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The Indiana Living Will form is a critical document for any Indiana resident thinking about their future healthcare preferences. This document allows individuals to outline their wishes regarding medical treatment in situations where they may not be able to communicate their decisions due to illness or incapacity. By completing this form, a person can specify whether they desire life-prolonging measures, such as mechanical ventilation or tube feeding, in the event of a terminal illness or permanent unconsciousness. Moreover, it addresses matters related to pain relief, emphasizing the signer's comfort and dignity, even in scenarios where extending life might not be possible or desired. The Indiana Living Will ensures that medical professionals and loved ones are aware of and can respect the individual's healthcare preferences. This approach not only provides peace of mind to the person filling out the form but also reduces the burden on family members during challenging times by making critical decisions in advance.

Example - Indiana Living Will Form

Indiana Living Will Declaration

This Living Will Declaration is made in accordance with the Indiana Living Will Act, Indiana Code 16-36-4-10. It is a legal document that outlines the desires of the undersigned regarding medical treatment in the event that they can no longer communicate their wishes.

Part I: Declaration

Full Name: ___________________________

Date of Birth: ___________________________

Social Security Number: ___________________________

Address: ___________________________

City: ___________________________ State: IN Zip Code: ________

I, ________________, being of sound mind, willfully and voluntarily make known my desire that my dying should not be artificially prolonged under the circumstances set forth below. I hereby declare that:

  1. If at any time I should have an incurable injury, disease, or illness certified to be a terminal condition by two physicians who have personally examined me, one of whom is my attending physician, and the physicians have determined that my death is imminent and will occur whether or not life-sustaining procedures are utilized and where the application of life-sustaining procedures would serve only to artificially prolong the dying process, I direct that such procedures be withheld or withdrawn, and that I be permitted to die naturally.
  2. I desire that my life not be artificially prolonged by life-sustaining measures, except that if I am unable to communicate my desires, I wish to receive any type of treatment or procedure that may be necessary to keep me comfortable and free of pain.

In the absence of my ability to give directions regarding the use of life-sustaining measures, it is my intention that this declaration shall be honored by my family, physicians, and any health care facility in which I may be a patient.

Part II: Appointment of Health Care Representative

I hereby designate the following individual as my Health Care Representative to make any and all health care decisions for me in accordance with the laws of the State of Indiana should I become incapable of making my own decisions:

Representative's Name: ___________________________

Relationship to Declarant: ___________________________

Address: ___________________________________________

City: ___________________________ State: IN Zip Code: ________

Primary Phone: ___________________________

Alternate Phone: ___________________________

In the event the Health Care Representative named above is unable, unwilling, or unavailable to act in this capacity, I hereby appoint the following individual as my alternate Health Care Representative:

Alternate Representative's Name: ___________________________

Relationship to Declarant: ___________________________

Address: ___________________________________________

City: ___________________________ State: IN Zip Code: ________

Primary Phone: ___________________________

Alternate Phone: ___________________________

Part III: Organ Donation (Optional)

I may also, at my discretion, choose to make an anatomical gift. If I choose to make such a gift, my desires are indicated below:

  • I wish to donate only the following organs or parts: ________________
  • I wish to donate any needed organs or parts.
  • I do not wish to make an anatomical gift.

Signature and Acknowledgment

This document is intended to be legally binding and to operate as a declaration under the laws of Indiana governing living wills. By signing it, I affirm that I am emotionally and mentally competent to make this will and that I understand its import.

