Power of Attorney Forms and Living Will
It is important to "get your house in order." In the event that you are incapacitated and are not capable of making health care decisions for yourself, filling out these documents will ensure that your wishes are honored.
The Power of Attorney for Health Care is more comprehensive than a Living Will. It covers more situations when a person is mentally incapacitated and is more flexible. It designates a person with whom the health care provider can discuss the patient's situation rather than the Living Will, which is just a written statement.
These documents address:
Designation of Agent (Choosing who would be responsible for decision making on your behalf. You will need to designate a primary agent and an alternate agent.)
Provision of Feeding Tube.
Admission to Nursing Home or CBRF Facilities.
Anatomical Gifts.
The Use of Life-Sustaining Procedures.
Preferred Physician and/or Long-term Care Facilities.
Revocation of Prior Living Wills.
Experimental Treatment.
Alleviation of Pain.
Religious Preferences.
Visitation (If you do or do not wish to be visited in an incapacitated condition, or would prefer to designate allowed visitors.)
Consultation (Whether your agent receives input or shares information with others-such as children.)
Witnesses
You will need to arrange for 2 witnesses who are not related by blood or marriage.
Distribution
Sign one (1) original, and make 5 copies. Distribute to: (1) Original to Physician (2) Hospital (3) Family member (4) Safe place at home (5) Designated agent
To Obtain Copies of the Forms:
Send a self-addressed business size envelope to:
Living Will/Power of Attorney for Health Care
Division of Health
P.O. Box 309
Madison, WI 53701-0309,
Comparison of Wisconsin’s Health Care Advance Directives
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Declaration to Physician Living Will |
Power of Attorney for Health Care |
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What it is |
Written statement to Physicians |
Appointment of another person authorizing them to make health care decisions if you become incapacitated. |
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When does it become effective? |
When two physicians examine you and state you are either terminal where death is imminent or in a persistent vegetative state. |
When two physicians (or one physician and one psychologist) personally examine you and sign a statement. |
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Document becomes effective when the patient is: |
1. Terminally ill |
Anytime someone is incapacitated |
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Procedures covered: |
1. Life sustaining procedures to be withheld or withdrawn. |
You designate your wishes regarding any specific procedures you desire to have or decline. |
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It does not apply: |
When patient is: |
Authorizing electroshock therapy, experimental mental health drugs and treatment. Admission to mental facilities. |
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How to revoke the document |
1. Destroy all copies. |
1. Destroy all copies |
Durable Power of Attorney for Finances and Other Property
A durable power of attorney is a way for you to plan ahead to authorize someone else to manage your finances and make financial decisions if you ever become unable to do so yourself. This enables you to choose the individual (or individuals) to make these decisions and to decide generally or specifically what you would want those decisions to be.
If you do not complete a durable power of attorney but later become incapacitated there may be decisions and transactions that need to be completed (for example, selling you house, closing a bank account, selling stocks, cashing in a Certificate of Deposit, signing a contract for services, filing tax returns, etc.), which no one else can do for you without proper legal authority.
(Note: Even where a husband and wife own a home jointly, if for example, the house needs to be sold and the husband is no longer mentally capable of signing his name, the wife cannot sign for him).
Without a durable power of attorney in place, it may be necessary for your family or others to ask the court to appoint a guardian of the estate for you. This process can be costly, time consuming, cumbersome and emotionally draining. You will have no control as to who will be appointed.