Free Louisiana Living Will Template

Free Louisiana Living Will Template

The Louisiana Living Will form is a legal document enabling individuals to outline their preferences for medical treatment in the event they become unable to communicate their decisions themselves. It represents a person's desire regarding life-sustaining procedures, including the use of ventilators and resuscitation efforts, when faced with a terminal condition or irreversible coma. To ensure your healthcare wishes are known and respected, consider filling out the form by clicking the button below.

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When it comes to planning for the future, especially when considering end-of-life care, the Louisiana Living Will form provides a vital legal tool for individuals to outline their healthcare preferences. This form allows residents of Louisiana to specify what medical treatments they do or do not want to undergo if they become unable to make decisions for themselves due to illness or incapacity. It acts as a clear directive to family members and healthcare providers, ensuring that the individual's wishes are respected even when they cannot voice them. Understanding how to prepare and what to include in this document is crucial, as it covers various aspects, from life-sustaining treatments to pain management preferences. Completing a Living Will is a significant step in estate planning, offering peace of mind to both the person it concerns and their loved ones, by affirming that personal healthcare choices will be honored.

Louisiana Living Will Example

Louisiana Living Will Template

This Living Will is designed to reflect the desires of the undersigned regarding medical treatment preferences in the event that they become unable to communicate these wishes directly. This document is created in accordance with the Louisiana Health Care Directive Act.

Personal Information

Full Name: ___________________________________

Date of Birth: _______________________________

Address: _____________________________________

City: ________________________________________

State: Louisiana

Zip Code: ____________________________________

Primary Phone: _______________________________

Email Address: _______________________________

Health Care Directive

I, ___________________________________ [your name], a resident of Louisiana, hereby issue this Living Will to explicitly state my wishes regarding medical treatment under circumstances where I am no longer able to express consent.

Should I be in a state wherein my attending physician, in consultation with another physician, determines my condition to be either:

  • Terminal and incurable; or
  • I am in a persistent vegetative state;

I direct the following regarding the extension of my life:

  1. Life-Sustaining Treatment: I wish to ________ (receive/decline) life-sustaining treatments that serve only to prolong the process of dying if I am in a terminal condition or in a persistent vegetative state. Life-sustaining treatment includes, but is not limited to, mechanical ventilation, dialysis, artificial nutrition, and hydration.
  2. Artificial Nutrition and Hydration: I wish to ________ (receive/decline) artificially supplied food and water if I am unable to take sustenance by mouth, except as indicated by my specific preferences detailed below.

Specific Preferences

Here, you may provide any specific preferences or particular treatments you want to receive or refuse that haven't been covered above:

________________________________________________________________________________________________________________________________

Primary Physician

Name: _______________________________________

Phone: ______________________________________

Alternate Physician

Name: _______________________________________

Phone: ______________________________________

Signature

By signing below, I affirm that I fully understand the contents of this document and the implications of declaring such directives regarding my health care. I also affirm that this declaration accurately reflects my desires concerning treatment decisions.

Signature: _______________________________ Date: ________________

Print Name: ______________________________

Witness Declaration

This document was signed in my presence. The signatory appeared to be of sound mind and under no duress, fraud, or undue influence. I am not the person's attending physician, an employee of the attending physician, nor have any claim against the person's estate upon death.

Witness 1 Signature: ___________________________ Date: ________________

Print Name: ___________________________________

Witness 2 Signature: ___________________________ Date: ________________

Print Name: ___________________________________

PDF Overview

Fact Description
Purpose The Louisiana Living Will form allows individuals to declare their wishes regarding medical treatment in situations where they are unable to communicate their decisions due to illness or incapacity.
Governing Law The Louisiana Living Will is governed by the Louisiana Revised Statutes, specifically La. R.S. 40:1151-1163, known as the Louisiana Declaration Concerning Life-Sustaining Procedures Act.
Witness Requirement The form must be signed in the presence of two witnesses who are not related by blood or marriage to the declarant and who will not benefit from the death of the declarant.
Notarization While notarization is not required by Louisiana law for a living will to be valid, it is recommended to notarize the document to add an additional layer of legal protection.
Revocation The declarant can revoke the Louisiana Living Will at any time, regardless of the declarant's physical or mental condition, by a signed and dated writing, by physically destroying the original document, by an oral expression of the intent to revoke, or by creating a new living will that contradicts the old one.