Signature: ___________________________ Date: ____________

Witness (non-relative and not a beneficiary): ___________________________

Address: ___________________________________________

City: ___________________________ State: IN Zip Code: ________

Signature: ___________________________ Date: ____________

Document Specifications

Fact Number Fact Detail
1 The Indiana Living Will, also known as an Advance Directive, is governed by the Indiana Code 16-36-4.
2 This form allows a person to make decisions about their future healthcare, including the refusal of life-prolonging measures, in the event they become unable to communicate their wishes.
3 It can include the person's preferences regarding the use of artificial nutrition and hydration.
4 The individual creating a Living Will must be at least 18 years old and of sound mind.
5 For an Indiana Living Will to be legally valid, it must be signed by the individual in the presence of a witness or a notary public.
6 The witness to the Living Will cannot be the individual's healthcare provider, an employee of a healthcare provider, or any person entitled to any part of the individual’s estate upon death.
7 Once completed and properly executed, the Indiana Living Will is permanent unless it is revoked by the individual.
8 Revocation can be done at any time by the declarant through a written and signed document, or by orally informing the attending physician.
9 Healthcare providers in Indiana are legally obligated to follow the instructions laid out in a valid Living Will, as long as they are aware of its existence and it applies to the medical situation at hand.

How to Fill Out Indiana Living Will

Making decisions about your healthcare in situations where you might not be able to communicate your wishes can be incredibly daunting. A Living Will provides a way for individuals in Indiana to document their preferences for medical treatment in advance. This legal document speaks for you when you cannot, ensuring that your healthcare providers and loved ones understand your desires regarding life-prolonging treatments, artificial nutrition, and hydration. Filling out a Living Will form correctly is essential for it to be effective. Here are the steps to follow to ensure your Indiana Living Will accurately reflects your wishes.

  1. Start by obtaining the official Indiana Living Will form. Make sure it is the most current version to ensure compliance with Indiana state laws.
  2. Read the form thoroughly before beginning to fill it out. This ensures you understand all the sections and the type of information you need to provide.
  3. Enter your full name at the beginning of the form to establish your identity as the declarant—the person making the Living Will.
  4. carefully review the sections regarding life-prolonging procedures, artificial nutrition, and hydration. Indicate your wishes by initialing next to the appropriate statements that reflect your choices regarding accepting or refusing these types of treatments.
  5. If you wish to donate your organs, fill in the section designated for organ donation. Specify which organs or tissues you would like to donate and for what purposes, such as transplantation, therapy, research, or education.
  6. Appoint a healthcare representative by providing their full name, relationship to you, and contact information. This person will have the authority to make healthcare decisions on your behalf in case you are unable to communicate your wishes directly.
  7. Ensure that all the information provided on the form is accurate and reflects your true wishes. Any inconsistency may lead to confusion or misinterpretation in the future.
  8. Sign and date the form in the presence of a witness. The witness must also sign, attesting that you are of sound mind and signing the document voluntarily.
  9. Keep the original signed document in a safe but accessible place. Provide copies to your healthcare representative, family members, or close friends, and consider filing a copy with your primary healthcare provider.

After you've filled out and signed your Indiana Living Will, your next step is to ensure that the relevant parties are aware of the document and understand your wishes. Communication is key. Talk to your healthcare representative, family, and healthcare providers about your decisions. By taking these steps, you're not only putting your healthcare preferences in writing but also making sure that those who may be involved in your care are informed and prepared to honor your wishes.

Things to Know About Indiana Living Will

What is a Living Will in Indiana?

A Living Will in Indiana is a legal document that allows an individual to outline their preferences regarding medical treatment if they become unable to communicate their decisions due to severe illness or incapacitation. It specifies the types of medical treatments and life-sustaining measures a person wants or does not want.

Who should have a Living Will?

Any person over the age of 18 who wishes to have control over their medical treatment should consider creating a Living Will. It's particularly important for those with serious health issues or concerns about potential future health crises to have one in place.

How can I create a Living Will in Indiana?

To create a Living Will in Indiana, you must complete the Living Will form, which outlines your healthcare choices. This document must be signed in the presence of a witness or notary public. It's advisable to seek guidance from a legal professional to ensure the document accurately reflects your wishes and meets all legal requirements.

Does an Indiana Living Will need to be notarized or witnessed?

