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Advance directives are legal documents that allow you to dictate your medical treatment and end-of-life care preferences ahead of time if you become incapacitated or unable to communicate. In Wisconsin, they typically include a living will which specifies end of life medical decisions and a healthcare power of attorney for which designates a trusted person to make decisions on your behalf.
Advance directives, often called advanced directives, are legal documents that outline your medical wishes and preferences. They can also appoint a specific individual to make medical decisions for you if you are incapacitated. Advance directives are an important part of any comprehensive estate plan.
Importantly, they only go into effect if the individual is unable to communicate or make their own decisions. These documents specifically address times when you are unconscious or otherwise incapacitated. So long as you are of sound mind and can communicate your wishes, you can work with your medical team directly about different decisions and options.
A living will is a legal document that outlines what types of life saving measures can be attempted if you are incapacitated and cannot be consulted. These medical decisions may include or involve being put on a ventilator, tube feeding, palliative care, CPR, and other care options or considerations. This is a legal document, and it’s recommended you provide a copy to your power of attorney, close relatives, and your healthcare providers.
A declaration to physicians is another term people use for living wills. These are not different documents. Attorneys and medical professionals will all know them by both names, but in Wisconsin these are living wills.
A Do Not Resuscitate order specifically instructs emergency responders not to perform CPR if your breathing or heartbeat stops. While a living will may include a request for no CPR, a DNR is often more accessible and readily understood by more people, including emergency responders if they are called to your home. Some people choose to display their DNR in their home if they are particularly at risk to ensure it is seen by all caregivers and potential emergency responders.
A healthcare power of attorney appoints a person to act on your behalf in the event you are incapacitated. While a living will gives preferences on specific possibilities, there are many more decisions that need to be made in a medical event. A healthcare power of attorney names someone who can approve or disapprove surgeries or specific medications. They can also choose between treatment options or healthcare facilities.
A medical emergency can happen any time, so all adults should have advance directives in place. Of course, the odds of needing to use them increase with age, so these become more important the older you get. That said, you can only create these documents while you are of sound mind. Elderly people who develop dementia can no longer sign legally binding documents. By the time you need them, it’s often too late to create them, so waiting for the “right time” can result in your wishes not being known or honored. It is much better to have advance directives and not use them for many years than to need them but not have them.
Your spouse or children do not have the automatic legal right to make all medical decisions for you. Without advance directives, family disputes revolve around what they want and what they think you may have wanted. Sometimes families have to fight for one person to get legal guardianship over you, which is time consuming. It also gives you no control over who in your family “wins” that fight – and when families are having these types of fights, no one is winning.
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Once completed, copies of your advance directives should go to your primary doctor and healthcare providers. Ask that they scan them into your official medical records, or scan them through an online portal if that’s an option for you. You should also provide a copy to the agent you assigned as your healthcare power of attorney, so they know they are your agent and know your wishes in advance.
You should also keep a list of everyone and every organization who has a copy, so if you update your directives in the future you ensure those same people get the updated version.
While it isn’t required, it is often a good idea to talk to close family members, even if they are not your power of attorney, to let them know who is. These conversations can be difficult, but they can also save time and stress in an emergency when various family members are trying to figure out who is making those decisions and who knows your wishes.
Having an attorney is always beneficial when creating advance directives. Most people only deal with advance directives a couple of times in their lifetime, but estate planning attorneys have seen hundreds or even thousands of these legal documents and can help ensure yours are as comprehensive as you want them to be.
These documents can often be combined with other estate planning documents, like a financial power of attorney and a will or trust. An attorney may also be necessary for complicated family dynamics or complex medical situations.
