding tube if you develop an illness or injury that cannot be cured and your death is imminent. The declaration does not give the authority to anyone to make healthcare decisions on your behalf.
For example, a Living Will specifies whether your wishes are to accept or refuse treatments or machines which keep your heart, lungs, or kidneys functioning when they are unable to function on their own.
A Living Will goes into effect only when two physicians agree in writing that you are near death and that you are unable to understand or to express your healthcare options or wishes to others.
If are too sick to return home, you require 24-hours nursing care, and no longer qualify for inpatient hospital services, your family/significant others will need to request a judge to order protective placement in a nursing home or CBRF.
Completing a Durable Power of Attorney for Health Care prevents your family from the hardship of the court proceedings.
Durable Power of Attorney for Healthcare
Durable Power of Attorney for Healthcare is another type of advance directive. The Durable Power of attorney is a legal health care document that appoints an individual to make medical decisions on your behalf, should you become unable to make these decisions for yourself. The form like a living will allow you make these decisions but give proxy to the agent to interpret your wishes when unexpected medical issues come up. If you do not have a Durable power of attorney the decisions default to a spouse or adult children or parents. Durable Power of Attorney for Healthcare allows you to withhold or have withdrawn food and fluids, i.e., tube feedings, and to give consent to be admitted to an extended care facility if needed. The Durable Power of Attorney for Healthcare goes into effect only when two physicians or a physician and psychologist agree in writing that you are no longer able to understand your treatment options or to express your wishes to others.
Copies of the Durable Power of Attorney for Healthcare and your Living Will are given to your physician, your healthcare agent, and your family; a copy should also be placed in your Hospital medical record. Keep the original form in a safe place where you and others can find it easily. (Do not keep it in a safe deposit box.)
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Who Can Make an Advance Directive?
An Advance Directive may be completed by anyone 18 years of age or older and of sound mind.
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What if I Change my Mind?
You can cancel or replace a Living Will or Durable Power of Attorney for Healthcare at any time. Follow the directions on the forms you completed and make sure the appropriate healthcare professionals and healthcare facilities receive updated forms.
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Where Can I Get an Advance Directive Form?
Advance Directive forms are available through St. Nicholas Hospital's Care Managers and Admitting Department. If you have specific questions about the forms, ask your nurse to contact the Care Management staff for you. They are also available to assist you in completing the forms.
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Asking Questions/Making Decisions
It is your right and your duty to yourself to understand as much about your medical care as you can. This means asking questions. Your physician should be the primary source of answers because you will be making decisions together. Ask your physician to explain what you do not understand. Other Hospital staff may also provide helpful information. When you have answers to your questions, you can then make informed decisions regarding your medical care. Some of these decisions include but are not limited to: intravenous (IV) therapy; tube feeding; mechanical breathing assistance (ventilators); CPR (a procedure done to restore heartbeat and respirations); medications (life-saving); and diagnostic tests. We also encourage open discussion with your family, clergy, or friends to work through difficult decisions.
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In Conclusion
It is difficult to make good decisions in the midst of a crisis, so it is important to think and talk about these issues before they occur. If you have any questions about Advance Directives, please discuss them with your doctor, nurse, Patient Advocate, Chaplin, or Care Management Nurse.
Concerns about compliance with Advance Directives may be filed with Wisconsin Bureau of Quality Assurance. This can be done by contacting the regional ombudsman at the Board on Aging and Long Term Care:
214 N. Hamilton Street
Madison, WI 53073-2118
1-800-242-1060
Or in writing to the Bureau of Quality Assurance:
P.O. Box 309
Madison, WI 53701
If help is needed with this, please call:
Care Management Nurse • 920-459-4688
Care Management Social Worker • 920-459-4621
Patient Advocate • 920-459-4620
Social Worker • 920-457-5770
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