Fillable Living Will Template for New Hampshire State Access Your Form

Fillable Living Will Template for New Hampshire State

A New Hampshire Living Will form serves as a legal document allowing individuals to express their wishes regarding medical treatment in the event they are unable to communicate due to severe illness or injury. It outlines specific instructions for healthcare providers about life-sustaining treatments and end-of-life care preferences, ensuring a person’s healthcare decisions are respected even when they cannot speak for themselves. For those looking to secure their healthcare wishes in New Hampshire, completing a Living Will form is a vital step. Click the button below to begin filling out your form.

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Outline

In the picturesque state of New Hampshire, residents have the power to make crucial decisions about their healthcare through a document known as the Living Will. This legal form provides a means for individuals to outline their wishes concerning medical treatments they wish to accept or refuse, especially in scenarios where they are no longer able to communicate their decisions due to severe illness or incapacitation. By completing this form, one ensures their healthcare preferences are respected, offering peace of mind to themselves and their loved ones. The New Hampshire Living Will covers a range of medical decisions, including the acceptance or refusal of life-sustaining treatments and the use of artificial nutrition and hydration. Importantly, it empowers individuals to make their end-of-life wishes known, thereby guiding family members and healthcare providers during difficult times. This pivotal document not only addresses ethical considerations surrounding patient autonomy and dignity but also alleviates the emotional and financial burdens often experienced by families making healthcare decisions on behalf of their relatives. Emphasizing the importance of forward planning, the New Hampshire Living Will stands as a critical tool for those wishing to have control over their medical treatment and to uphold their personal values and beliefs.

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New Hampshire Living Will Template

This document serves as a Living Will, created in accordance with the New Hampshire Advance Directives law (RSA 137-J) to document the wishes of the undersigned regarding healthcare decisions in the event of incapacity.

Part I: Personal Information

Full Name: ___________________________________________________________

Date of Birth: ___________________ (MM/DD/YYYY)

Address: _____________________________________________________________

City: ___________________________________ State: New Hampshire ZIP: ____________

Part II: Treatment Preferences

This section documents my healthcare decisions to be used if I am unable to communicate my wishes directly. These decisions relate to the use or non-use of life-sustaining treatments and artificial nutrition and hydration.

Initial Declaration:

I, _____________________________ (print name), being of sound mind, voluntarily create this declaration to control my healthcare. I understand the full import of this declaration and I am emotionally and mentally competent to make this declaration.

Specific Instructions

In the case of an end-of-life decision, I direct the following:

  1. That if my condition is deemed terminal and irreversible, I elect to receive / not to receive (circle one) all treatments other than those needed for comfort care.
  2. That if I am in a state of permanent unconsciousness, I elect to receive / not to receive (circle one) lifesaving treatments that could sustain life artificially.
  3. Regarding artificial nutrition and hydration, I elect to receive / not to receive (circle one) such sustenance if I can no longer eat or drink by mouth.

I recognize that my healthcare provider has the right to reject my directives if they are contrary to reasonable medical standards.

Part III: Signature

By signing below, I acknowledge that I fully understand the contents of this document and that I am not under any undue influence. This Living Will represents my wishes as of the date signed.

Date: ___________________ (MM/DD/YYYY)

Signature: ___________________________________________________________

Print Name: ___________________________________________________________

Part IV: Witness Statement

State law requires you to have this document witnessed. The witness to this Living Will certifies that the principal is personally known to me, that they signed or acknowledged this Living Will in my presence, that they appear to be of sound mind and under no duress, fraud, or undue influence, and that I am not the person appointed as agent by this document.

Witness Name: ___________________________________________________________

Witness Signature: __________________________________ Date: _______________

Witness Address: _________________________________________________________

City: _____________________________ State: New Hampshire ZIP: ___________

File Details

Fact Name Description
Definition A New Hampshire Living Will is a legal document that allows an individual to express their wishes about their medical treatment in the event that they become unable to communicate these wishes themselves.
Governing Law The New Hampshire Living Will is governed by the New Hampshire Revised Statutes Annotated (RSA) 137-J, known as the "Advance Directives for Health Care Law."
Components It can include decisions regarding the use of life-sustaining treatment, artificial nutrition and hydration, and other end-of-life care options.
Requirements To be valid, a New Hampshire Living Will must be signed by the declarant in the presence of two or more witnesses who are not related to the declarant by blood, marriage, or adoption and who are not beneficiaries of the declarant’s estate.
Revocation The declarant can revoke a Living Will at any time, in any manner, without regard to mental or physical condition. The revocation becomes effective when it is communicated to the attending physician.

