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Living Will Declaration

This Living Will is being created in accordance with the laws of [State Name]. It serves to outline my preferences regarding medical treatment in the event that I am unable to communicate my wishes.

I, [Your Full Name], born on [Your Date of Birth], residing at [Your Address], declare this Living Will on this [Date].

In the event that I become terminally ill, comatose, or in a persistent vegetative state, I desire the following medical treatments:

  • If I am unable to make my wishes known, I do not want to receive life-sustaining treatment that only prolongs the dying process.
  • I wish to receive comfort care to relieve pain and suffering.
  • If I am capable of communicating, I prefer to discuss any treatment options directly with my healthcare provider.

Furthermore, I wish to specify my preferences concerning the following:

  1. Resuscitation: I do not wish to have cardiopulmonary resuscitation (CPR) performed if my heart stops or I stop breathing.
  2. Mechanical Ventilation: I do not wish to be placed on a ventilator if I am unable to breathe on my own.
  3. Tube Feeding and Hydration: I do not wish to receive artificial nutrition and hydration if I am not expected to recover.

This Living Will reflects my preferences as of today and supersedes any previous declarations I may have made. I understand that I may revoke or change this document at any time while I am still competent.

Signed:

[Your Signature]

Date: [Date]

Witnesses:

It is required to have two adult witnesses sign below, affirming that I appear to be of sound mind and under no duress during the signing of this document.

  • Witness 1 Name: ________________________
  • Witness 1 Signature: _____________________
  • Date: ________________________________
  • Witness 2 Name: ________________________
  • Witness 2 Signature: _____________________
  • Date: ________________________________

Please ensure that copies of this document are provided to my healthcare provider and any family members involved in my care.

Documents used along the form

A Living Will is an important document that outlines an individual's preferences regarding medical treatment in the event they become unable to communicate their wishes. However, it is often used alongside several other forms and documents that can help clarify a person's healthcare decisions and financial matters. Below is a list of commonly associated documents that complement a Living Will.

  • Durable Power of Attorney for Healthcare: This document allows an individual to designate someone else to make healthcare decisions on their behalf if they are unable to do so. It is crucial for ensuring that a trusted person can advocate for the patient's wishes.
  • Do Not Resuscitate (DNR) Order: A DNR order instructs medical personnel not to perform CPR if a patient's heart stops beating. This document is specific to resuscitation efforts and can be vital in emergency situations.
  • Health Care Proxy: Similar to a Durable Power of Attorney, a health care proxy appoints an individual to make medical decisions for someone else. This document is particularly useful when immediate decisions are required.
  • Advance Directive: An advance directive is a broader term that encompasses both Living Wills and Durable Powers of Attorney for Healthcare. It serves as a comprehensive guide for medical decisions and preferences.
  • Physician Orders for Life-Sustaining Treatment (POLST): This form translates a patient's preferences regarding life-sustaining treatment into actionable medical orders. It is often used for patients with serious illnesses.
  • Financial Power of Attorney: This document allows an individual to appoint someone to manage their financial affairs. It is important for ensuring that financial decisions can be made in the event of incapacitation.
  • Organ Donation Form: This form indicates a person's wishes regarding organ donation after death. It can provide clarity for family members and medical professionals at a critical time.
  • Durable Power of Attorney: This essential document allows an individual to designate another person to make decisions on their behalf, especially in instances where they are unable to do so themselves. It serves as a crucial means for individuals to ensure their affairs are managed according to their wishes should they become incapacitated. For more information, you can refer to the Durable Power of Attorney.
  • Funeral Planning Document: While not legally binding, this document outlines a person's wishes for their funeral and burial arrangements. It can alleviate stress for loved ones during a difficult time.

By utilizing these documents alongside a Living Will, individuals can create a comprehensive plan that addresses both their medical and financial needs. This proactive approach can provide peace of mind and ensure that their wishes are respected in times of crisis.

