Glossary and Q&A

Advance care planning terms

Advance directive: A general term that describes two kinds of legal documents: living wills and health care powers of attorney. Both allow a person to give instructions about future medical care should he or she be unable to participate in medical decisions due to serious illness or incapacity. Each state regulates the use of advance directives differently.

Advance care planning: Advance Care Planning is a PROCESS for planning for future health care decisions. It’s not a one-time event, but something that may change over time as you age and your health changes. 

Life support: Can include a breathing tube, electrical shock, tube feedings and IV medications. 

Cardiopulmonary Resuscitation (CPR): CPR is a group of treatments used when someone’s heart and/or breathing stops. CPR is used in an attempt to restart the heart and breathing. It may consist only of mouth-to-mouth breathing or it can include pressing on the chest to mimic the heart’s function and cause blood to circulate. Electric shock and drugs also are used frequently to stimulate the heart. 

Do Not Resuscitate (DNR): If the heart were to stop, efforts would not be made to restart it. In Wisconsin, emergency responders are required by state law to perform CPR and all life-sustaining procedures, unless the individual has a DNR bracelet on his or her wrist. 

Guardianship: Legal relationship created when an individual is determined by the court to be unable to make decisions. A designated decision-maker is appointed to make both financial and medical decisions for the individual unless the court order is reversed. 

Health care power of attorney: A legal form that allows an individual to empower another with decisions regarding his or her health care and medical treatment. Health care power of attorney becomes active when a person is unable to make decisions or consciously communicate intentions regarding treatments. 

Hospice: Holistic patient and family services usually in the home, focused on those with serious illness who are at the end of life and are no longer involved with curative treatment. Hospice focuses on the physical, psychological and spiritual needs of the patient. Its goal is to achieve the best quality of life available to the patient by relieving suffering and controlling pain and symptoms. Core services include nursing, social work and chaplain support. Other services are determined on an individual basis. 

Living will: A living will is a type of advance directive used to list specific medical preferences. It is sometimes used as an addendum to a Durable Power of Attorney for Health Care. It may also be called a “directive to physicians,” “health care declaration” or “medical directive.” 

Palliative care: A comprehensive approach to treating serious illness that focuses on the physical, psychological and spiritual needs of the patient. Its goal is to achieve the best quality of life available to the patient by relieving suffering and controlling pain and symptoms. This can be provided at the same time as curative treatment. 

Note: Some of the language used here derives from the National Hospice and Palliative Care Organization (NHPCO). 

Q: It sounds complicated. What exactly is it? 

A: It is an advance directive (think: “giving directions in advance”). In other words, it is a form that lets you select in advance, the person YOU want to make health care decisions for you in the event you ever lose the ability to voice your decisions. 

Myth vs. fact

MYTH: A Health Care Power of Attorney form is just for someone who is close to death, so I don’t need one yet. 

FACT: A Health Care Power of Attorney form is not just about old age or end of life. In fact, it is recommended for everyone 18 and older. Let’s face it —life can be unpredictable. At any age a medical crisis could leave someone unable to make his/her own health care decisions. 

MYTH: I don’t have time to get an attorney to help me, and I don’t want the added hassle of tracking down people who have to notarize it. 

FACT: No attorney is necessary and the forms are available at this clinic. The clinic social worker can provide information as needed. Once you are ready to sign your form, you will need two adults who are not relatives or care providers to sign as your witnesses. Neighbors or friends are often willing witnesses. 

MYTH: Once I complete the form, I am locked into those decisions. 

FACT: You may complete a new document to reflect changes in your situation. Only the most recent document will be used if ever needed. 

MYTH: Once I complete it, my decisions will be made by the person I identify as my agent. 

FACT: A health care power of attorney is a legal document that goes into effect only if you are incapacitated and/or unable to speak for yourself.