HEALTH CARE
It is not only our RIGHT but our RESPONSIBILITY as competent adults 18 and over to understand our options in health care and make our Advance Directives known.
An Advance Directive is a document that allows us to give directions, about our future medical care. Modern medical science and technology is keeping people alive much longer than in the past. If illness or injury leaves us unable to communicate directly and coherently to doctors and family, an Advanced Directive protects our right to make medical choices regarding our care. The directions we give speak for us. Taking time to thoughtfully complete an Advance Directive can help family avoid the responsibility, stress and sometimes conflict in making difficult decisions regarding our care. Currently there are two kinds of decision making tools available, a Living Will and a Power of Attorney for Health Care.
Copies of our completed directive should be given to the health care agents, lawyer and other significant individuals (clergy or physician). It will need to be accessible, often on short notice as your physician may have to make some important decisions often without a lot of time. Make a list of individuals who have the document and provide a copy with each designated person.
As long as a person is competent, we may change our minds and remake our documents. REMEMBER the revised form should be given to the same people who received the first form.
It is good to revisit your Directives every few years and see if there have been any important changes. You may want to revise your directive. You may find this out through your physician, attorney, hospital or legal information center.
LIVING WILL
The "Living Will" or "Declaration to Physician", allows an individual in the event of a terminal illness or incurable injury where death is imminent or where a person is in a persistent vegetative state to refuse certain life support devices and life-sustaining procedures be withheld.
In Wisconsin, life-sustaining procedures include assistance with respiration, artificial maintenance of heart rate or blood pressure, blood transfusions and kidney dialysis. Because of a change to the law in 1991 it may also include withholding or withdrawal of artificial nutrition or hydration, also known as tube feedings. Documents signed prior to 1991 do not include this option.
The Living Will must be witnessed by two individuals who are; not related to the individual, or entitled to any part of the estate, or any one providing medical care.
You may receive up to four free copies of the statutory Declaration to Physicians (Living Will) by sending a self-addressed, stamped envelope to:
Declaration to Physicians, Division of Health, P.O. Box 309, Madison, WI 53701-0309
POWER OF ATTORNEY FOR HEALTH CARE
The Wisconsin Legislature authorized in May 1990 a standard form which allows a competent individual (the principal), 18 and over, to appoint another person his or her "health care agent". A health care agent can make health care decisions if and when the principal is unable to do so.
There is a primary agent and an optional alternate health care agent. When choosing agents they should be someone the individual really trusts. This person could be their advocate and speak out on behalf of the person. The principal must meet with the selected agents and discuss thoroughly how they feel. The health care agent (s) do not have to be the same person who is designated to handle financial issues.
The Power of Attorney deals with not only life support decisions but has a broad health care decision making authority for any time the principal is mentally incapacitated.
The power of attorney for health care document may be drafted by an attorney or completed on a standard statutory form. Copies may be obtained by sending a stamped, self-addressed envelope to: Power of Attorney for Health Care, Division of Health, P.O. Box 309, Madison, WI 53701-0309
Or for a kit including the, step-by-step instructions for completing the documents, send a business size envelope with four first class stamps to: CWAG, 2850 Dairy Drive, Madison, WI 53718 (608) 224-0660 or toll free 1-800-488-2596
FINANCIAL PLANNING
Like the need to plan for health care directives, we need to plan for financial decision making. In the event of mental incapacity such as a stroke or dementia it is easier to choose well ahead of time the person we really trust who will handle our finances. If a person is not chosen we run the risk of needing guardianship. Financial planning involves many transactions such as selling, buying or renting property, paying bills, accessing investments, purchasing needed health and long term care, dealing with insurances and other important financial matters. It is important to note that except for representative payees and conservatorships, all of following tools used in advanced financial planning are unsupervised and there could be the potential for abuse.
Joint Tenancy Bank Accounts: This kind of account is useful for individuals of any age who have a physical disability which prevents them from shopping, cashing checks or paying bills. This is created at the bank and it means that there are two people who are listed as the account holders. Names may appear with an 'or' in-between them, Sally Mother or Peter Son.
Dual-Signature Bank Accounts: Unlike the above option which only requires one signature on the check, this option requires two signatures. Two signatures are required before the check will be paid. Note that money in the account becomes frozen if one of the account holder dies.
Representative Payees for Government Benefits: Individuals who are prevented from managing their money properly because of mental or physical disabilities or substance abuse often benefit from this option which allows the government to issue benefit checks to someone other than their beneficiary. This is beneficial to those with moderate means and is available even after the onset of incapacity. There are some safeguards and minimal accounting requirements. The four government programs that offer this arrangement are: Social Security, Veterans Administration, Supplemental Security Income and Railroad Retirement. Contact those agencies for further information and instruction.
Private Paying Service: If a person has adequate resources and basic needs a private bill service may be employed. Other options may be to use direct payment plans such as those that are now offered by many of the utility companies. Money management services are also available in some communities.
Durable Power of Attorney: This is used for the handling of property and finances. A competent individual (principal) names a trusted individual to handle their property and or finances. The power may be broad or specific. Individuals may want to contact an attorney for to create this document to ensure all the legal requirements are met. Individuals with very modest estates may consider using the document created by the state. For a copy of the standard Wisconsin state power of attorney and step-by-step instructions, send a self addressed stamped envelope with two first class stamps to: CWAG, 2850 Dairy Drive, Madison, WI 53718 (608) 224-0660 or toll free 1-800-488-2596
Revocable Living Trusts: Trusts are used to avoid problems if a person becomes incapacitated. It avoids guardianship while assuring professional management necessary for the estate. Trusts may be modified or terminated at any time. Revocable trusts should be drafted by lawyers because it is necessary to know Wisconsin Law.
Conservatorship: This trusted position is like a guardianship but there are important differences. The first is while the individual is still competent a conservator is appointed who accepts the position voluntarily. The court approves or disapproves the selection but another person may not be imposed. Conservatorships do have the advantage of court oversight through accountings. They have basically replaced durable powers of attorney. The disadvantage involves the expenses in setting up the Conservatorship and any necessary court appearances. Any changes must go through the courts.
Further Questions and Information regarding advanced planning alternatives or protective services and placement call Wisconsin Guardianship Support Center hotline at 1-800-488-2596. This hotline is operated by the Coalition of Wisconsin Aging Group's Elder Law Center.