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Many people wish to have a say in the kind of medical treatment they receive, especially in situations where they may not be able to communicate their wishes directly due to illness or incapacity. This is where the importance of a Louisiana Living Will form comes into play. It serves as a legal document that outlines an individual's preferences for medical treatment and end-of-life care, ensuring their wishes are respected even when they cannot verbalize them. In Louisiana, this form not only allows individuals to delineate their healthcare directives but also appoints a trusted person to make decisions on their behalf if they are unable to do so. It covers a wide range of decisions, from the acceptance or refusal of medical treatment to the preferences about life-sustaining procedures and organ donation. Drafted with careful consideration, the Louisiana Living Will form acts as a critical safeguard, providing peace of mind to both the person it pertains to and their loved ones, knowing that healthcare choices are made according to one's values and preferences.

Form Example

Louisiana Living Will

This Louisiana Living Will is made in accordance with the Louisiana Declaration Concerning Life-Sustaining Procedures Act. It is designed to express the wishes of the individual, referred to as the declarant, regarding medical treatment in circumstances where they are no longer able to communicate their decisions due to incapacity.

Please fill out the following information accurately to ensure your wishes are understood and respected.

Personal Information
  1. Full Name: ___________________________________________________
  2. Date of Birth: _______________________________________________
  3. Social Security Number: ______________________________________
  4. Address: _____________________________________________________
  5. City: ______________________ State: LA Zip: __________________
Declaration

I, ___________________________ (insert your full name), being of sound mind, willfully and voluntarily declare my desire that my dying shall not be artificially prolonged under the circumstances set forth below, and I hereby declare:

  • If at any time I am incapacitated and (a) have a terminal and irreversible condition that will result in my death within a relatively short time, or (b) I am unconscious and, to a reasonable degree of medical certainty, I will not regain consciousness, or (c) I suffer from a condition that is not terminal but which is irreversible and which will result in my death without the use of life-sustaining procedures,
  • I direct that such procedures be withheld or withdrawn when they serve only to prolong the process of dying, and that I be permitted to die naturally with only the provision of appropriate nutrition and hydration, pain relief, and comfort care.

This declaration only applies if I am unable to communicate my intentions and if my condition is as described above.

Additional Instructions (Optional)

You may provide additional instructions such as preferences regarding pain relief, hospice care, etc.

__________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________________

Signature

This declaration is to be signed by the declarant in the presence of two witnesses who are not heirs or legatees of the declarant and who are not responsible for financing the declarant's medical care.

______________________________ ______________________________
Signature of Declarant Date

Witnesses:

  1. Witness 1 Name: _____________________________________________
  2. Witness 1 Signature: _________________________________________
  3. Witness 1 Address: ___________________________________________
  4. Witness 2 Name: _____________________________________________
  5. Witness 2 Signature: _________________________________________
  6. Witness 2 Address: ___________________________________________

PDF Characteristics

Fact Detail
Purpose The Louisiana Living Will form allows individuals to outline their preferences for medical treatment should they become unable to communicate their wishes due to a terminal condition.
Governing Law The form is governed by the Louisiana Revised Statutes, Title 40:1299.58.1 et seq., also known as the Louisiana Declaration Concerning Life-Sustaining Procedures Act.
Execution Requirements To be legally valid, the form must be signed by the declarant in the presence of two witnesses who also need to sign the document.
Revocation An individual can revoke their Louisiana Living Will at any time, regardless of their mental state, through a written revocation, oral declaration, or by destroying the document.

Instructions on Filling in Louisiana Living Will

In Louisiana, a living will is a legal instrument that allows individuals to express their wishes regarding medical treatment in the event they are unable to communicate those wishes due to incapacity. This document is crucial for guiding healthcare providers and family members during difficult decisions about end-of-life care. Filling out a Louisiana living will form is a straightforward process, but it requires careful consideration and clear expression of one's healthcare preferences. Here are the steps needed to fill out the form properly to ensure that your healthcare wishes are known and can be acted upon.

