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Advance Directives

Making decisions about your health care before you become sick or hurt is the best way to protect your rights as a patient.

Advance directives are printed documents that allow you to specify the type and kind of medical care you would want in the future in case you are unable to communicate your wishes.

You can appoint someone to make health care decisions on your behalf if you become incapable of making them yourself. This person has absolutely no authority to make any decisions on your behalf until a point at which you become unable to make decisions for yourself. THESE DIRECTIVES CAN BE CHANGED OR REVOKED BY YOU (the patient) AT ANY POINT.

Berlin Memorial Hospital wants you to be aware of your right to formulate an advance directive document.

As part of your admission assessment, your nurse will ask if you have formulated an advance directive or if you would like information about advance directives. If you have already completed an advance directive, please be certain that a copy is provided to the hospital and to your physician’s office.

If you would like more information about Wisconsin’s legally sanctioned advance directives, your nurse will provide you with the booklet, “Power of Attorney For Health Care in Wisconsin.” The booklet contains forms for both the Durable Power of Attorney for Health Care and Living Will, as well as information to assist you in completing the forms of your choice. An informational video is also available upon request. If, after reading the booklet and viewing the video, you still have specific questions about Wisconsin’s Advance Directives laws, please contact our Social Services Department at 361-5562 or 361-5563.

The State of Wisconsin also has a law regarding emergency “Do Not Resuscitate” orders. Qualified persons may obtain an order from their primary care physician enabling the person to obtain a special bracelet. The bracelet indicates to all emergency personnel (including ambulance and emergency staff) that the wearer does not want to be resuscitated if he or she stops breathing or his or her heart stops. The Wisconsin law defines who may be considered a qualified patient as someone at least 18 years of age, not pregnant, and meeting one of three other qualifications. For additional information, please ask your physician or nurse.

It is the policy of Berlin Memorial Hospital to comply with the terms of your legally executed advance directive document in the event that you become incapacitated. If your physician cannot, for conscience reasons, comply with your directive, he or she may refer you to another physician who will. Your advance directive document will be implemented only if you have been judged to be incapacitated by legal standards; you always retain the right to participate in planning for your care and your right to refuse medical treatment as long as you are competent to do so.

The decision to formulate an advance directive is entirely yours. Berlin Memorial Hospital will always provide the same quality of care and treatment whether or not you choose to formulate an advance directive.

For more information on Advance Directives visit the Wisconsin Department of Health Services [click]

Advance Directive Forms - click


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