Advance Directive vs Living Will vs Medical Power of Attorney in New Hampshire

If you've been searching for whether you need a living will, a healthcare proxy, or a medical power of attorney in New Hampshire, here's the answer that most national legal websites get wrong: in NH, these are not separate documents. The state combines them into a single statutory form under RSA 137-J.

Understanding how the pieces fit together — and what each piece actually controls — prevents the most common planning mistakes.

The Combined Form Explained

Most states require separate documents for agent designation and treatment instructions. New Hampshire took a different approach. The statutory advance directive form under RSA 137-J has two integrated sections:

The Durable Power of Attorney for Health Care (DPOAH) — this is the "who" section. You name a specific person (your healthcare agent) authorized to make medical decisions when you lack capacity. This is what other states call a "healthcare proxy" (Massachusetts) or "medical power of attorney" (Texas, Ohio).

The Living Will — this is the "what" section. You document your specific treatment preferences: whether you want life-sustaining measures continued or withdrawn if you are terminally ill or permanently unconscious, your preferences about artificial nutrition and hydration, and any conditions you consider excessively burdensome.

You complete both sections in a single document, with a single signing session and one set of witnesses (or one notary).

How They Interact

Here's the critical nuance that catches many people: your healthcare agent's real-time decisions legally take precedence over the Living Will's written instructions. The agent can adapt to circumstances the Living Will didn't anticipate.

For example, your Living Will might state that you don't want artificial nutrition if you're permanently unconscious. But your agent might face a situation where you're temporarily unconscious after surgery with a strong recovery prognosis. The agent can authorize short-term feeding support that the Living Will's blanket language might seem to prohibit — because the agent understands context that a pre-written document cannot.

This is by design. The DPOAH gives your agent flexibility to respond to the actual medical situation, while the Living Will provides a documented baseline of your values and preferences to guide those decisions.

What About the Financial Power of Attorney?

The healthcare DPOAH is entirely separate from a financial power of attorney (also called a "durable general power of attorney"). They cover different domains:

Having one does not substitute for the other. Your healthcare agent cannot access your bank accounts, and your financial power of attorney agent cannot make medical decisions — unless the same person holds both roles, which is a common and practical arrangement.

Do You Need All the Pieces?

For comprehensive planning in New Hampshire, you need:

1. The advance directive (DPOAH + Living Will combined) — this is the document governed by RSA 137-J
2. A financial durable power of attorney — separate document, governed by RSA 564-E
3. A POLST or DNR order (only when medically appropriate) — signed by your physician, not by you

The advance directive is the foundation. Without it, the financial POA cannot make healthcare decisions, and the POLST/DNR cannot exist without a clinical conversation informed by your documented preferences.

Why the Distinction Matters

The most dangerous planning gap is completing only one piece. A Living Will without a DPOAH means you've documented your preferences but appointed no one to enforce them — your family falls into the default surrogacy hierarchy. A DPOAH without a Living Will means you've appointed someone to decide but given them no documented guidance about your values.

New Hampshire's combined form prevents this gap by design. But you still need to complete both sections thoughtfully, not just sign the boilerplate.

The New Hampshire Advance Directive & Living Will Kit walks you through each section of the combined form — agent selection, treatment preferences, Living Will burdens addendum, and execution — so nothing is left blank or vague.

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