  1. Gather necessary information including your full legal name, date of birth, and specific wishes regarding life-sustaining treatment, such as mechanical breathing, tube feeding, and treatments aimed only at keeping you comfortable.
  2. Begin by entering your personal information at the top of the form, including your full legal name and date of birth.
  3. Read the introductory section carefully, which explains the purpose of the form and the nature of decisions you might need to make.
  4. Specify your wishes regarding the acceptance or refusal of life-sustaining treatments by checking the appropriate boxes or filling in the blanks provided. This section allows you to make decisions about treatments that could prolong your life, such as resuscitation, mechanical ventilation, and artificial nutrition and hydration.
  5. If you have strong feelings about specific treatments not mentioned in the form, it's a good idea to attach a separate signed and dated statement detailing your wishes. This attachment should be referenced in the appropriate section of the living will form.
  6. Designate a healthcare agent or proxy, if desired, who will have the authority to make healthcare decisions on your behalf in case you are unable to communicate your wishes. Include the name, relationship, and contact information of your chosen agent.
  7. Most states, including Louisiana, require the living will to be witnessed or notarized, or both. Check the specific requirements for Louisiana. Generally, two adult witnesses, who are not related to you and who would not inherit from you, must sign the form, attesting that you are of sound mind and under no duress or undue influence at the time of signing.
  8. Review the document carefully to ensure all the information is correct and that your healthcare wishes are clearly expressed.
  9. Sign and date the form in the presence of the required witnesses or notary. Ensure that the witnesses or notary also sign the form, as applicable.
  10. After completing the form, make several copies. Keep the original in a safe but accessible place. Provide copies to your healthcare agent (if you have designated one), family members, close friends, and your doctors to ensure that your healthcare preferences are well known.

After filling out the Louisiana living will form, it's important to discuss your wishes with your designated healthcare agent (if you have one), family members, and healthcare providers to ensure that they understand your preferences. By taking these steps, you can feel more secure in the knowledge that your healthcare wishes will be respected, even if you're unable to communicate them yourself.

Listed Questions and Answers

What is a Louisiana Living Will?

A Louisiana Living Will is a legal document that allows an individual, known as the declarant, to outline their preferences for medical treatment in situations where they are no longer able to communicate their decisions due to incapacity or terminal illness. This form allows you to make decisions in advance regarding life-sustaining treatments, including the refusal or request of such treatments.

Who can set up a Louisiana Living Will?

Any individual aged 18 or older and of sound mind can set up a Louisiana Living Will. The person must fully understand the nature and purpose of the document, including the implications of the choices made within.

What are the requirements for a Louisiana Living Will to be legally valid?

To ensure a Louisiana Living Will is legally valid, it must meet the following requirements:

  1. The declarant must sign the document in the presence of two witnesses.
  2. The witnesses must also sign the document, acknowledging that the declarant is of sound mind and is making these decisions voluntarily.
  3. The document should clearly state the declarant’s treatment preferences, including any specific situations where life-sustaining treatments should or should not be applied.

How can I revoke or change my Louisiana Living Will?

A Louisiana Living Will can be revoked or changed at any time by the declarant, provided they are of sound mind. Revocation can be done in several ways:

  • By creating a new living will that states different wishes.
  • By physically destroying the document.
  • By expressing the intent to revoke, either orally or in writing, in the presence of a witness.

Changes to a living will should preferably be made by drafting a new document that reflects the current wishes of the declarant, ensuring it is signed and witnessed according to Louisiana laws.

Who should have a copy of my Louisiana Living Will?

Ensuring that the right people have a copy of your Louisiana Living Will is crucial for it to be effectively implemented. Consider giving a copy to:

  • Your primary care physician and any specialists you see regularly.
  • A healthcare agent, if you have designated one.
  • Close family members or friends who are likely to be involved in your care.
  • Your attorney, if you have one.

Does a Louisiana Living Will expire?

A Louisiana Living Will does not have a set expiration date and remains valid until it is revoked. However, it is a good practice to review and, if necessary, update your living will periodically, especially after significant life events such as marriage, divorce, the birth of a child, or a change in health status. This ensures that the document always reflects your current wishes.

Common mistakes

When filling out a Louisiana Living Will form, people often aim to ensure their healthcare wishes are respected, especially in situations where they cannot communicate those wishes themselves. However, mistakes made during the completion process can lead to confusion, frustration, and, sometimes, the not following of an individual's true intentions. Here are nine common mistakes to avoid:

  1. Not reading the form thoroughly before starting. It's crucial to understand every section to ensure your wishes are accurately reflected.

  2. Failing to discuss your wishes with your family. While it might be a tough conversation, discussing your wishes with your loved ones ensures everyone understands your healthcare preferences.

  3. Omitting to appoint a healthcare proxy or agent. This person will make healthcare decisions on your behalf if you're unable to do so. Not naming one can lead to unwanted confusion or delays.

  4. Choosing the wrong person as a proxy or agent. The person you choose should fully understand your wishes and be willing and able to act on them.

  5. Not being specific about your medical treatment preferences. Vague language can lead to interpretation errors in critical situations.

  6. Skipping the signature date. A Living Will without a date risk being considered invalid.

  7. Failing to get the required witness or notary signatures. This oversight can question the form’s authenticity and validity.

  8. Forgetting to review and update the form periodically. As circumstances and preferences change, so should your Living Will.

  9. Not making copies available to relevant parties. Your healthcare proxy, family members, and primary care doctor should have copies of your Living Will.

Avoiding these mistakes can help ensure that your healthcare wishes are honored and can provide peace of mind to both you and your loved ones. It’s also advisable to consult with a legal professional to ensure that your Living Will complies with Louisiana law and accurately reflects your intentions.

