Dr. Heidi Sykora RN, DNP, GNP-BC, APNP Nurse Practitioner Protecting Your Health Care Wishes Dr. Heidi Sykora RN, DNP, GNP-BC, APNP Nurse Practitioner

Milwaukee Center for Independence Since 1938, the Milwaukee Center for Independence has been assisting individuals and families with special needs and barriers to achievement reach their highest level of independence. MCFI is a nonprofit organization that serves more than 15,000 people in more than 50 programs each year. They include newborns, working-age adults, people with mental illness and the frail elderly. We do that through our four core program areas: Children's Programs, Long-term Care, Behavioral Health and Employment Services.

Objectives Attendees will: Understand the difference between a Financial Will, Living Will and Power of Attorney for Health Care Learn how to become a self-advocate for a person-centered health care plan Discuss steps for completion and execution of Advance Directives including the Power of Attorney for Health Care and Living Will Describe the use of the Five Wishes document to guide individual choice of personal care and medical treatment

Advance Directives Documents that provide direction regarding health care decisions when you are unable to make your own decisions

Advance Directives Two Parts: Power of Attorney for Health Care Identifies a person to make health care decisions when you are not able to

Advance Directives Two Parts: 2. Living Will Instructions to your physician and loved ones regarding choices when you are unable to communicate your wishes It is important to have a discussion with your physician about your choices

Health Care Living Will The Health Care Living Will directs health care decisions NOT financial decisions. The financial will is a separate document. The POWER OF ATTORNEY FOR FINANCES AND PROPERTY can be found at: http://www.dhs.wisconsin.gov/forms/advdirectives/F00036.pdf

Who Can Witness? Any competent adult may witness EXCEPT: Relative by blood, marriage or adoption Person who has financial interest in the estate of the individual A person who is directly financially responsible for the declarant’s health care. An individual who is a health care provider, other than a chaplain or a social worker

Five Wishes A document to guide the completion of ADVANCE DIRECTIVES More detailed than the Wisconsin Power of Attorney and Living Will documents Recognized in 42 states including Wisconsin Individual form costs $5 (provided free today for participants) Can be completed on line

Wish 1 The Person I Want To Make Care Decisions For Me When I Can't Power of Attorney for Health Care also known as “POA, Health Care Agent, Proxy or Surrogate” Must be competent adult to designate health care agent Only activated with the signature of two physicians or one physician and one psychologist when an individual is unable to make his/her own decisions

Wish 1 For an individual to designate a Health Care Power of Attorney (POA) (aka Health Care Agent) they must be competent and they must designate a competent adult to be the POA. An individual who is of sound mind and has attained age 18 may voluntarily execute a Power of Attorney for Health Care. An individual for whom an adjudication of incompetence and appointment of a guardian of the person is in effect under State Statute Chapter 880 is presumed not to be of sound mind.

Wish 1 Gives Health Care Agent right to make all health care decisions if you are unable must be activated Admission to nursing home, hospice or assisted living Authorize medical procedures May place limitations on Health Care Agent

Wish 2 The Kind Of Medical Treatment I Want Or Don't Want Also known as Living Will Life support measures Instructions for Feeding Tube

Wish 3 My Wish For How Comfortable I Want To Be Physical Psychological Environmental

Wish 4 My Wish For How I Want People To Treat Me Psychological Spiritual Dignity

Wish 5 My Wish For What I Want My Loved Ones To Know Remembrance Forgiveness Care after death Funeral arrangements

Forms Available http://www.agingwithdignity.org/forms/5wishes.pdf http://www.dhs.wisconsin.gov/forms/advdirectives/F00060.pdf

Summary Advance Directives are documents that direct health care when you are unable to express your wishes. Wisconsin has two forms comprising Advance Directives: The Health Care Power of Attorney and The Living Will. The forms can be accessed at no cost on line.

Summary Five Wishes is a document that is more detailed and includes physical health care choices as well as personal psychological and spiritual expressions. The form is available on line at the cost of $5 each. The Advance Directives must be witnessed by two people who are not a relative or health care provider.

Summary Your physician must be given a copy of your Advance Directives which becomes a part of your medical record. Advance Directives can be changed at anytime by destroying previous forms and completing a new form.

Summary Advanced Directives are activated only when you are not able to make your own decisions. In Wisconsin, this is determined by either two physicians or one physician and 1 psychologist. Under certain conditions, your physician can override your advanced directives, so it’s important to discuss your decisions with your physician.

Questions?