Living Will Forms: Advance Directives Explained

What Is a Living Will?

A living will, also known as an advance directive, is a written statement of your wishes regarding medical treatments if you are incapacitated. It typically covers life-sustaining measures like CPR, mechanical ventilation, tube feeding, and dialysis. The document becomes active only when you cannot express your own decisions.

Living wills are not the same as a last will and testament, which deals with property after death. They also differ from a durable power of attorney for health care, which names someone to make decisions for you. Some states combine both into a single advance directive form.

The legal requirements for living wills vary by state. Most states require your signature and that of a notary or witnesses. Some states have specific forms that must be used, while others accept any clear expression of your wishes. Always check your state's rules.

• States with statutory forms: Many states provide official forms that are legally recognized.
• Witness requirements: Usually one or two adult witnesses, or a notary public.
• Revocation: You can revoke or change your living will at any time.
• Emergency situations: Paramedics may not be able to honor it; they must provide life-saving care.
• Doctor's role: Physicians are generally required to follow the document or transfer care.

Why You Need a Living Will

Without a living will, your family may face difficult decisions without guidance. They might disagree about what you would have wanted. This can lead to stress and guilt during an already emotional time.

A living will ensures your wishes are known and respected. It gives you control over your medical care, even when you cannot speak. It also relieves your loved ones of the burden of guessing your preferences.

Consider your personal values. Some people want every possible treatment to prolong life. Others prioritize comfort and dignity. A living will lets you document these choices clearly, so your care aligns with your beliefs.

• Avoid family disputes: Clear instructions reduce conflict.
• Prevent unwanted treatment: You can refuse aggressive measures you do not want.
• Ensure quality of life: Specify what quality of life means to you.
• Peace of mind: Knowing your wishes are recorded brings comfort.

What to Include in a Living Will

Start with your personal information: full legal name, date of birth, and address. Then state your general philosophy about medical care. For example, you might say you value extending life, or you prioritize comfort and pain relief.

Address specific treatments. Indicate your preferences for CPR, mechanical ventilation, tube feeding, and organ donation. You can also include wishes about pain management, even if it may hasten death.

Consider adding a statement about pregnancy. Some states restrict living wills for pregnant women. You may want to specify your wishes if you are pregnant and incapacitated.

Include a durable power of attorney section if your state allows it. This names a health care agent who can make decisions not covered in your living will. This person should understand your values and be willing to advocate for you.

• Life-sustaining treatments: CPR, ventilator, dialysis, surgery.
• Artificial nutrition and hydration: Tube feeding and IV fluids.
• Pain relief: Medications that may affect consciousness.
• Organ and tissue donation: Your preferences.
• Funeral and burial wishes: Some states allow you to include these.

How to Create a Living Will

First, research your state's requirements. Visit your state's attorney general or health department website. Many provide free forms and instructions. You can also use reputable online services that generate state-specific forms.

Fill out the form carefully. Be specific about your wishes. Avoid vague language like 'no heroic measures.' Instead, say 'I do not want CPR if my heart stops.' This clarity helps doctors and family understand your intent.

Sign the document in the presence of required witnesses or a notary. Your witnesses should not be family members or anyone who might inherit from you. They must be adults and competent.

Once signed, make copies. Give one to your primary care doctor, one to your health care agent, and one to a trusted family member. Keep the original in a safe but accessible place. Do not lock it in a safe deposit box where it cannot be found quickly.

• Use a state-specific form: This ensures compliance with local law.
• Review and update: Revisit your living will every few years or after major life events.
• Talk to your doctor: Discuss your wishes to ensure they are feasible.
• Share with loved ones: Make sure they know where the document is and what it says.
• Carry a card: Some people keep a wallet card noting they have a living will.

Living Will vs. Other Advance Directives

A living will is one type of advance directive. Another common type is a durable power of attorney for health care, also called a health care proxy. This document appoints someone to make decisions for you, but it does not specify treatments.

Some states have combined forms that include both a living will and a health care proxy. This is often called an advance health care directive. Using a combined form can be more comprehensive and easier to manage.

A do-not-resuscitate (DNR) order is a different document. It is a medical order from a doctor that tells emergency responders not to perform CPR. A living will may include a DNR request, but you might also need a separate DNR form for out-of-hospital settings.

Understand the differences. A living will speaks for you when you cannot. A health care proxy appoints a spokesperson. Both are valuable, and using them together provides the most complete protection.

• Living will: Written instructions about treatments.
• Health care proxy: Named person to make decisions.
• Combined directive: Includes both instructions and a proxy.
• DNR order: Do-not-resuscitate instruction for medical personnel.
• Physician orders for life-sustaining treatment (POLST): A medical order for seriously ill patients.

Common Mistakes to Avoid

One common mistake is not updating the document after a major life change, like a divorce or a diagnosis. Your wishes may change, and an outdated living will might not reflect your current values.

Another mistake is being too vague. Phrases like 'if I have no chance of recovery' can be interpreted differently. Define what recovery means to you. Specify conditions like terminal illness, permanent unconsciousness, or severe brain damage.

Failing to discuss your wishes with your family is also a problem. Even with a written document, your loved ones need to understand your reasoning. They may have to advocate for you, so they should be prepared.

Finally, do not forget to sign and witness the document. An unsigned living will is invalid. Also, make sure your witnesses meet legal requirements. If you are unsure, consult a lawyer or a legal aid service.

• Not updating after life changes.
• Using vague language.
• Not talking to family.
• Forgetting to sign or notarize.
• Keeping the document in an inaccessible place.