Advance Directives

What is an Advanced Directive?
This is a term used to describe an individual’s stated wishes for healthcare, made in advance so that if the person is later incapacitated and unable to express those wishes, the healthcare providers will know what he or she wants. Advance Directives are expressed in documents such as the Living Will or Power of Attorney for Healthcare.

Who Can make an Advanced Directive?
Anyone 18 years of age or older and of “sound mind,” can make an advance directive.

Why should an Advanced Directive be made?
An advance directive speaks for an individual when they are unable to do so. Because it tells others the care and treatments the individual wants or does not want and/or who will make health care decisions when the person can not express their wishes, it may relieve family from the burden of guessing what their loved one would want.

How does an individual make an Advanced Directive?
There are two ways to make an advance directive.

  1. Completion of either a living will or a power of attorney for health care document. These forms can be obtained from the Division of Health and Family Services. (See website address below for Wisconsin.)
    A lawyer is not needed to complete these forms. However, two persons must witness the individuals signature on these forms. The forms themselves describe who may or may not be a witness.
  2. Wishes can also be expressed using other forms. These formal documents do not have to be used to make an advance directive.

What is the Living Will?
It is a written directive in which an individual specifies that their dying should not be prolonged with certain medical treatments. In Wisconsin, the Living Will is in effect only when a patient is terminally ill or in a persistent vegetative state.

What is a Power of Attorney for Healthcare?
This is a written directive to make decisions on an individual’s behalf if they should become unable to make such healthcare decisions for themselves. This person is known as the healthcare “agent”.

What is the difference between a Living Will and a Power of Attorney?
A living will goes into effect only when death is very near or when a person is in a vegetative state and has no cognitive abilities. It deals only with the use or non-use of life prolonging measures.

A power of attorney for health care also goes into effect when an individual can no longer make health care decisions, but the person does not have to be close to death or in a vegetative state. The power of attorney for health care allows another person to speak for and make health care decisions for the individual that is not limited to just artificial life support. The type of decisions this person can make depends upon the extent of authority the individual gives when they complete the form.

What is the difference between a Durable Power of Attorney and the Power of Attorney for Health Care?
The term durable is added to indicate that the principal intends to create a power of attorney that remains effective even if the principle becomes incapacitated. Before our statutes were changed to authorize durable powers of attorneys, such documents terminated upon incapacity. (Without knowing it most often these terms are used interchangeably, in error). More often then not the durable power of attorney (poa) probably refers to financial poa and the health care poa is a different document (see above).

Should a person have both a living will and a Power of Attorney for Health Care?
It is not necessary to have both a living will and a power of attorney for health care. If an individual does have both documents, they should make sure they do not conflict. If they do conflict, a health care provider will follow the instructions of a power of attorney for health care rather than instructions in the living will.

When should a person complete a Living Will and/or Power of Attorney?
It is never too early to complete this.

What if a person changes his mind?
A living will or power of attorney for health care can be cancelled at any time. The different ways you can do this are explained on the forms you complete when a living will is made or appoint a power of attorney for health care.

Does the health care provider have to follow an individual's Advance Directives?
Some health care providers and physicians may have policies or beliefs which prohibit them from honoring certain advance directives. It is important to discuss advance directives with these people to make them aware of the individuals wishes and to determine if they will honor the advance directives. If they will not, the individual may want to choose another health care provider.

What happens if someone doesn't make an Advance Directive?
There is a greater chance you will receive more treatments than you may want if you have not made an advance directive.

If a person cannot speak for him or her self and has not made an advance directive, a physician will generally look to the family, friends, or clergy for decisions about the individuals care. If the physician or health care facility is unsure, or if the family is in disagreement about the decision, the physician may ask the courts to appoint a person (guardian) who will make decisions for the individual.

Where should Advance Directives be kept?
Advance directive should be kept in a safe place where it can easily be found. (It should not be kept in a safe deposit box.) Make sure family members and the lawyer, if the individual has one, knows there was an advance directive made and knows where it is located. Ask the physician to make your advance directive part of the permanent medical record.

In Wisconsin, copies of the forms may be obtained by the Wisconsin Department of Health and Family Services either by:

Sending a stamped, self-addressed business sized envelope to:

Living Will/ Power of Attorney
Division of Public Health
PO Box 309
Madison, WI 53701-0309 or

Printing the form from the Internet:
http://www.dhfs.state.wi.us/forms/AdvDirectives/index.htm