Louisiana Living Will: Usage Steps

A Louisiana Living Will is an important legal document that allows individuals to outline their preferences for medical treatment in the event they are unable to communicate their decisions due to illness or incapacity. This document is also referred to as an advance directive. Preparing a Living Will can provide peace of mind for both you and your loved ones by ensuring that your healthcare wishes are known and can be followed. Let's walk through the steps needed to properly complete this form.

To fill out the Louisiana Living Will form, follow these steps:

  1. Gather Required Information: Before you start, make sure you have all the necessary information, including your personal details (name, address, date of birth), and the details of your healthcare representative (if you choose to appoint one), including their name, relationship to you, and contact information.
  2. Read the Form Carefully: Take your time to read through the entire form to understand the scope and implications of the decisions you're about to make. This ensures that your choices align with your values and wishes.
  3. Specify Your Treatment Preferences: Clearly indicate your wishes regarding life-sustaining treatments, including resuscitation, mechanical ventilation, and artificial nutrition and hydration, among others. Be as specific as possible to avoid any ambiguity.
  4. Appoint a Healthcare Representative: If you want someone to make healthcare decisions on your behalf when you're unable to do so, fill in the section designated for appointing a healthcare representative. Include all required details.
  5. Sign the Form: In Louisiana, your Living Will needs to be either notarized or signed in front of two witnesses who are not related to you by blood or marriage and who do not stand to inherit from you. Make sure this step is completed according to the state requirements.
  6. Store Your Living Will Safely: Once the form is completed and signed, store it in a safe place. Also, it's a good idea to give copies to your healthcare representative (if you have one), close family members, and your primary care physician.
  7. Review Periodically: Your preferences for medical treatment may change over time. Review and possibly update your Living Will periodically to ensure it still reflects your current wishes.

Completing a Louisiana Living Will is a straightforward process, but the decisions you make can have significant implications. It's advisable to discuss your wishes with your loved ones and consult with a healthcare professional or an attorney if you have questions. This proactive step ensures your healthcare priorities are respected and understood by everyone involved.

Your Questions, Answered

What is a Louisiana Living Will?

A Louisiana Living Will is a legal document that allows an individual to outline their wishes regarding medical treatment in the event that they become unable to communicate or make decisions for themselves due to illness or incapacity. This form typically addresses scenarios involving life-sustaining treatments, resuscitation, and the use of mechanical ventilation, among others.

Who should have a Louisiana Living Will?

Any competent adult in Louisiana who wishes to have control over their medical treatment in scenarios where they might not be able to express their wishes should consider creating a Living Will. It is a proactive step to ensure one's healthcare preferences are known and respected, regardless of future health conditions or unexpected medical emergencies.

How can I create a Louisiana Living Will?

To create a Louisiana Living Will, one must complete the specific form designed to capture their healthcare preferences in detail. This form should be filled out clearly and accurately reflect the individual's wishes. Once completed, it must be signed in the presence of two witnesses, who also need to sign the document, making it legally binding. Consulting with a healthcare provider and a legal professional can also provide valuable insights and ensure the document's completeness and compliance with Louisiana laws.

Are there any specific requirements for witnesses of a Louisiana Living Will?

Yes, Louisiana law requires that the witnesses to a Living Will be competent adults. Importantly, these witnesses cannot be individuals who have a financial interest in the death of the person creating the Living Will, such as heirs or beneficiaries of life insurance policies. Additionally, healthcare providers who are currently treating the patient should not serve as witnesses to avoid any potential conflict of interest.

What happens if I change my mind after creating a Louisiana Living Will?

Individuals are free to revoke or amend their Louisiana Living Will at any time. To revoke, one can either create a new document that outlines different wishes, or they can explicitly express their intent to revoke the previous document through a written declaration, signified by their signature and date. Communicating these changes to healthcare providers and ensuring all old copies are replaced or destroyed is crucial to prevent confusion.

Is a Louisiana Living Will the same as a Medical Power of Attorney?

No, a Louisiana Living Will and a Medical Power of Attorney serve different purposes. A Living Will specifically outlines an individual's preferences regarding medical treatments under certain conditions. In contrast, a Medical Power of Attorney designates another person to make healthcare decisions on behalf of the individual, should they become unable to do so themselves. While both are essential components of advance healthcare planning, they address distinct aspects of healthcare decision-making.

How does a Louisiana Living Will come into effect?

A Louisiana Living Will becomes effective when the individual becomes incapacitated and is unable to communicate or make decisions regarding their medical care. A physician must certify the individual's incapacity. Once in effect, healthcare providers are legally obligated to follow the instructions outlined in the Living Will, as long as these instructions comply with Louisiana law and medical standards.

