Imagine if you were too sick or injured to express your health care wishes. Who would you want to make those decisions and guide your care? An advance directive is a legal document that allows you to express your end of life, health care wishes ahead of time.

Everyone over the age of 18 should have an advance directive on file. People often think they are too healthy to have an advance directive. The reality is that none of us know the future and at any moment, something could happen to us where we become incapable of making decisions for ourselves.

An advance directive has two parts. Since this is your document, you can complete the form in its entirety or you can complete only certain questions. The most important section to be completed is the first part in which you name an agent. This section of the document allows you to designate a person or persons whom you trust and who would be willing to represent your wishes in the event you need someone to make decisions on your behalf. This person(s) is called your health care power of attorney (POA).

The second part of the document is called the living will. It allows individuals to express their thoughts relating to care intended to prolong life. People can choose to accept or refuse medical care commonly related to dialysis, resuscitation, breathing machines and tube feedings. It is also possible to express your wishes related to organ and tissue donation. This part of the form is the most difficult because it causes people to really reflect on their values and beliefs on end-of-life treatment. Some people find it difficult to think about how they would like to die. Therefore, this part of the form often poses the biggest barrier in completing the advance directive.

Once you have completed your advance directive, it must be made legal. This can be done by having it notarized or having it signed by two witnesses, who are not your power of attorney. After it is legal, you should give a copy to your doctor, power of attorney and family.

This document is an important part of your medical record.

Some of the choices you may put in your directive are:

• The person you want to be your health agent and make decisions about your health care for you.
• Your goals, values and preferences about health care.
• The types of medical treatment you want or don't want.
• Where you would like to receive care.
• Instructions about treatments such as artificial nutrition and hydration, CPR, and dialysis.
• Donation of organs, tissues and eyes.
• Funeral arrangements.

Next steps:

1. Review and complete the Advance Health Care Planning: Making Your Wishes Known Booklet.
2. Complete an Advance Health Care Directive Form. Have it notarized or signed by two witnesses who are not your power of attorney.
3. Give a copy to your doctor, power of attorney and family.
4. If necessary, complete a Provider Orders for Life Sustaining Treatment (POLST) Form. This form is a more specific advance care planning document specifically for people who are living with serious illness. It translates your advance directive into a form. It allows people to make decisions about life-sustaining treatment prior to a medical emergency. Having a conversation with your doctor about end-of-life treatment options can be difficult, but this document can serve as a talking tool which can make that conversation a little easier. Talking with your doctor about the POLST form will include discussing benefits of cardiopulmonary resuscitation (CPR), goals of treatment, interventions relating to antibiotics, nutrition and hydration. When a crisis occurs at home, people often call 911. By law, emergency medical staff has to provide maximum curative care. However, for some people who are living with serious illness, maximum curative care isn't always what that person wants and can sometimes be more harmful. A POLST is a doctor's order emergency medical staff can follow to help a person toward a desired outcome.
5. Contact these departments if you need more information:
   • Hospice: 608-392-9790
   • Palliative Care: 608-392-8930
   • Social Services: 608-785-0940