Yes, after completing the form, you must sign it in the presence of a witness who is at least 18 years old, or have it notarized. This step confirms that the document is legally binding and that you were of sound mind and not under undue influence when you signed it.

What should be included in a Living Will?

An Indiana Living Will should include instructions about the use of life-sustaining treatments, such as mechanical ventilation, feeding tubes, and CPR. It should also specify whether you wish to donate your organs and tissues after death. Clearly stating your healthcare preferences can ensure your wishes are followed.

Is a Living Will the same as a Power of Attorney?

No, a Living Will is not the same as a Power of Attorney. A Living Will outlines your healthcare preferences, while a Power of Attorney for Healthcare appoints someone to make medical decisions on your behalf. These documents can complement each other as part of a comprehensive healthcare directive plan.

What happens if I change my mind about my Living Will?

If you change your mind about your Living Will, you can revoke it at any time. You should destroy the original document, notify anyone who has a copy, and create a new Living Will if your healthcare preferences have changed. Communicating these changes to your healthcare providers and loved ones is crucial.

Can my family override my Living Will?

In Indiana, a Living Will is legally binding, and healthcare providers are bound to follow it as long as it's available. However, if family members are unaware of the Living Will or its contents, disputes can arise. Ensuring that your family and healthcare providers have copies and understand your wishes can help prevent conflicts.

Where should I keep my Living Will?

Keep your Living Will in a secure yet accessible place. Inform your family, close friends, and healthcare providers about its location. You might also consider giving a copy to your physician and the hospital where you receive treatment to include it in your medical records.

Common mistakes

When it comes to preparing for the future, completing a Living Will is a wise step. However, in Indiana, like everywhere else, people often make mistakes when filling out this important document. These errors can range from simple oversights to significant misunderstandings of the form’s requirements, potentially leading to confusion or, worse, a document that doesn't reflect the person's true wishes.

A common mistake is not providing clear instructions regarding the person's health care wishes. The Indiana Living Will form is designed to guide individuals through expressing their preferences for medical treatment if they become unable to communicate these wishes themselves. Vague or incomplete instructions can leave family members and healthcare providers uncertain about the person's true desires.

Another issue is failing to update the document. Life changes, such as new medical diagnoses, changes in marital status, or shifts in personal beliefs about medical care, can all warrant a review and possible update of the Living Will. Without these updates, the document might not accurately reflect the person's current wishes.

Here are some of the top mistakes people make on the Indiana Living Will form:

  1. Not signing the document in the presence of a witness or notary public, as required by Indiana law.
  2. Choosing a health care representative who is not fully informed about the person's medical treatment preferences.
  3. Omitting contact information for the chosen health care representative, making it hard to reach them in case of an emergency.
  4. Forgetting to discuss their Living Will with family members, leading to potential disputes or confusion in stressful times.
  5. Not being specific enough about what life-prolonging treatments the person does or does not want to receive.
  6. Skipping the section that allows the addition of specific instructions about artificial nutrition and hydration.
  7. Not including a provision for donating organs or tissues, if that is the person’s wish.
  8. Filling out the form without fully understanding all the medical terms and implications of choices made.
  9. Not keeping the completed form in an accessible place where it can be easily found when needed.
  10. Failing to provide copies of the Living Will to the person's healthcare providers, the health care representative, and important family members.

To ensure the Indiana Living Will form truly represents one's end-of-life wishes, it is crucial to avoid these common mistakes. It's not just about completing the form, but about thoughtful consideration of what is truly wanted. When completed correctly and thoughtfully, the Living Will is a powerful document that clearly communicates a person's healthcare preferences, providing peace of mind for them and their loved ones.

Documents used along the form

When considering end-of-life arrangements in Indiana, an individual might first think of a Living Will as the primary document for outlining their healthcare wishes. However, it's important to understand that a comprehensive plan often includes more than just a Living Will. Several additional documents work in conjunction with a Living Will to ensure an individual's healthcare and financial decisions are clearly communicated and respected. Here are four other pivotal documents often used together with an Indiana Living Will form.