Detailed Instructions for Filling Out New Hampshire Living Will

Once you've decided to complete a Living Will in New Hampshire, you're taking a significant step towards ensuring your healthcare preferences are respected and followed should you be unable to communicate them yourself. This document is straightforward to fill out, but requires clarity and reflection on your end. Here's how you can accurately complete the New Hampshire Living Will form:

  1. Begin by clearly printing your full legal name at the top of the document to identify yourself as the principal.
  2. Read each section carefully to understand the choices available regarding your healthcare and life support preferences.
  3. In the sections provided, mark your specific preferences regarding the use of life-sustaining treatments and artificially provided nutrition and hydration. Consider each option's implications carefully.
  4. If there are specific situations or conditions under which you would prefer to decline life-sustaining treatments, make sure to describe these conditions in the space provided.
  5. Appoint a healthcare agent by providing the name, relationship, contact number, and address of the person you trust to make healthcare decisions for you, in case you're incapacitated. This step is optional but recommended.
  6. It's crucial to sign and date your Living Will in the presence of two witnesses or a notary public. The witnesses must be adults, and they cannot be the individuals you have appointed as your healthcare agent.
  7. Finally, discuss your Living Will with your family, close friends, and healthcare providers to ensure they understand your wishes. Provide them with a copy or let them know where to find one.

Once you've completed these steps, your Living Will is valid and operational. It acts as a guide for your loved ones and healthcare providers, making your healthcare wishes known and legally recognized. Remember, you can update or revoke your Living Will at any time should your preferences or circumstances change.

Your Questions, Answered

What is a Living Will in New Hampshire?

A Living Will in New Hampshire 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. It specifically addresses situations where life-sustaining treatment or artificial nutrition and hydration can be withheld or withdrawn if you are in a terminal condition, permanently unconscious, or in a similar condition as specified by New Hampshire law.

How do I create a New Hampshire Living Will?

To create a Living Will in New Hampshire, you must draft a document that complies with state requirements. This includes clearly stating your healthcare preferences, signing the document in front of two witnesses, and ensuring the witnesses sign as well. The witnesses must not be your healthcare provider, an employee of your healthcare provider, the operator or an employee of a healthcare facility treating you, or any person who stands to inherit upon your death or is legally responsible for your healthcare costs.

Do I need a lawyer to prepare my Living Will in New Hampshire?

No, you do not need a lawyer to prepare your Living Will. However, consulting with a legal professional can help ensure that the document accurately reflects your wishes and complies with New Hampshire law. Additionally, a lawyer can provide advice on how a Living Will works in conjunction with other estate planning documents, such as a durable power of attorney for healthcare.

Can I change or revoke my Living Will?

Yes, you can change or revoke your Living Will at any time as long as you are mentally competent. To make changes, you should create a new Living Will that reflects your current wishes and follow the same signing and witness process as the original. To revoke a Living Will, you can destroy the document, create a new one that states your intention to revoke the previous one, or communicate your intention to revoke it to your healthcare provider.

When does my Living Will become effective?

Your Living Will becomes effective when it is delivered to your healthcare provider and you are determined to be unable to make decisions regarding your healthcare. Typically, this involves a medical evaluation by one or more physicians who conclude that you are no longer able to understand, make, or communicate healthcare decisions.

Is a Living Will the same as a Durable Power of Attorney for Healthcare?

No, a Living Will and a Durable Power of Attorney for Healthcare are not the same. A Living Will specifically addresses the withholding or withdrawal of life-sustaining treatment in certain medical conditions. In contrast, a Durable Power of Attorney for Healthcare allows you to appoint someone else (an agent) to make healthcare decisions on your behalf if you are unable to do so. These documents can complement each other as part of comprehensive healthcare directives.

Common mistakes

When individuals embark on the task of filling out a New Hampshire Living Will form, intentions are generally clear—they aim to lay out their wishes for medical treatment should they become unable to communicate their desires directly. However, despite the straightforward goal, a number of common errors can complicate the process, potentially leading to misunderstandings when the document is most needed. Understanding and avoiding these mistakes can ensure that the person's true wishes are both clearly expressed and respected.

