Advance Directives

Make your Decisions Known

At CHI Health, we are committed to hearing the voice of our patients throughout their care. We know there are times when our patients cannot make their own decisions known because of their illness or situation. At these times, Advance Directives documents can be helpful tools for those making healthcare and treatment decisions on the patient’s behalf. All adult patients are encouraged to complete their Advance Directives documents, and are asked to bring copies with them when they visit any of our facilities.

Because making healthcare decisions is an important matter, we recommend that you talk to your physician and those close to you about your values and your healthcare wishes. You may also want to consult an attorney, but there is no legal requirement to do so in order to complete Advance Directives.

Once you have completed your Advance Directives documents, be sure to give copies to those close to you, to your physician and to any healthcare facility in which you receive care (such as a hospital.). Be sure to provide updated copies should your wishes change in the future.

The Advance Directives booklets are available in several languages and include forms you can use to complete your own Advance Directives documents. Please note these forms are not exclusive to CHI Health and can be used at any health care organization in Nebraska and Iowa.

Common Types of Information in Advance Directives

Durable Power of Attorney for Health Care

Information about who you want to make healthcare and treatment decisions on your behalf when you cannot make them yourself. This person is known as your surrogate decision-maker (or your "Attorney-in-Fact").

Durable Power of Attorney for Mental Health Care

Information about who you want to make decisions on your behalf specifically for your mental healthcare and treatment needs. Generally, if you do not name someone to make decisions specifically for your mental healthcare and treatment needs, the person(s) named as your surrogate decision-maker(s) for your general healthcare and treatment needs can make these decisions on your behalf. 

Living Will Declaration

Information about your preferences for life-sustaining treatments and end of life care if you are in a terminal condition, a persistent vegetative state, or a state of permanent unconsciousness from which you will not likely recover.

Five steps for Advance Directives:

1. Learn more about Advance Directives
   • Advance Directives Resource Page
   • Think about what you might want your treatment to be like in certain medical circumstances, particularly about your care if you have a life-limiting illness. This might include exploring your preferences regarding CPR, meeting your nutritional needs, understanding what to expect and what can provide comfort. Talk with your health care provider or contact the Ethics Center for more information.
2. Select your Representative/surrogate
   • Resource: Selecting a Surrogate Decision-maker
   • When you think about who you want to represent your voice in decision-making when you cannot, you should:
     • Select someone you trust
     • Select someone who knows your values, beliefs and wishes
     • Select someone who can be available to your care team
     • Select someone who is willing to be your representative
3. Complete your Advance Directives documents
   • Resource: Advance Directives forms are available in the booklet and online.
   • Once you’ve completed your Advance Directives documents, be sure to give copies to:
     • Your provider(s)
     • The person(s) you name as your surrogate/representative
     • Others who you want to know your preferences
     • Carry a copy of the Advance Directives Wallet Card with you in a wallet, purse or glove compartment
4. Talk to your surrogate, loved ones and your providers about your wishes
   • Resource: Conversation Starter
5. Review your Advance Directives periodically to be sure they are current
   • Annually as New Year’s Resolution
   • Before annual physicals
   • Any time your preferences or contact information for your representatives/surrogate changes.