Louisiana Advance Directive: What It Includes and How to Complete One

Louisiana residents frequently execute a single advance directive that combines two legal instruments: a Living Will (Declaration Concerning Life-Sustaining Procedures) and a Healthcare Mandate (the civil law equivalent of a medical power of attorney). Bundling them into one document means one signing ceremony, one set of witnesses, and no gaps in coverage — the living will handles terminal situations while the mandate covers everything else.

But Louisiana's civil law framework makes execution trickier than in most states. The witness rules, terminology, and registration process all differ from common-law states, and using a generic template from a national website can create problems when a hospital's legal department reviews the paperwork during an emergency.

What a Louisiana Advance Directive Covers

A combined advance directive addresses three scenarios:

Terminal or irreversible conditions. The living will portion directs physicians to withhold or withdraw life-sustaining treatment — ventilators, feeding tubes, artificial hydration — when two physicians certify that your condition is incurable with no reasonable expectation of recovery. This is governed by La. R.S. 40:1151.

Temporary or permanent incapacity. The healthcare mandate portion names a mandatary (agent) authorized to make medical decisions when you cannot. Unlike the living will, this activates during any incapacity: post-surgical unconsciousness, a traumatic brain injury, advanced dementia, or a stroke. Governed by Civil Code Article 2989.

Mental health treatment. Louisiana also recognizes an Advance Directive for Mental Health Treatment, which allows you to document preferences for psychiatric care — including medication choices, hospitalization preferences, and ECT consent — in case of a mental health crisis. This is a separate document from the medical advance directive.

Execution Rules

Louisiana's execution requirements are among the most rigid in the nation. A combined advance directive must meet the strictest standard of its component documents:

• Written and signed by the principal (you)
• Notarized — while the living will portion technically doesn't require notarization, the healthcare mandate does, so the combined document should be notarized
• Two competent adult witnesses must sign
• Witnesses cannot be related to you by blood or marriage, entitled to any part of your estate, your attending physician, or an employee of your healthcare facility
• Both witnesses and the notary must be present simultaneously during signing

The witness exclusion rule catches most people. If your adult daughter witnesses your advance directive, the document may be challenged as invalid. Neighbors, coworkers, church members, or friends with no inheritance interest are the safest choices.

How to Register

Louisiana maintains an End-of-Life Registry through the Secretary of State's office. Registration is optional but provides tangible benefits:

• Laminated wallet card that alerts first responders to your registered directive
• Engraved DNR identification bracelet (if your directive includes a DNR component)
• On-file verification — hospitals and EMS can confirm your directive exists

The registration fee is $20. You can also register a will separately for $10. Revocation of a registered directive requires a $5 filing.

Registration doesn't replace distributing physical copies. Your mandatary, primary care doctor, local hospital, and any specialist managing ongoing conditions should each have a copy.

How It Coordinates with LaPOST

If you have a terminal illness, your physician may recommend a Louisiana Physician Orders for Scope of Treatment (LaPOST) form. This is a separate medical order — printed on distinctive gold paper — that translates your wishes into immediately actionable physician orders. EMS personnel are trained to recognize and follow LaPOST forms on scene.

The key difference: your advance directive states what you want. A LaPOST form is a physician order that tells medical personnel what to do. The advance directive guides planning; the LaPOST guides the emergency response.

A LaPOST must be signed by both a licensed physician and the patient (or authorized representative). It is designed for individuals with serious, life-limiting conditions — not for healthy adults completing general advance planning.

Why Louisiana-Specific Forms Matter

National document platforms routinely use common-law terminology that Louisiana hospitals may not recognize. "Power of attorney" instead of "mandate." "Holographic" instead of "olographic." References to legal concepts like "tenancy by the entirety" that don't exist in Louisiana's civil law system.

Beyond terminology, some platforms still direct users to register LaPOST forms electronically — despite Louisiana disabling its statewide LaPOST electronic registry in June 2024 after a vendor contract terminated.

The Louisiana Advance Directive & Living Will Kit uses correct civil law terminology, includes the proper witness screening checklist (with the specific disqualifications Louisiana requires), and provides current registration instructions for the Secretary of State's End-of-Life Registry. It covers both the healthcare mandate and living will in a single execution workflow, along with standalone reference sheets for the signing protocol and emergency wallet cards.

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