Can a Louisiana Living Will be used to refuse all medical treatment?

Yes, a Louisiana Living Will can specify a preference to refuse all medical treatments, including life-sustaining measures such as artificial ventilation or feeding tubes. However, it cannot be used to authorize anything illegal, such as euthanasia. The purpose of a Living Will is to respect the individual's healthcare preferences, including the refusal of treatment under certain conditions.

What should I do with my completed Louisiana Living Will?

Once a Louisiana Living Will is completed and signed, it is advisable to provide copies to a trusted family member or friend, your designated healthcare proxy (if you have one), and your primary healthcare providers. It's also beneficial to keep a copy in a safe but accessible place and consider registering it with any existing state registries or electronic medical records systems to ensure its availability when needed.

Common mistakes

Filling out a Louisiana Living Will form can seem straightforward, but mistakes can easily be made. These errors can complicate your wishes being followed in the manner you intended. Understanding common pitfalls can ensure that your living will reflects your wishes accurately and is legally sound.

One common error is neglecting to include all necessary personal information. The form requires details such as full name, address, and date of birth. Overlooking even one of these can render the document incomplete or cause confusion about whose wishes are being expressed.

Another mistake is not being specific about medical treatments you do or do not want. A living will is designed to communicate your wishes regarding life-sustaining treatments if you are unable to do so yourself. Being vague about your preferences can leave healthcare providers uncertain about your care, potentially leading to decisions that contradict your desires.

A critical oversight is failing to update the document following significant life changes, such as marriage, divorce, or a change in health status. What was once a true reflection of your wishes may not apply under new circumstances. Regularly reviewing and updating your living will ensures it always aligns with your current desires.

Not discussing your wishes with family members and your healthcare proxy is a significant misstep. These conversations ensure that those involved in your care understand your preferences and are prepared to advocate for them, reducing potential conflicts or confusion when the document needs to be enacted.

Improper witnessing or notarization can invalidate the document. Louisiana law has specific requirements for witnessing and notarization that must be followed for the living will to be legally binding. Ignoring these protocols can mean that your living will is not acknowledged by healthcare providers or might be contested by family members.

Many individuals mistakenly believe one copy of the form is sufficient. However, having multiple copies and ensuring they are accessible—to your healthcare proxy, family members, and primary care physician—guarantees that your wishes are known and can be acted upon promptly.

Selecting the wrong person as your healthcare proxy, or not appointing one at all, can be a grave error. The appointed proxy should be someone who understands your values and is willing and able to make healthcare decisions on your behalf. A poor choice can lead to decisions that are against your wishes.

Lack of specificity about when the living will should take effect is another common error. It is crucial to clarify under what circumstances you want your living will to guide your medical care. Without this guidance, your healthcare providers might be hesitant to rely on your living will.

Assuming that all healthcare providers will automatically honor your living will can lead to unmet expectations. It is necessary to discuss your living will with your healthcare providers and confirm they are willing to follow your directives. Some may have policies or personal beliefs that could interfere with honoring your wishes as stated.

Last but not least, failing to legally finalize the document by not correctly signing and dating it in front of the required witnesses or notary, as per Louisiana law, can result in the entire living will being considered invalid. This final step is crucial to ensure that your end-of-life wishes are respected and carried out.

Avoiding these common mistakes can help ensure that your Louisiana Living Will form is a clear, legally binding document that accurately reflects your end-of-life wishes. Being thorough and thoughtful in preparing your living will can provide peace of mind to you and your loved ones.

Documents used along the form

When individuals in Louisiana decide to create a Living Will, they often find it beneficial to complement this document with additional forms to ensure a comprehensive approach to their health care and estate planning. A Living Will itself is designed to express an individual’s wishes regarding medical treatment in circumstances where they are unable to communicate those wishes directly. The following forms and documents are commonly used alongside a Louisiana Living Will to provide a well-rounded and thorough plan for future healthcare decisions and to ensure personal wishes are respected and followed.