1. Insufficient detail: One of the most significant missteps involves providing too little information. Given the broad range of medical interventions and scenarios, a Living Will should be as comprehensive as possible. Including exhaustive details about medical treatments and conditions, beyond broad statements about life support, ensures that healthcare providers can make decisions aligned with the individual’s values and preferences.

  1. Not consulting healthcare providers: Before completing a Living Will, it’s wise to discuss potential medical scenarios with a healthcare provider. This conversation can illuminate the implications of different choices, helping to refine and clarify the person’s wishes. Failing to have this discussion can lead to decisions that might not actually reflect the individual's preferences when confronted with specific health conditions.
  2. Neglecting to appoint a durable power of attorney for health care: While the Living Will focuses on the person’s desires regarding treatment, it’s crucial to also designate someone to make health care decisions if the individual becomes unable to do so. This agent can address circumstances not covered by the Living Will, ensuring that decisions are made in the person’s best interest.
  3. Assuming one size fits all: People sometimes mistakenly believe that a single form or document can meet their needs in all states. However, states may have different requirements for Living Wills. It’s essential to use a form that is specifically designed to be valid in New Hampshire to ensure that the Living Will is recognized and can be acted upon.
  4. Forgetting to update the document: Life circumstances and health preferences can change over time. A Living Will should be reviewed and potentially updated in response to significant life events such as marriage, the birth of a child, a diagnosis of a chronic illness, or a change in health care wishes.
  5. Overlooking the need for witnesses or notarization: New Hampshire may require Living Wills to be witnessed or notarized to be legally valid. Skipping this step can render the document unenforceable, which means the person’s treatment preferences might not be honored.
  6. Failing to distribute copies: After completing a Living Will, it’s important to ensure that copies are readily available to those who might need them, such as family members, the appointed health care agent, and doctors. Keeping the Living Will hidden or in a safe deposit box that only the individual can access can prevent it from being used when needed.
  7. Allowing misconceptions to guide decisions: Some individuals may hold incorrect beliefs about what living wills can and cannot do, such as thinking they only apply to terminal illness or that they eliminate the possibility of receiving palliative care. Clarifying these misconceptions can lead to more informed and aligned healthcare directives.

Avoiding these errors when completing a New Hampshire Living Will can significantly improve the document's effectiveness and ensure that it faithfully represents the individual’s healthcare preferences. This forward planning and attention to detail can provide both the person and their loved ones with peace of arms, knowing their wishes will be respected during challenging times.

Documents used along the form

When preparing a Living Will in New Hampshire, it's common to consider other legal documents that help ensure wishes are respected and clearly communicated regarding healthcare and end-of-life decisions. These documents complement the Living Will by covering areas it does not or by providing more specific instructions or appointing individuals to make decisions on one's behalf. Here are four such documents commonly used alongside a Living Will:

  1. Durable Power of Attorney for Healthcare: This legal document allows an individual to designate another person, known as a healthcare agent, to make healthcare decisions on their behalf should they become unable to do so. Unlike a Living Will, which directs specific actions in certain situations, this power of attorney gives the agent authority to make real-time decisions based on current circumstances and treatments not foreseen when the Living Will was drafted.
  2. Do Not Resuscitate (DNR) Order: This medical order is signed by a physician and instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a patient's heart stops or if the patient stops breathing. It is specific to resuscitation and does not impact other treatments. A DNR is crucial for individuals who want to ensure that their wishes regarding resuscitation are respected by medical personnel.
  3. Organ and Tissue Donation Registration: This is a document or registry entry where individuals can express their wishes about organ and tissue donation upon death. It's important for individuals who wish to donate to make this known in advance, ensuring that their wishes are followed and potentially saving lives after their passing.
  4. Personal Directive or Letter of Instruction: This is an informal document that can accompany a Living Will. While not legally binding, it can provide guidance and explanation about personal values and preferences regarding end-of-life care, funeral arrangements, and how one wishes to be remembered. It serves as a complement to the more formal Living Will and Durable Power of Attorney for Healthcare, offering a personal touch and additional instructions that might not be covered in legal documents.

