At Gundersen Health System, we believe advance care planning (ACP) is part of good healthcare. It involves thinking and talking about goals, values and healthcare choices. This process will help those closest to you and your healthcare team provide the best care when you can no longer decide for yourself. A written plan called an advance directive is the desired result.
All adults should start with basic planning. Meaningful conversation is the best way to begin planning for future healthcare decisions. We invite you to meet with one of our trained facilitators. At no cost to you, he or she can guide and support you through each aspect of advance care planning.
Most adults should use an advance directive called a power of attorney for healthcare (POAHC). This form is legal in Wisconsin, Minnesota and Iowa. The document lets you appoint someone to be your healthcare agent. He or she can make choices on your behalf when you are no longer able to do so.
You can also put written instructions in this type of advance directive. The facilitator can help you complete the document. You can meet more than once if needed. Written documents are most helpful when you have taken the time to:
- Understand the decisions you need to think about
- Reflect on your values and goals
- Discuss your choices with those close to you
Advance care planning is an ongoing process. You should review your advance directive every few years because your goals, values and health choices may change.
Adults living with chronic illness can participate in advance care planning specific to that illness. We call this conversation Next Steps.
Frequently Asked Questions
What is advance care planning?
Advance care planning is a way to:
- Make sure you receive the level of care you prefer – no more and no less.
- Let others know what to do when you are too hurt or sick to express yourself.
- Permit people you trust to act on your behalf.
What is an advance directive?
An advance directive is the end result of advance care planning. In most cases, it is a written legal document. Gundersen Health System encourages patients to complete a document called a power of attorney for healthcare. Other options could be writing a letter or talking about your future care with someone who records your wishes.
What is a Power of Attorney for Healthcare (POAHC)?
This legal document allows you to appoint someone you trust to make your medical decisions if you become incapable. The person(s) you name will serve as your healthcare agent(s). You can include instructions about what medical care you do and do not want in the future. The POAHC is the type of advance directive recommended by Gundersen Health System.
What is the difference between a POAHC and living will?
A power of attorney for healthcare (POAHC) lets you appoint one or more healthcare agent(s) to make healthcare decisions when you are incapable. A living will does not let you name healthcare agent(s).
Why should I have a power of attorney for healthcare?
This legal document is the best way to make sure your wishes are known and followed. Without it, your family or loved one(s) may not be able to make decisions on your behalf. They could be forced to petition the courts for the right to decide, pay legal expenses or allow treatment they think you would not want.
How do I complete a power of attorney for healthcare?
There are two ways to begin this process.
- Make an appointment with a Gundersen staff member trained to lead discussion of future healthcare decisions. For this conversation, we recommend you bring the person(s) you are thinking of naming as healthcare agent(s).
- If you prefer, you can start the process right on this website with the POAHC form.
Call Advance Care Planning to make an appointment or ask a question while you work on your own. If you have a MyCare account, click the Advance Care Planning link under My Medical Record and choose from several options. (608) 775-6000 or (800) 362-9567, ext. 56000,
What should I do with my power of attorney for healthcare when it is done?
- Make a copy for each person you have listed as your healthcare agent.
- Take a copy to the doctor's office where you receive care.
- Keep the original in a place where those close to you can find it.
If you are a Gundersen Health System patient, you can:
- Fax to: (608) 775-3488 Attention: HIM – Advance Directives
- Mail to:
Gundersen Health Information Management
1900 South Ave., AVS-002
La Crosse, WI 54601
- Scan document and email to: firstname.lastname@example.org
Who can be my healthcare agent?
He or she can be anyone you trust. You could choose a family member, close friend, neighbor or religious leader. This person should be able to answer "yes" to all of these questions.
- Am I willing to be a healthcare agent?
- Do I know what you would want if you could make your own choices?
- Can I make the choices even if I do not agree with them?
- Am I able to make difficult healthcare choices even if I feel stressed and upset?
You cannot appoint any employee of a facility where you receive care unless the person is a close relative.
Does my agent need to live close by?
No. In most cases a healthcare facility can contact your agent in a timely fashion. To ensure this, keep phone numbers for your agent(s) up to date.
What does it mean if I check 'yes' under agent authority for a nursing home?
This gives your agent authority to make decisions about nursing home admission. It does not express your wishes for or against going to a nursing home. If you select "no" a judge would appoint a legal guardian to decide where you will go.
What does it mean if I check 'yes' under agent authority to withhold or withdraw a feeding tube and/or IV hydration?
This gives your agent authority to decide whether you should have a feeding tube or IV placed or removed. It does not express your wishes for or against tube feeding or IV hydration. You can state your wishes in your advance directive.
How do I change my advance directive?
There are several types of changes you might need to make. One is to update contact information for your healthcare agent(s). If you only want to change a phone number or an address, let us know through MyCare, during an office visit, or by calling (608) 775-1347 or (800) 362-9567, ext. 51347.
To change healthcare agent name(s) or provide new instructions, you must complete a new advance directive.
What if I want to donate organs or tissue?
Stating your wishes about organ and tissue donation is optional. An advance directive is one place to express your feelings or values about organ and tissue donation.
Can I decide whether or not I want an autopsy performed on my body?
Yes, you can state your wishes about autopsy in your advance directive.
How do I make my advance directive a legal document?
After you complete your power of attorney for healthcare, sign it in the presence of two witnesses. The date of your signature and theirs must be the same. You may bring your document to Gundersen Health System for witnessing.
When can my healthcare agent make my medical decisions?
Agents can only make healthcare decisions if you are unable to decide for yourself. How this is decided varies from state to state. In Wisconsin, either two doctors or a doctor and a psychologist must agree you are incapable. In Iowa and Minnesota, incapacity is determined by one doctor.
What should I do when I travel?
Carry a wallet card that tells health professionals you have a power of attorney for healthcare and where it is on file.
Will my advance directive be followed in other states?
Most states recognize valid advance directives from other states. If you have an advance directive from another state, show it to your healthcare provider. He or she can help you find out if it is valid where you now receive medical care. If you plan to reside in a new state, think about completing a new advance directive that will be valid there.
Does my family already have authority to make my decisions for me?
Family members are not automatically granted the right to make healthcare decisions for you. This varies from state to state. Laws in the state where you receive treatment can affect who is allowed to make treatment decisions for you. The only way to be sure a family member can make healthcare choices on your behalf is to name him or her as a healthcare agent in your POAHC.
When should I update my power of attorney for healthcare?
Review it every 5 to 10 years or if there is a significant change in your life. Think of "The five D's" as a guide of when to update.
- Death of a loved one
What is a Provider Orders for Scope of Treatment (POST) form?
A Provider Orders for Scope of Treatment form is completed by a patient and doctor, and used as guidelines for treatment for emergency situations in the community setting. For more information, view POST form information.