  • Durable Power of Attorney for Health Care: This legal document allows an individual to appoint someone they trust to make health care decisions on their behalf if they become incapacitated. This representative’s authority can include decisions beyond those covered in the Living Will.
  • General Durable Power of Attorney: Beyond health care decisions, this document grants a designated person the authority to handle a wide range of actions, such as financial matters, legal decisions, and other personal affairs, in the event of the principal's incapacity.
  • HIPAA Release Form: The Health Insurance Portability and Accountability Act (HIPAA) protects a person's medical records and personal health information. A HIPAA release form grants doctors permission to discuss the individual’s medical information with specified persons, typically including those named in the Living Will and Durable Power of Attorney for Health Care.
  • Declaration of Mental Health Treatment: This document dictates preferences regarding mental health treatment, such as medications, hospitalization, and psychotherapy, in instances where the individual can’t make these decisions themselves.
  • Do Not Resuscitate (DNR) Order: A DNR order is a request not to have CPR (cardiopulmonary resuscitation) if the heart stops or if breathing stops. This document is signed by a doctor and often discussed when preparing a Living Will.
  • Organ and Tissue Donation Registration: This allows individuals to specify their wishes regarding organ donation upon death. This choice can also be documented in the Living Will but may require registration with the state’s donor registry for clarity and legality.
  • Funeral and Burial Instructions: While not always a legal document, specifying wishes for funeral arrangements and burial or cremation can be a part of comprehensive end-of-life planning. These wishes can alleviate the burden on family members during a difficult time.

Complementing a Louisiana Living Will with these documents can provide a complete and clear directive regarding an individual’s preferences and instructions for various aspects of care and handling of their affairs in the future. It encourages discussions with loved ones about difficult topics, making it easier for them to make decisions that align with the individual's wishes during times of crisis or incapacity. Consulting with a legal professional can help in understanding these documents better and ensuring they are properly executed.

Similar forms

  • Healthcare Proxy: Similar to a Living Will, a Healthcare Proxy allows an individual to appoint someone to make health care decisions on their behalf should they become incapacitated. Both documents serve to ensure that medical treatment aligns with the person’s wishes when they're unable to communicate these preferences themselves.

  • Durable Power of Attorney for Healthcare: This document is akin to a Living Will in that it designates a proxy to make decisions about medical care. However, it is broader, allowing the proxy to make decisions about the entirety of a person’s healthcare, not just end-of-life care, which is typically the focus of a Living Will.

  • Advance Directive: An Advance Directive is a broad term that encompasses Living Wills and other healthcare directives, including the designation of a healthcare proxy. This document outlines treatments an individual wants or doesn't want in certain medical situations, helping guide healthcare providers and loved ones.

  • Do Not Resuscitate (DNR) Order: A DNR is similar to a Living Will in its focus on a specific medical decision, namely not to administer CPR if the heart stops or if breathing ceases. Like a Living Will, it is a directive meant to guide healthcare providers based on an individual’s preferences.

  • Medical Orders for Life-Sustaining Treatment (MOLST or POLST): Similar to a Living Will, these orders are designed to communicate an individual’s preferences for end-of-life care across different healthcare settings, not just the hospital. They are more detailed and are filled out by a healthcare professional in consultation with the patient.

  • Last Will and Testament: While differing in purpose — a Last Will and Testament deals with the distribution of an individual’s estate after death — it is similar to a Living Will in providing instructions that are meant to be followed upon the individual’s death, ensuring their wishes are respected.

  • Financial Power of Attorney: Even though this document concerns financial decisions, it is similar to a Living Will in that it designates someone to act on the individual’s behalf if they are unable to do so. Both documents ensure that important decisions align with the person’s wishes, maintaining their autonomy during incapacitation.

Dos and Don'ts

In Louisiana, a Living Will is a legal document that allows you to express your wishes about medical treatment in the event that you become unable to communicate due to illness or incapacity. When filling out a Louisiana Living Will form, it's important to be thorough and thoughtful. Below are some essential dos and don'ts to consider:

Do:
  1. Read the form carefully before you start writing. Understanding each section ensures that you accurately express your wishes.

  2. Talk to your family and loved ones about your decisions. This can help prevent confusion or conflict later on.

  3. Consult with a healthcare professional if you have questions about the medical terminology and treatment options mentioned in the form. Their insights can help you make informed decisions.

  4. Be as specific as possible about your wishes regarding life-sustaining treatments, including mechanical ventilation, resuscitation, and artificial hydration and nutrition.

  5. Sign and date the form in the presence of two witnesses who meet the requirements set forth by Louisiana law. The witnesses cannot be heirs or related to you by blood or marriage, and they should not be involved in your healthcare.

  6. Keep the original signed form in a safe but accessible place, and give copies to your primary care physician, a trusted family member, and your healthcare proxy, if you have appointed one.