Similar forms

  • Advance Directive: Like a Living Will, an Advance Directive allows individuals to outline their healthcare preferences in case they become unable to communicate. It can include both medical treatment preferences and appoint a healthcare proxy.
  • Durable Power of Attorney for Health Care: This document designates someone to make medical decisions on your behalf if you are unable to do so. It complements a Living Will by providing a trusted person to interpret and apply your wishes.
  • Do Not Resuscitate (DNR) Order: A DNR order specifically instructs medical personnel not to perform CPR if your heart stops or you stop breathing. It is a more focused document that aligns with the intentions expressed in a Living Will.
  • Health Care Proxy: Similar to the Durable Power of Attorney, a Health Care Proxy allows you to appoint someone to make healthcare decisions for you. This document can work alongside a Living Will to ensure your choices are honored.
  • Transfer-on-Death Deed: This document allows property owners in Arkansas to transfer real estate directly to beneficiaries upon their death, bypassing probate and simplifying the inheritance process. For more information, visit transferondeathdeedform.com/arkansas-transfer-on-death-deed/.
  • POLST (Physician Orders for Life-Sustaining Treatment): This is a medical order that outlines your preferences for life-sustaining treatments. It is similar to a Living Will but is intended for individuals with serious health conditions and is signed by a physician.

Misconceptions

Many individuals have misunderstandings about the Living Will form. Clarifying these misconceptions can help ensure that personal wishes regarding medical treatment are respected. Below are four common misconceptions:

  • A Living Will is the same as a Last Will and Testament. A Living Will specifically addresses medical decisions and end-of-life care, while a Last Will and Testament outlines the distribution of assets after death.
  • Only elderly individuals need a Living Will. Anyone, regardless of age, can benefit from having a Living Will. Unexpected medical emergencies can happen at any time, making it important for all adults to consider their preferences.
  • A Living Will guarantees that my wishes will always be followed. While a Living Will provides guidance, it may not cover every possible situation. Medical professionals will use their judgment, and family members may also have a say in decisions.
  • I can’t change my Living Will once it’s created. A Living Will can be updated or revoked at any time as long as the individual is mentally competent. It is important to review and adjust it as circumstances or preferences change.

Understanding Living Will

  1. What is a Living Will?

    A Living Will is a legal document that outlines your preferences for medical treatment in the event that you become unable to communicate your wishes. It typically addresses situations such as terminal illness or irreversible coma, guiding healthcare providers and loved ones in making decisions on your behalf.

  2. Why should I have a Living Will?

    Having a Living Will ensures that your healthcare preferences are respected even when you cannot express them. This document provides clarity to your family and medical team, reducing confusion and stress during difficult times. It can also prevent potential conflicts among family members regarding treatment decisions.

  3. What should I include in my Living Will?

    In your Living Will, you should specify your wishes regarding:

    • Life-sustaining treatments, such as resuscitation, mechanical ventilation, and feeding tubes.
    • Pain management and comfort care.
    • Organ donation preferences, if applicable.

    Consider discussing your wishes with a healthcare provider to ensure all relevant aspects are covered.

  4. Who should have a copy of my Living Will?

    It is important to share copies of your Living Will with key individuals, including:

    • Your primary care physician.
    • Family members or close friends who may be involved in your care.
    • Your designated healthcare proxy, if you have appointed one.

    Keep a copy for yourself in a safe but accessible location.

  5. Can I change my Living Will?

    Yes, you can change your Living Will at any time as long as you are mentally competent. To make changes, simply create a new Living Will that reflects your current wishes and ensure that all previous versions are revoked. Notify all relevant parties of the updates.

  6. Is a Living Will the same as a healthcare proxy?

    No, a Living Will and a healthcare proxy serve different purposes. A Living Will specifies your medical treatment preferences, while a healthcare proxy designates someone to make healthcare decisions on your behalf if you cannot do so. You may choose to have both documents to ensure comprehensive coverage of your wishes.

  7. Do I need a lawyer to create a Living Will?

    While it is not legally required to have a lawyer to create a Living Will, consulting one can be beneficial. A lawyer can help ensure that your document complies with state laws and accurately reflects your wishes. Many resources and templates are also available online if you prefer to create one independently.

  8. How is a Living Will different from a Do Not Resuscitate (DNR) order?

    A Living Will provides broader instructions regarding your overall healthcare preferences, while a DNR order specifically instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) in the event of cardiac arrest. A DNR can be included in your Living Will, but it is a separate document that may require additional steps to be put in place.