Together, these documents form a comprehensive approach to end-of-life planning. They work in conjunction with a Living Will to ensure that an individual's healthcare preferences are known, respected, and legally enforceable. Each document serves a unique purpose, contributing to the overall clarity and enforceability of one's final wishes. Being informed and prepared with these documents can provide peace of mind to individuals and their families during difficult times.

Similar forms

The New Hampshire Living Will form is similar to various other advance directive documents used across the United States, each designed to guide healthcare providers and loved ones regarding an individual's preferences for medical care should they become unable to express those wishes themselves. The similarity lies in the core purpose of these documents: to ensure that an individual’s healthcare preferences are known and respected at times when they may not be able to communicate. However, the scope, application, and legal requirements can vary significantly from one document to another.

Healthcare Power of Attorney (HCPA) is another document closely related to the New Hampshire Living Will. Like the Living Will, an HCPA allows an individual to outline their healthcare preferences. The crucial difference lies in how these preferences are executed. While a Living Will directly informs healthcare providers of an individual's treatment preferences under specific conditions, an HCPA designates another person, known as a healthcare agent or proxy, to make healthcare decisions on the individual’s behalf. This approach provides a more flexible response to varying medical situations, as the appointed agent can make decisions based on real-time circumstances and updates in medical treatment options.

Do-Not-Resuscitate (DNR) Order shares a common goal with the New Hampshire Living Will: to influence medical treatment based on the patient's wishes. A DNR specifically addresses the issue of resuscitation. It is a medical order indicating that a person does not wish to receive cardiopulmonary resuscitation (CPR) in the event of cardiac or respiratory arrest. Unlike the broader scope of a Living Will, which can cover various treatments and scenarios, a DNR focuses exclusively on the act of resuscitation. It is usually sought by individuals with serious illnesses or those who are at the end of their life and is typically signed by both the patient and their physician.

Medical Orders for Life-Sustaining Treatment (MOLST) or Physician Orders for Life-Sustaining Treatment (POLST) is another relevant document that aligns with the intentions behind a Living Will, albeit with some distinctions. MOLST or POLST forms are medical orders that are intended to guide emergency medical personnel and other healthcare providers about the types of life-sustaining treatment an individual wishes to receive or avoid. This can include preferences on the use of intubation, mechanical ventilation, and artificial nutrition and hydration. Differing from a Living Will which is prepared by the individual in anticipation of future incapacity, the MOLST or POLST is filled out by a healthcare provider based on conversations with the patient or their designated surrogate about the patient’s current health status and treatment preferences. This makes it particularly applicable in situations where an individual’s health condition is already severe, ensuring their treatment preferences are clearly communicated and legally documented.

Dos and Don'ts

When contemplating the preparation of a New Hampshire Living Will, a document that is crucial for outlining your healthcare wishes should you become unable to communicate them yourself, it is essential to approach it with a mindful and informed mindset. The process commands attention to detail, an understanding of its implications, and a thoughtful consideration of one's healthcare preferences. To assist in this process, here is a compilation of advised dos and don'ts.

  • Do take the time to fully understand the purpose and implications of each section of the Living Will form. It is designed to ensure your healthcare preferences are known and respected, even when you are not in a position to articulate them.
  • Do discuss your wishes with close family members, friends, and your healthcare providers to ensure they are aware of your preferences and the existence of your Living Will.
  • Do consult with a healthcare attorney or a legal advisor experienced in New Hampshire's specific laws regarding Living Wills to ensure your document is accurately prepared and valid.
  • Do clearly specify the circumstances under which you would want or not want certain medical treatments, including life-sustaining measures, to help prevent any ambiguity or misinterpretation.
  • Do appoint a trusted individual as your healthcare proxy or agent to make healthcare decisions on your behalf, ensuring they are willing and understand your healthcare preferences deeply.
  • Don't leave sections incomplete or allow ambiguity to cloud the intent of your directives. Ambiguities can lead to delays or conflicts in healthcare decision-making in crucial moments.
  • Don't use vague language. Be explicit about your wishes concerning life-sustaining treatment, pain management, and other interventions.
  • Don't forget to sign and date the Living Will form in the presence of witnesses or a notary as required by New Hampshire law, to ensure its legality and enforceability.