Documents used along the form

When preparing for the future, particularly in matters of health care and end-of-life decisions, it's crucial to be comprehensive. In Louisiana, the Living Will is a fundamental document that allows individuals to outline their wishes regarding medical treatment in the event they become unable to communicate those decisions themselves. However, a Living Will is often just one part of a broader set of legal documents designed to ensure a person's healthcare preferences are fully respected and adhered to. Below are several other important forms and documents that are commonly used alongside a Louisiana Living Will, each serving its own unique purpose in a person's healthcare and end-of-life planning.

  • Health Care Power of Attorney: This document enables an individual to appoint another person, known as the agent, to make healthcare decisions on their behalf if they are unable to do so themselves.
  • Durable Power of Attorney: Similar to a Health Care Power of Attorney, this document extends the power to make decisions on behalf of the individual to areas beyond health care, including financial and legal affairs.
  • Do Not Resuscitate (DNR) Order: A DNR order is a medical order signed by a healthcare provider that instructs healthcare professionals not to perform CPR if a patient's breathing stops or if the patient's heart stops beating.
  • Physician Orders for Life-Sustaining Treatment (POLST): It goes beyond a Living Will by converting an individual's wishes regarding end-of-life care into medical orders once they are seriously ill or toward the end of life.
  • Declaration for Mental Health Treatment: This form allows individuals to state their preferences for mental health treatment in the event they are found to lack capacity to make these decisions themselves.
  • Organ and Tissue Donation Registration: A document that allows individuals to register their decision to donate their organs and tissues upon death.
  • HIPAA Release Form: This form permits health care providers to share an individual’s health information with designated individuals, such as family members or other caregivers.
  • Emergency Contact Form: Although not legally binding, this form provides important contact information for family members, friends, and caregivers in case of an emergency.
  • Funeral Planning Declaration: A document where individuals can specify their preferences for their funeral arrangements, including the type of ceremony, burial, or cremation.
  • Guardianship Appointment: In the event that an individual becomes unable to make decisions for themselves, this document allows the appointment of a guardian to make personal, healthcare, and sometimes financial decisions on their behalf.

Together with a Living Will, these documents form a comprehensive plan that addresses a wide range of scenarios and ensures that an individual's preferences are known and respected. It is advisable for individuals to consult with legal and healthcare professionals when preparing these documents to ensure they are completed correctly and reflect the individual's wishes accurately. Understanding and preparing these documents ahead of time can provide peace of mind for both the individual and their loved ones, knowing that their healthcare and personal affairs are in order.

Similar forms

The Louisiana Living Will form is similar to several other documents used in estate planning and healthcare decision-making. While its primary purpose is to outline a person's wishes regarding medical treatment in the event they become incapacitated, there are a few key documents it shares characteristics with, each serving its own unique but somewhat overlapping role. These documents include the Healthcare Power of Attorney, the Durable Power of Attorney for Finances, and the Do Not Resuscitate (DNR) order.

Healthcare Power of Attorney (HCPA): The Louisiana Living Will form and the Healthcare Power of Attorney both play critical roles in managing an individual's medical care when they cannot make decisions themselves. However, while the Living Will specifies the types of medical treatment a person prefers or wishes to avoid, an HCPA appoints a specific person (an agent) to make healthcare decisions on the individual's behalf. The agent's decisions are based on the directives outlined in the Living Will, ensuring the person's healthcare wishes are followed when they cannot communicate their preferences directly.

Durable Power of Attorney for Finances (DPOA): Similar to the Healthcare Power of Attorney in its structure, the Durable Power of Attorney for Finances allows an individual to designate an agent to manage their financial affairs. Although it doesn't directly relate to healthcare decisions or living will directives, its importance in comprehensive estate and incapacity planning is undeniable. It ensures that, alongside healthcare needs, an individual's financial responsibilities are also taken care of according to their wishes, making it a complementary document to the Living Will.

Do Not Resuscitate (DNR) Order: A Do Not Resuscitate order is more specific than a Living Will but shares the overarching goal of directing medical care based on an individual's wishes. A DNR specifically instructs healthcare providers not to perform CPR if a person's breathing stops or if their heart stops beating. Unlike the broader scope of a Living Will, which can address various treatments and scenarios, a DNR focuses solely on the circumstances under which resuscitation should not be attempted. Both documents contribute to a person’s end-of-life care plan, ensuring their wishes are respected.

Dos and Don'ts

When it comes to planning for your future healthcare, a Living Will is a crucial document. Particularly in Louisiana, there are specific guidelines that you'll want to follow carefully to ensure your wishes are properly documented. Below is a practical list of dos and don'ts to consider when filling out the Louisiana Living Will form.