  • Healthcare Representative Appointment: This legal document allows an individual to appoint a trusted person as their healthcare representative. This appointed representative holds the authority to make healthcare decisions on behalf of the individual if they become unable to communicate their wishes directly.
  • Power of Attorney for Healthcare: Similar to the Healthcare Representative Appointment, a Power of Attorney for Healthcare gives someone else the legal authority to make healthcare decisions for an individual. However, it can offer broader powers beyond health care, depending on how the document is structured.
  • Financial Power of Attorney: This document appoints someone to manage the financial affairs of an individual, should they become incapacitated. While not directly related to healthcare decisions, it is often included in end-of-life planning to ensure comprehensive management of an individual's affairs.
  • Physician Orders for Scope of Treatment (POST): A POST form complements a Living Will by providing detailed instructions about specific treatments an individual wants or doesn't want at the end of life. It is filled out by a physician based on conversations with the patient and is especially useful in emergency situations where immediate decisions are necessary.

Together with a Living Will, these documents provide a robust framework for managing both healthcare and financial decisions in accordance with an individual's wishes. It's advisable for individuals to discuss these options with legal and healthcare professionals to ensure they're fully prepared for any future eventualities. Creating a comprehensive plan is a proactive step towards safeguarding one's health, financial well-being, and peace of mind.

Similar forms

The Indiana Living Will form is similar to Advance Directives found in other states, with a key purpose to outline an individual's healthcare preferences in scenarios where they are unable to communicate their decisions due to severe health conditions or incapacity. Much like Advance Directives, the Indiana Living Will allows for the specification of wishes regarding the use or refusal of life-sustaining treatments, artificial nutrition, and hydration. It also enables the appointment of a healthcare representative to make decisions on behalf of the person, ensuring that their healthcare preferences are respected and followed, mirroring the fundamental features of Advance Directives across the board.

Another document the Indiana Living Will form parallels is the Healthcare Power of Attorney (HCPOA). Both documents serve the integral function of appointing a trusted individual, known as a healthcare proxy or representative, who is authorized to make medical decisions on behalf of someone who is incapacitated or otherwise unable to make these decisions themselves. The main divergence between the two lies in their scope; while the Indiana Living Will primarily focuses on end-of-life decisions, the Healthcare Power of Attorney can encompass a broader range of healthcare decisions, not limited solely to those concerning life-sustaining treatment.

The Indiana Living Will form also bears resemblance to Do-Not-Resuscitate (DNR) orders. Both instruments communicate crucial healthcare preferences, specifically the desire not to have life-sustaining measures employed in certain situations. The critical difference resides in the scope and manner of implementation; a DNR is typically more limited in application, focusing specifically on not initiating resuscitation in the event of cardiac or respiratory arrest. Unlike the broader contextual application of an Indiana Living Will, which addresses a wider range of life-sustaining treatments beyond resuscitation, a DNR order is a direct instruction to healthcare providers, effective immediately upon its execution.

Dos and Don'ts

Completing the Indiana Living Will form is an important step in planning for future healthcare decisions. It ensures that an individual's healthcare preferences are known and followed should they become unable to communicate those decisions themselves. Here are essential guidelines to keep in mind:

Do:

  1. Ensure all information is accurately provided, including full legal names, addresses, and any other required personal information.
  2. Discuss your decisions with family members and healthcare providers to ensure they understand your wishes.
  3. Sign the document in the presence of a notary public or the required number of witnesses as specified by Indiana law.
  4. Keep the original document in a safe but accessible place, and provide copies to your healthcare proxy, family members, and healthcare providers.
  5. Review and update your Living Will as needed to reflect any changes in your health care preferences.

