The Louisiana Advance Directive fuses a living will and medical power of attorney together so that its executor can establish their goals concerning end-of-life care as well as designate a surrogate to make health care decisions for them. Of course, this declaration will only become effective if the principal is pronounced mentally unfit to make their own decisions by a health professional. To enact such an instrument, the declarant/principal must record who they want as an agent, what limitations on the authority will be implemented (if any), and what their preferences are regarding potential life-ending treatments.
This Document Contains:
Any person who wishes to become an organ/tissue donor may register through the Donate Life Louisiana Website.
Laws
Statutes – Persons Who May Consent to Surgical or Medical Treatment (§ 1159.4(A)(3), Declarations Concerning Life-Sustaining Procedures (RS 40:1151 et seq.)
Definition – “Declaration” means a witnessed document, statement, or expression voluntarily made by the declarant, authorizing the withholding or withdrawal of life-sustaining procedures, in accordance with the requirements of this Subpart. A declaration may be made in writing, orally, or by other means of nonverbal communication. (§ 1151.1(4))
Signing Requirements – Acknowledgment of Two (2) Witnesses (§ 1151.2(A)(2))
Other Versions (7)
- AARP
- Five Wishes (Aging with Dignity)
- Louisiana Elder Law Task Force
- Louisiana-Mississippi Hospice & Palliative Care Organization (LMHPCO)
- Prepare for Your Care
- Spanish/Español
- Vietnamese
Download: Adobe PDF
Instructions: Adobe PDF
Five Wishes (Aging with Dignity) Version
Download: Adobe PDF
Information: Adobe PDF
Louisiana Elder Law Task Force Version
Download: Adobe PDF
Louisiana-Mississippi Hospice & Palliative Care Organization (LMHPCO) Version
Download: Adobe PDF
Prepare for Your Care Version (also available in Spanish/en Español)
Download: Adobe PDF
Download: Adobe PDF
Download: Adobe PDF
Additional Resources
- Lallie Kemp Medical Center – You Decide Brochure
- Louisiana Elder Law Task Force – Advance Directive Guide
- Louisiana Healthcare Connections – Advance Medical Directives
- Louisiana State Bar – Advance Directive for Mental Health Treatment Guide
- Louisiana State Bar – End-of-Life Decisions
- Ochsner Health – Advance Care Planning Conversations (in Spanish, in Vietnamese)
- Peoples Health – Louisiana Advance Directives Handout
Related Forms (5)
- Advance Directive for Mental Health Treatment
- Advance Directive Wallet Cards
- Durable (Financial) Power of Attorney
- HIPAA Authorization Form
- Physician Orders for Scope of Treatment (LaPOST) Form
Advance Directive for Mental Health Treatment
Download: Adobe PDF
Laws: RS 28:221 et sec.
Advance Directive Wallet Cards
Download: Adobe PDF
Durable (Financial) Power of Attorney
Download: Adobe PDF, MS Word (.docx)
HIPAA Authorization Form (specific to Blue Cross, Blue Shield, & HMO)
Download: Adobe PDF
Physician Orders for Scope of Treatment (LaPOST) Form
Download: Adobe PDF
Spanish Version: Adobe PDF
Laws: RS 40:1155.1 et seq.