Do:

  1. Read the form carefully before you start filling it out. Make sure you understand every section and what it's asking for.
  2. Consult with a healthcare professional if you have questions about medical treatments or terminologies mentioned in the form.
  3. Discuss your wishes with family members or close friends who might be affected by your decisions, ensuring they understand your preferences.
  4. Use clear and precise language to describe your healthcare wishes, avoiding any ambiguity.
  5. Sign and date the form in the presence of two witnesses, as required by Louisiana law. Make sure the witnesses meet the state’s criteria.
  6. Keep the original form in a safe but accessible place, and inform your family and healthcare providers of its location.
  7. Review and update your Living Will periodically, particularly after any significant health diagnosis or life event.

Don't:

  1. Fill out the form in haste without giving thorough thought to your future healthcare preferences.
  2. Use vague or general phrases that are open to interpretation. Be specific about your wishes concerning life-sustaining treatment and other healthcare interventions.
  3. Forget to specify a healthcare proxy or agent if Louisiana law allows, someone who will make decisions for you if you are unable to do so.
  4. Leave any sections blank that apply to you. If a section does not apply, indicate with “N/A” (not applicable) to show it was considered and determined to be non-applicable.
  5. Sign the document without the required witnesses as per Louisiana state law. Witnesses play a crucial role in validating your Living Will.
  6. Make changes to the document without following proper legal procedures, such as initialing near changes, re-executing it, or creating a new document entirely.
  7. Fail to communicate with your healthcare provider about your Living Will. Ensure it becomes part of your medical records.

Correctly filling out your Louisiana Living Will is a step towards peace of mind, knowing your healthcare preferences are documented. By following these guidelines, you can ensure your wishes are understood and respected.

Misconceptions

The Louisiana Living Will form is an essential document that allows individuals to outline their wishes regarding medical treatment in circumstances where they may not be able to communicate their decisions due to illness or incapacity. In navigating the complexities of healthcare and legal documentation, it is crucial to dispel common misconceptions surrounding the Louisiana Living Will form:

  • It is only for the elderly. Many people believe that a Living Will is only necessary for older individuals. However, unforeseen medical situations can occur at any age, making it important for adults of all ages to consider their preferences and document them accordingly.
  • A lawyer is required to create a Living Will. While legal guidance can be helpful in complex circumstances, Louisiana law does not mandate the involvement of a lawyer to draft a Living Will. Forms are available that comply with state requirements, and individuals can complete them without legal representation, provided all legal requirements are met.
  • A Living Will is the same as a Last Will and Testament. There is a common misconception that a Living Will and a Last Will and Testament are interchangeable. A Living Will specifies your wishes concerning medical treatment if you are unable to make decisions for yourself, while a Last Will and Testament deals with the distribution of your estate after your death.
  • It is too complicated to change once it's completed. Some people hesitate to create a Living Will under the misconception that once it is done, it cannot be altered. However, a Living Will can be revised or revoked at any time, providing the individual is competent to make these decisions.
  • Living Wills are not legally binding in Louisiana. Contrary to this belief, Living Wills are legally recognized in Louisiana, as long as they meet state-specific requirements. This means healthcare providers are required to follow the directives outlined in these documents within the bounds of the law.
  • A verbal statement is enough to enforce your wishes. While verbal wishes regarding healthcare preferences are important, formal documentation is crucial. A Living Will provides a clear, legally binding document that ensures your healthcare wishes are understood and respected, even when verbal communication may not be possible.

Understanding these misconceptions about Louisiana Living Wills can remove barriers to completing this important document, encouraging residents to take proactive steps in managing their healthcare wishes. It’s never too early to document your preferences, ensuring that your specific wishes are followed, should you be unable to communicate them.

Key takeaways

  • The Louisiana Living Will form allows individuals to document their preferences regarding medical treatment in situations where they are no longer able to communicate their desires due to a terminal condition.
  • It is crucial for individuals to thoroughly consider and specify the types of life-sustaining treatments they would or would not want to receive. This can include decisions about mechanical ventilation, resuscitation, and artificial nutrition and hydration.
  • To ensure that the living will is legally binding, the individual must sign the document in the presence of two witnesses. These witnesses must meet certain requirements specified by Louisiana law.
  • It's important to discuss your living will with your healthcare provider to make sure your wishes are clearly understood and can be incorporated into your medical care plan.
  • After completing the living will, it should be kept in a place where it can be easily accessed in an emergency. Copies should be given to a trusted family member or friend, your healthcare agent (if you have designated one), and your healthcare providers.
  • Residents of Louisiana should be aware that the state's laws change from time to time. It's advisable to review and possibly update your living will periodically to ensure it aligns with current laws and reflects your current wishes.
  • If an individual wishes to change or cancel their living will, they should follow the legal procedures for doing so. This often involves creating a new document or physically destroying the existing one.
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