Don't:

  1. Leave any sections incomplete; unanswered questions may lead to confusion or misinterpretation of your wishes.
  2. Forget to have the document properly witnessed or notarized, as failing to do so could invalidate the entire document.
  3. Assume that your family knows what you want; have a conversation about your Living Will and ensure everyone is clear on your wishes.
  4. Fail to consider all aspects of your healthcare preferences, including conditions under which you would refuse treatment.
  5. Forget to give a copy of the Living Will to your healthcare representative and any alternates named in the document.

Misconceptions

When it comes to preparing for future healthcare decisions in Indiana, many people consider creating a Living Will. However, there are several misconceptions about the Indiana Living Will form that can lead to confusion. By clearing up these misunderstandings, individuals can make more informed decisions about their healthcare planning.

  • It requires a lawyer to complete. A common misconception is that you need a lawyer to fill out an Indiana Living Will. While legal advice can be beneficial, especially in complicated situations, Indiana law doesn’t require a lawyer to complete or validate it. The forms are designed to be filled out by the individual, following the provided instructions.
  • It covers all medical decisions. Another misunderstanding is that a Living Will addresses every possible medical decision. In reality, a Living Will in Indiana specifically relates to life-prolonging procedures when a person is terminally ill or permanently unconscious and cannot make decisions for themselves. It does not cover other medical treatments or decisions about non-life-prolonging care.
  • It goes into effect as soon as it's signed. Many believe that once the Living Will is signed, it immediately impacts their medical treatment. The truth is, the Living Will only comes into play under the conditions it describes, such as terminal illness or permanent unconsciousness, where the individual is unable to communicate their healthcare preferences.
  • It can't be changed or revoked. Some people think that after creating a Living Will, it is set in stone. However, in Indiana, an individual can change or revoke their Living Will at any time, as long as they are mentally competent. This can be done by creating a new Living Will or through a clear indication of the intent to revoke it, such as destroying the document or verbally expressing the desire to do so in the presence of witnesses.

Understanding these key misconceptions can help Indiana residents make informed decisions about their healthcare directives and ensure their wishes are respected. By taking the time to learn about and correctly fill out a Living Will, individuals can provide valuable guidance to their loved ones and healthcare providers in difficult times.

Key takeaways

When considering the completion and utilization of the Indiana Living Will form, it's important to be aware of several key factors that ensure your directives are clearly understood and legally enforceable. A Living Will provides peace of mind for both you and your loved ones by clearly stating your wishes regarding medical treatment in the event that you are unable to communicate them yourself. Here are six essential takeaways to guide you through this process:

  • Understand What a Living Will Covers: The Indiana Living Will form is specifically designed to document your wishes concerning life-prolonging treatments, including the use of ventilators, feeding tubes, and other forms of artificial life support, should you become terminally ill or permanently unconscious.
  • Legal Requirements Must be Met: For your Living Will to be considered valid in Indiana, you must be at least 18 years old, of sound mind, and the document must be signed by you in the presence of two adult witnesses who are not related to you by blood or marriage, nor entitled to any part of your estate.
  • Consider a Health Care Representative: While filling out your Living Will, it may be beneficial to designate a health care representative. This person will have the authority to make other medical decisions on your behalf that are not covered by your Living Will, ensuring all aspects of your health care are managed according to your preferences.
  • Communicate Your Wishes: After completing the form, it's crucial to inform family members, close friends, and your physicians about your Living Will. Providing copies to these individuals and your healthcare providers helps ensure your wishes are respected and followed.
  • Review and Update Regularly: Over time, your preferences for medical treatment may change. It’s wise to review your Living Will periodically and make necessary updates to reflect your current wishes. Remember, a new document must meet the same signing and witnessing requirements to be legally valid.
  • Keep the Original Document Safe: Store your original Living Will in a secure but accessible place. It's also a good idea to keep an electronic version that can be easily shared with healthcare providers or loved ones as needed.

By keeping these considerations in mind, you can ensure that your Indiana Living Will accurately reflects your healthcare preferences and provides clear guidance for those who may be involved in making medical decisions on your behalf.

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