Don't:
  1. Rush through the process. Take your time to consider each decision carefully.

  2. Use vague language. Unclear statements can lead to differing interpretations of your wishes.

  3. Forget to update your Living Will. As your health status or preferences change, make sure your document reflects these changes.

  4. Leave sections blank. If a section does not apply, it's better to write "N/A" or "Not Applicable" instead of leaving it empty. This shows that you did not overlook the section.

  5. Fail to notify your family or healthcare proxy about where you keep your Living Will. They should know its location to ensure your wishes are honored.

  6. Assume that your doctor knows your wishes without discussing them. A direct conversation paired with providing a copy of your Living Will is the best approach.

Misconceptions

When it comes to planning for the future, especially regarding healthcare decisions, it's crucial to have accurate information. In Louisiana, the Living Will form is a legal document that allows individuals to outline their wishes for medical treatment if they're unable to communicate those wishes themselves. However, there are several misconceptions about this document that can lead to confusion. Let's address some of these misconceptions to provide clarity.

  1. Only the Elderly Need a Living Will: Many believe that living wills are only for the elderly. However, unexpected medical situations can happen to anyone at any age. A living will ensures that your healthcare preferences are known and respected, no matter your age.

  2. It Disallows All Medical Treatment: Some think that a living will automatically means no medical treatment will be provided. In reality, it allows you to specify which treatments you do or do not want, including life-sustaining measures.

  3. You Can't Change It Once It's Done: Another misunderstanding is that a living will is set in stone once it's signed. You can update or revoke your living will at any time as your wishes or circumstances change.

  4. Living Wills and Last Wills are the Same: People often confuse living wills with last wills and testaments. A living will deals with healthcare decisions, while a last will addresses the distribution of your estate after death.

  5. It Requires a Lawyer to Create: While consulting with a lawyer is advisable for any legal document, you can complete a living will without one. Louisiana provides forms and guidelines to help individuals create their own living wills.

  6. Your Family Knows What You Want: Assuming family members will know your medical treatment preferences without a living will can lead to stress and conflict. A living will communicates your wishes clearly, reducing the burden on your loved ones.

  7. It's Too Expensive: The belief that creating a living will is costly prevents many from completing one. However, the process can be affordable, especially if you utilize available resources and forms provided by the state.

  8. A Living Will Means No Emergency Treatment: Some fear that having a living will means emergency responders will not provide life-saving treatment. In truth, emergency medical personnel are focused on stabilizing patients, and living wills come into play once the patient is under hospital care.

  9. Living Wills Are Only for Terminal Illnesses: While it's commonly thought that living wills are only for terminal conditions, they actually cover a range of situations where you might be unable to make or communicate decisions about your medical care.

Understanding the truth behind these misconceptions can empower individuals to make informed decisions about their healthcare wishes. A living will can be a valuable part of healthcare planning, providing peace of mind for both you and your family.

Key takeaways

When considering the preparation and application of a Louisiana Living Will form, it’s essential to understand its significance and the proper steps to ensure it effectively represents your wishes regarding medical treatment. Here are key takeaways to guide individuals in the process:

  • Understanding the Purpose: A Louisiana Living Will allows individuals to document their preferences for medical treatment in the event they become unable to communicate or make decisions due to a serious health condition. It's a legal document that speaks for you, ensuring your medical treatment preferences are honored.
  • Legally Binding Document: Once properly filled out and executed according to Louisiana state laws, the Living Will becomes a legally binding document. This means healthcare providers are required to follow the instructions provided in the document, as long as they comply with the law. It’s important to be thorough and precise in detailing your wishes.
  • Requirements for Execution: To ensure the Louisiana Living Will form is legally binding, it must be signed in the presence of two witnesses who are not your heirs or beneficiaries. This step is crucial for the document to be recognized under Louisiana law. The witnesses must also meet certain criteria, emphasizing the importance of understanding these requirements before executing the document.
  • Review and Update: Life circumstances and preferences change, which means it’s important to review and possibly update your Living Will periodically. This might be due to changes in health status, family dynamics, or even evolving medical technologies and treatment options. Revisiting your Living Will ensures it accurately reflects your current wishes and circumstances.

Adhering to these key takeaways can provide peace of mind, knowing that your wishes regarding medical treatment will be respected, especially when you cannot voice them yourself. Ensuring your Living Will is properly executed and up to date is an essential step in personal and medical planning in Louisiana.

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