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Barriers to Completing Advance Care Planning: Insights From the Wausau Free Clinic

Grace F Wittenberg^1,2, Lauren Woyak³, Jeffrey Todd²

¹Department of Regional Campuses, Medical College of Wisconsin-Central Wisconsin, Wausau, Wisconsin, wittenberggrace@gmail.com.

WMJ : Official Publication of the State Medical Society of Wisconsin

|September 15, 2025

Abstract

Background:

Advance care planning (ACP) encourages individuals to express their health care wishes should they become incapacitated and to use an advance directive to designate an individual to make health care decisions on their behalf.

Methods:

A survey on ACP was administered at the Wausau Free Clinic in Wausau, Wisconsin in English or Spanish to participants 18 or older from February to May 2023.

Results:

Of 46 respondents, 80% had not heard of ACP. One in 10 said a physician had had a conversation with them about ACP. Health care access and lack of education were the biggest challenges to ACP.

Discussion:

Most individuals who utilize the clinic were unaware of ACP. Wisconsin is not a "next of kin" state, which increases the importance of ACP completion.

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