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When considering the future, especially in terms of health care preferences, individuals often turn to legal documents to ensure their wishes are followed. Among these documents, the New Hampshire Living Will form stands as a critical tool, providing a means for residents to outline their desires regarding medical treatment in instances where they are unable to communicate their preferences themselves. This form allows for the specification of what life-sustaining treatments, if any, one wishes to receive in scenarios such as terminal illness or permanent unconsciousness. Its importance cannot be overstated, as it not only communicates a person's healthcare desires but also relieves family members and healthcare providers of the burden of making difficult decisions during emotional times. Moreover, it's framed by the state's guidelines to ensure legality and effectiveness. The document is designed to be comprehensive, covering various aspects from the desire for pain relief to the refusal of artificial nutrition and hydration, making it an indispensable component of healthcare planning in New Hampshire.

New Hampshire Living Will Preview

New Hampshire Living Will Template

This Living Will is designed to be in compliance with the New Hampshire Advance Directives Law (RSA 137-J). It is a legal document that outlines the preferences for medical treatment of the person named below in situations where they are unable to make decisions for themselves due to incapacitation. This document only becomes effective under the conditions specified by New Hampshire state law.

Personal Information

Full Name: ___________________________

Address: _____________________________

City: _______________ State: NH Zip Code: _________

Date of Birth: ________________________

Phone Number: ________________________

Statement of Desires for Medical Treatment

I, _______________ [Full Name], being of sound mind, hereby direct that my health care providers and family or other individuals who may be responsible for my care, make health care decisions in accordance with my desires as stated below. In the event that I am unable to communicate my desires myself, the following wishes shall guide the provision of my care.

  1. Preference regarding the use of life-sustaining treatment if I am in a condition that is terminal and irreversible:

    a) I wish to receive all available life-sustaining treatments, including artificial nutrition and hydration.

    b) I do not wish to receive life-sustaining treatment, with the exception of the following treatments: ________________.

  2. Preference regarding the use of life-sustaining treatment if I am in a state of permanent unconsciousness:

    a) I wish to receive all available life-sustaining treatments, including artificial nutrition and hydration.

    b) I do not wish to receive life-sustaining treatment.

  3. Other preferences about my health care (e.g., pain relief, hospitalization, hospice care, etc.):

    ____________________________________________________________________________________.

    ____________________________________________________________________________________.

Designation of Health Care Agent

If I am unable to make my own health care decisions, I designate the following individual as my health care agent to make health care decisions for me. This person will have the authority to make all health care decisions for me, in accordance with my wishes, including decisions about life-sustaining treatment:

Name of Health Care Agent: _________________________

Relationship to Me: _______________________________

Address: _________________________________________

City: ________________ State: NH Zip Code: _________

Phone Number: ___________________________________

Signature and Acknowledgement

I understand the purposes and effects of this document and I voluntarily sign this Living Will on this day__________ of _______________, 20____.

Signature: ___________________________

Print Name: __________________________

State of New Hampshire
County of ____________________

On this day, personally appeared before me, ______________________ [Notary Public/Justice of the Peace], the person known to me (or proved to me on the oath of _______________________) to be the person whose name is subscribed to the within instrument and acknowledged that (s)he executed the same for the purposes therein contained.

In witness whereof, I hereunto set my hand and official seal.

_____________________________________
Notary Public/Justice of the Peace

My Commission expires: _______________

File Attributes

Fact Name Description
Governing Law The New Hampshire Living Will is governed by RSA 137-J, the New Hampshire Advance Directives Act.
Purpose It allows individuals to articulate their wishes regarding medical treatment in the event they become unable to communicate due to illness or incapacity.
Who Can Make One Any competent individual who is 18 years of age or older can make a Living Will in New Hampshire.
Witness Requirement The form must be signed in the presence of two witnesses who are not related to the individual by blood, marriage, or adoption and who are not beneficiaries of the individual's estate.

Guidelines on Filling in New Hampshire Living Will

When preparing for the future, it's important to consider all possibilities. A Living Will allows individuals in New Hampshire to express their wishes regarding medical care in the event that they can no longer make decisions for themselves. It's a critical document for ensuring your healthcare preferences are honored. Properly completing the New Hampshire Living Will form is a straightforward process, but attention to detail is crucial. Below are steps designed to guide you through filling out the form accurately to ensure your wishes are clearly articulated.