The steps you take today to draft a Living Will can provide invaluable peace of mind for both you and your loved ones. It ensures your healthcare preferences are understood and respected, thereby reducing the burden on family members during difficult times. Remember, it is not just about planning for the end of life but about making your wishes known and ensuring they are followed, thereby retaining control over your healthcare decisions.

Misconceptions

When thinking about the New Hampshire Living Will form, several misconceptions commonly arise. Clearing up these misunderstandings is crucial for ensuring everyone understands their rights and options regarding healthcare decisions.

  • It requires a lawyer to complete: Many believe that you must hire a lawyer to create a valid Living Will in New Hampshire. However, while legal advice can be beneficial, it's not mandatory. Individuals can complete the form themselves, provided they follow state requirements.
  • It's the same as a Last Will and Testament: Another common misconception is that a Living Will is the same as a Last Will and Testament. However, a Living Will focuses on healthcare decisions if one is incapacitated, while a Last Will and Testament deals with the distribution of assets after death.
  • It's only for the elderly: People often think Living Wills are solely for the elderly. In reality, anyone over the age of 18 can and should consider creating a Living Will. Accidents and sudden illness can happen at any age, making it important to have your wishes documented.
  • You can't change it once it's made: Some may hesitate to create a Living Will, thinking it's set in stone. However, you can revise or revoke your Living Will at any time, as long as you are mentally competent to do so.
  • It's too expensive: The concern over cost stops some from creating a Living Will. However, in New Hampshire, the forms are readily available and can be completed without any fees, making it an accessible option for everyone.
  • It covers all end-of-life decisions: While a Living Will is comprehensive, it does not cover every single end-of-life issue. Discussions with loved ones and possibly the designation of a durable power of attorney for healthcare can ensure all bases are covered.
  • It's only about life support removal: Many assume a Living Will solely directs the removal of life support. While it does address this, it also covers various other treatments and conditions, allowing individuals to accept or refuse specific types of care.
  • Doctors can override it: A pervasive myth is that doctors can override the directives in a Living Will. In reality, New Hampshire law requires healthcare providers to follow the wishes outlined in your Living Will, ensuring your choices are respected.

Understanding the New Hampshire Living Will form is the first step toward making informed decisions about your healthcare. Dispelling these myths helps clarify the process and underscores the importance and benefits of having one's healthcare wishes legally documented.

Key takeaways

When considering the preparation of a Living Will in New Hampshire, individuals are faced with an important legal tool that facilitates the expression of their health care wishes, specifically concerning end-of-life care and life-sustaining treatments. The following key takeaways can help guide you through filling out and using the New Hampshire Living Will form:

  • Understand that a Living Will is a legal document that clarifies your wishes regarding medical treatment if you become unable to communicate them yourself. This includes decisions around life-sustaining measures and end-of-life care.
  • Be aware that New Hampshire law recognizes Living Wills, allowing individuals to dictate their healthcare preferences formally. This ensures your desires are respected when you may not be in a position to communicate them.
  • Fill out the Living Will form when you are of sound mind, making clear, conscious decisions about your health care preferences. This preemptive measure is essential for it to be considered valid.
  • Consider consulting with a healthcare provider or a legal professional to understand fully the implications of your choices on the form. Their insights can provide valuable clarity on complex medical and legal terminologies and outcomes.
  • Discuss your decisions with family members or close friends. Sharing your preferences with loved ones ensures they understand your wishes and can help advocate on your behalf if necessary.
  • Appoint a Health Care Proxy in addition to completing your Living Will. This is someone you trust to make healthcare decisions for you if you’re unable to do so. While the Living Will speaks to specific scenarios, a Health Care Proxy can address situations not covered by the document.
  • Ensure that the form is properly witnessed as required by New Hampshire law. Witnesses or a notary can attest to the authenticity of your signature and your capacity to make these decisions, adding legal weight to the document.
  • Keep the original document in a safe but accessible place, and provide copies to your appointed Health Care Proxy, family members, and your primary care physician. Accessibility is key in an emergency.
  • Review and update your Living Will periodically. As your health changes or as you experience major life events, revisiting your Living Will ensures that the document always reflects your current wishes.

By following these guidelines, you can ensure that your healthcare preferences are documented, understood, and respected, regardless of your ability to communicate them personally. A well-prepared Living Will is a critical component of comprehensive health care planning, offering peace of mind to both you and your loved ones.

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