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Patients > Advance Medical Directives

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?
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


What Is an Advance Directive?
An Advance Directive is a written document, completed and signed by you, that gives instructions about healthcare decisions. An Advance Directive expresses your personal wishes and 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 two types of Advance Directives the State of Wisconsin recognizes are Living Will and Durable Power of Attorney for Healthcare.

Living Will
A Living Will informs your physician that you want to die naturally if you develop an illness or injury that cannot be cured. It tells your physician that, when you are near death, he or she should not use any life-prolonging measures which postpone, but do not prevent, death.

A Living Will, for example, allows you to refuse treatments or machines which keep your heart, lungs, or kidneys functioning when they are unable to function on their own. It does not allow you to refuse drugs or procedures that reduce pain.

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 your healthcare options or to express your wishes to others.

Durable Power of Attorney for Healthcare
A Durable Power of Attorney for Healthcare also goes into effect when you cannot make healthcare decisions, i.e. when you are incapacitated due to illness or injury, although not necessarily near death. The Durable Power of Attorney for healthcare allows you to designate another person (agent) to speak for you and to make healthcare decisions on your behalf if you are unable to do so. The types of decisions the agent can make depends upon the extent of authority you give when you complete the form.

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. 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 Care Management and Admitting Departments. 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.

Finally, 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:

Board on Aging and Long Term Care:
1402 Pankratz Street
Suite 11
Madison, WI 53704-4001
1-800-242-1060

Or in writing to:
Division of Quality Assurance
P.O. Box 2969
Madison, WI 53701

If help is needed with this, please call:
Care Management Nurse • 920-459-4688
Patient Advocate • 920-459-4620
Social Worker • 920-459-4621

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St. Nicholas HospitSt. Nicholas Hospital, 3100 Superior Avenue, Sheboygan, WI Ph:920-459-8300
 100 Superior Avenue
 Sheboygan, WI 53081
 920-459-8300