  1. Gather personal information, including your full legal name, date of birth, and address, to accurately identify yourself on the form.
  2. Read the instructions on the form carefully to understand the specific provisions and options available for your Living Will.
  3. Decide on your healthcare preferences, including the types of life-sustaining treatments you would want or not want, such as mechanical ventilation, tube feeding, or resuscitation.
  4. Fill in the section regarding your healthcare preferences. Be precise and clear about your wishes to avoid any ambiguity.
  5. Choose a health care agent (also known as a durable power of attorney for health care), if you desire, who will make medical decisions for you if you’re unable to do so. Provide the agent's full name, relationship to you, and contact information.
  6. Review the witness requirements specific to New Hampshire. Typically, a Living Will must be signed in the presence of two witnesses who are not related to you and do not stand to inherit from you.
  7. Sign and date the form in the presence of the required witnesses. Ensure the witnesses also sign, date, and provide their addresses on the form.
  8. If required, have the form notarized, depending on the specific requirements outlined in New Hampshire law for the Living Will to be considered legally valid.
  9. Keep the original signed copy of your Living Will in a safe but accessible place. Provide copies to your chosen health care agent, family members, and primary care doctor.

By following these steps, you are taking an important step in managing your future healthcare. It's more than just filling out a form; it's about making your wishes known and ensuring they are respected. Remember, situations change, and reviewing and updating your Living Will periodically is also advisable to ensure it continues to reflect your current wishes.

More About New Hampshire Living Will

What is a Living Will?

A Living Will, often referred to as an advance directive, is a legal document that outlines a person's decisions about their healthcare, including the refusal of or request for medical treatment, in the event they become incapable of communicating those wishes themselves. In New Hampshire, it serves as a guide for healthcare providers and loved ones regarding a person's end-of-life care preferences.

Who should have a Living Will in New Hampshire?

Any person aged 18 or older, who wishes to have control over their medical treatment decisions in the event they cannot communicate due to illness or incapacity, should consider creating a Living Will. It’s particularly crucial for those with strong preferences about end-of-life care or those with specific medical conditions to have one in place.

How can one create a Living Will in New Hampshire?

In New Hampshire, creating a Living Will involves several steps:

  1. Filling out the New Hampshire Advance Directive form, which includes the Living Will section.
  2. Clearly stating your healthcare and end-of-life preferences, including treatments you do or do not want to receive.
  3. Signing the document in the presence of two adult witnesses, who also need to sign it, affirming that you are of sound mind and not under duress or undue influence.
  4. It is not required to notarize the document in New Hampshire, but it's recommended to do so for additional verification.

Can a Living Will be changed or revoked?

Yes, a person can change or revoke their Living Will at any time as long as they are of sound mind. To change it, they need to create a new document that reflects their new wishes and distribute it to all parties who had the previous version. To revoke it, they can either create a new document that states their intention to revoke the previous Living Will, destroy the document intentionally, or verbally express their wish to revoke it in front of witnesses.

What happens if someone does not have a Living Will in New Hampshire?

Without a Living Will, healthcare decisions will be left to the discretion of the attending physicians or transferred to a legally appointed guardian or close family members. This may lead to decisions that are contrary to the person’s wishes or cause disagreements among family members about the course of treatment.

How does a Living Will differ from a Durable Power of Attorney for Healthcare?

A Living Will specifically outlines a person's healthcare preferences, particularly about end-of-life care and treatment. A Durable Power of Attorney for Healthcare, on the other hand, designates another person to make healthcare decisions on their behalf, should they become incapacitated. While a Living Will provides direct instructions, a Durable Power of Attorney for Healthcare gives decision-making authority to someone else, based on the incapacitated person’s previously communicated wishes.

Is a Living Will legally binding across state lines?

While many states have laws recognizing Living Wills made in other states, the specific terms and conditions may vary. Therefore, if a person with a New Hampshire Living Will moves to or spends a lot of time in another state, it’s advisable to review and possibly update their Living Will to ensure it complies with the new state’s regulations.

Common mistakes

When filling out the New Hampshire Living Will form, individuals often aim to ensure their health care preferences are known and respected in case they can't make decisions for themselves. Despite these good intentions, common mistakes can inadvertently complicate or undermine their wishes. Being aware of these mistakes can help individuals create a clearer, more effective document.

  1. Not discussing the document with family members and health care providers. Before finalizing a Living Will, it's crucial to talk about its contents with those who will be involved in your care. This ensures everyone understands and respects your decisions, reducing the likelihood of disputes or confusion when the document needs to be implemented.

  2. Forgetting to update the document. Life circumstances and medical wishes can change, but people often forget to update their Living Will accordingly. Regularly reviewing and revising the document ensures that it always reflects your current preferences.

  3. Failing to include specific instructions for different medical scenarios. A common mistake is providing too general of guidance without considering various medical situations. Including detailed wishes for different scenarios can help guide your caregivers and health care providers in making decisions that align with your values.

    • Not being specific about which life-sustaining treatments you want or don't want.

    • Omitting preferences regarding pain management and palliative care.

  4. Neglecting to designate a health care proxy or not discussing your wishes with them. Choosing someone to make health care decisions on your behalf if you're unable is a crucial component of your Living Will. Make sure this person is willing and informed about your preferences and values.

  5. Failing to properly sign and witness the document according to New Hampshire laws. A Living Will must be signed in the presence of witnesses or notarized to be legally valid. Overlooking these requirements can render the entire document ineffective.

By avoiding these mistakes, individuals can help ensure that their health care preferences are clearly communicated and honored. A well-prepared Living Will can provide peace of mind to both the individual and their loved ones, knowing that their wishes will guide future health care decisions.

Documents used along the form

When planning for the future, especially in matters of health and end-of-life care, it's crucial to have a comprehensive set of legal documents. The New Hampshire Living Will form is a significant part of such planning, allowing individuals to outline their wishes regarding life-sustaining treatments if they become unable to communicate those wishes themselves. Alongside a Living Will, there are several other key documents that individuals typically consider to ensure their healthcare preferences are fully documented and respected. Below is a list of up to five other important forms and documents that are often used in conjunction with a New Hampshire Living Will.

  • Durable Power of Attorney for Healthcare: This document designates another person as the decision-maker regarding medical treatments when the individual is incapacitated. It complements a Living Will by covering health care decisions that might not be outlined in the Living Will.
  • Do Not Resuscitate (DNR) Order: A DNR order is a medical order signed by a physician that instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if the patient's breathing stops or if the heart stops beating. It is typically used by individuals with severe health issues or those at the end of life.
  • Organ and Tissue Donation Registration: This document allows individuals to specify their intent to donate organs and tissues upon death. The registration can be done through the state's registry or indicated on a driver's license in some states.
  • Health Insurance Portability and Accountability Act (HIPAA) Release Form: This form authorizes healthcare providers to disclose personal health information to designated individuals. It's essential for situations where family members or other designated agents need access to medical records to make informed healthcare decisions.
  • Physician Orders for Life-Sustaining Treatment (POLST): POLST is a form that translates an individual's end-of-life preferences into medical orders. It is used for people who are seriously ill or frail, providing specific instructions on the types of life-sustaining treatment they wish to receive or avoid.

Properly organizing these documents and discussing their contents with loved ones and healthcare providers ensures that an individual's healthcare wishes are understood and respected, even when they can no longer communicate those wishes themselves. Preparation can alleviate significant stress for both the individual and their loved ones during difficult times, making the process of navigating healthcare decisions more straightforward and aligned with the individual's values and preferences.

Similar forms

The New Hampshire Living Will form is similar to several other legal documents that are designed to help individuals plan for their healthcare and end-of-life decisions. These documents, while serving similar purposes, have unique features that cater to different aspects of healthcare planning and personal wishes.

Advance Directive: Like the New Hampshire Living Will, the Advance Directive is a document that allows individuals to outline their healthcare preferences in case they are unable to communicate these decisions themselves. The similarity lies in their core purpose of ensuring that the individual’s healthcare wishes are known and considered. However, the Advance Directive typically encompasses two main components: a Living Will and a Durable Power of Attorney for Healthcare. The Living Will portion specifies the type of medical care desired, much like the New Hampshire Living Will. In contrast, the Durable Power of Attorney for Healthcare appointee makes healthcare decisions on behalf of the individual if they are incapacitated, extending the document's scope beyond the specifications of a Living Will.

Healthcare Proxy: This document is akin to the New Hampshire Living Will in that it appoints someone to make healthcare decisions on behalf of the individual if they are unable to do so themselves. The similarity primarily lies in the focus on healthcare decision-making during times when the individual cannot express their wishes. The Healthcare Proxy, however, does not typically contain detailed directives on the individual's specific treatment preferences. Instead, it empowers another person to make those decisions, implying a level of trust in the appointed proxy to act in the best interest of the individual according to known wishes and values.

Do Not Resuscitate (DNR) Order: The Do Not Resuscitate Order shares a common goal with the New Hampshire Living Will in directing healthcare providers concerning life-sustaining treatment. Specifically, a DNR order instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) if the person's breathing stops or if the heart stops beating. While it is similar in its intent to ensure that medical treatment aligns with the individual's wishes, a DNR is more specific in its scope, applying only to CPR and not to other forms of medical intervention. This document is often used in conjunction with a Living Will to provide comprehensive instructions for emergency and end-of-life care.

Dos and Don'ts

When completing the New Hampshire Living Will form, it's important to approach the document with care and diligence. The following guidelines can help ensure that the form is filled out correctly and reflects your wishes accurately.

  • Do read the instructions carefully to understand the scope and implications of the document before you start filling it out.
  • Don't rush through the process. Take your time to consider your healthcare preferences and how you want them to be handled.
  • Do discuss your decisions with those close to you, such as family members, close friends, and your healthcare provider. These discussions can provide valuable insights and ensure that your wishes are understood and respected.
  • Don't leave any sections blank unless the instructions explicitly say it's permissible. Unanswered questions could lead to confusion or misinterpretation later on.
  • Do use clear and precise language to describe your healthcare preferences. Ambiguity could make it difficult for your healthcare provider to follow your wishes.
  • Don't forget to sign and date the form once it's completed. In most cases, your signature will need to be witnessed or notarized to make the document legally binding.
  • Do make copies of the completed document. Give a copy to your healthcare provider, a trusted family member or friend, and keep one for your records.
  • Don't assume that your healthcare provider will automatically know your wishes. Make sure they have received and understood your Living Will.

Misconceptions

When navigating through the intricacies of a New Hampshire Living Will, several misconceptions often stand in the way of making informed decisions. Understanding these key points ensures individuals are better prepared for future healthcare planning.

  • A Living Will is the same as a Last Will and Testament: People frequently confuse these two distinct documents. A Living Will specifies your healthcare preferences in the event you're unable to make decisions, focusing on end-of-life care. Contrastingly, a Last Will and Testament deals with the distribution of your estate after your death.
  • Having a Living Will means you won’t receive any medical treatment: This is a common fear but it’s unfounded. A Living Will does not deny you medical treatment. Instead, it guides your healthcare providers on the types of life-sustaining treatments you would or wouldn’t want, should you become unable to voice your preferences. It ensures treatments align with your wishes, rather than stopping all treatment.
  • You only need to tell your family about your Living Will: While discussing your wishes with your family is crucial, it's equally important to ensure your healthcare providers and legal representative(s) have copies of your Living Will. This documentation ensures there is no confusion or delay when it comes time to enforce your healthcare preferences.
  • Completing a Living Will is too complex and requires a lawyer: Many believe that drafting a Living Will is a complicated process that necessitates legal assistance. However, New Hampshire and many other states offer resources to help individuals create their own Living Will without the need for a lawyer. It’s about clearly stating your healthcare wishes in writing, following state-specific guidelines to ensure it’s legally valid. Of course, consulting with a legal professional can provide clarity and peace of mind but is not required for the creation of a Living Will.

Dispelling these misconceptions encourages a proactive approach to healthcare planning. Understanding the truths behind a New Hampshire Living Will enables individuals to make empowered decisions regarding their healthcare future.

Key takeaways

When it comes to making healthcare decisions in advance, the New Hampshire Living Will form is an essential tool for residents. This document allows individuals to outline their preferences concerning medical treatment in situations where they might not be able to express their wishes. Here are several key takeaways to consider when filling out and using this form:

  • The New Hampshire Living Will form is legally binding. This means that healthcare providers are required to follow the instructions provided within the document, assuming these instructions are clear and applicable to the situation at hand.
  • It's crucial to be as specific as possible when detailing your healthcare preferences. Ambiguities could lead to confusion or delay in your care. Detailed preferences help ensure your wishes are clearly understood.
  • Before completing the form, one should discuss their wishes with family members and healthcare providers. These conversations can provide valuable insights and help ensure that your decisions are well-informed and considered from multiple perspectives.
  • The form must be witnessed or notarized to be considered valid. This step is not just a formality; it provides a level of protection and ensures that your wishes were expressed without undue influence.
  • It's advisable to review and potentially update your Living Will periodically. Life circumstances and medical preferences can change, and your document should reflect your most current wishes.
  • After completing the New Hampshire Living Will form, make sure to distribute copies to key individuals. This includes your healthcare provider, a trusted family member, or friend, and potentially your legal representative. Having the document readily accessible ensures it can be used when needed.
  • Remember, you have the right to revoke or change your Living Will at any time. If you decide to make changes, ensure that you follow the correct process for revocation or amendment, including distributing new copies of the document to all relevant parties.

Ultimately, a New Hampshire Living Will is about providing peace of mind for both you and your loved ones by clearly communicating your healthcare wishes. Taking the time to complete this document thoughtfully and carefully is a proactive step in managing your health care preferences and ensuring they are respected.

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