How to Write a Living Will So Your Family Never Has to Guess

Why does a living will matter?

On 25 February 1990, Terri Schiavo collapsed at home in St. Petersburg, Florida. She was 26. Her heart had stopped. Paramedics restarted it, but her brain was badly damaged.

Terri had not written a living will. So nobody could show, on paper, what she wanted.

Her husband, Michael, said she would not want to be kept alive by machines with almost no chance of recovery. Her parents, Robert and Mary Schindler, disagreed. They wanted her care to continue.

In January 2000, a Florida judge held a trial to work out what Terri would have wanted. Eighteen witnesses spoke. Then the fight grew. There were 14 appeals in Florida courts and five lawsuits in federal court. The Florida legislature, the US Congress and President George W. Bush all stepped in (Wikipedia summary of the court record).

The legal fight ran from 1998 until Terri died in 2005. Both sides later wrote books. Her parents gave theirs the subtitle A Lesson for Us All.

This guide takes no side in that fight. Its point is simpler: a few signed pages could have spoken for Terri. Our page on the Terri Schiavo case tells the full story.

In 1789, Benjamin Franklin wrote that "in this world nothing can be said to be certain, except death and taxes" (letter to Jean-Baptiste Le Roy, via Wikiquote). We plan for taxes every year. Most of us never plan for the other one.

A review of 150 US studies (published 2011 to 2016) found that only 36.7% of adults had any advance directive. That is about 1 in 3. Only 29.3% had a living will (Yadav et al., Health Affairs, 2017).

Writing one takes an afternoon, not a lawyer.

What is a living will, and how is it different from a health care proxy?

A living will is a letter to the doctors who will meet you on a day you cannot speak. It tells them which treatments you want, which you do not want, and when each choice applies (National Institute on Aging).

It is not a will. A will covers your money and property after you die. A living will covers your medical care while you are alive.

It only works when you cannot make or share your own decisions. Many state laws narrow this further. Florida's law, for example, covers three situations: a terminal condition, an end-stage condition, or a persistent vegetative state. That last one means awake but with no sign of awareness (Florida Statutes §765.302). Your state's form will list its own situations.

A health care proxy is a different paper. It names one person to make decisions for you. Many states call it a durable power of attorney for health care. Read our guide on how to choose a health care proxy.

Think of it like this. Your living will is a map. Your proxy is a guide. A map cannot show every road. When doctors reach a road your map does not show, your guide decides which way you would go. That is why it helps to have both.

A map can also be ignored. NIA says an advance directive is "legally recognized but not legally binding." Doctors will try to follow it, but some situations are unclear. A doctor may also refuse for reasons of conscience or hospital policy. Then they must tell your proxy and consider moving your care (NIA). This is one more reason to talk, not only to write.

What should I put in my living will?

Start with your values, not the medical list. Ask yourself:

• What makes a day worth living for you?
• Would you accept a hard treatment if it gave you a good chance to go home?
• Is there a state you would not want to live in, even if machines could keep you alive?
• Is there an event you would want to stay alive for, like a wedding or a birth?

Your answers shape every choice below. The first four come from NIA's list of common decisions (NIA).

CPR (cardiopulmonary resuscitation). This tries to restart your heart if it stops. NIA notes that CPR is less likely to work for older adults with long-term illness. You can say yes in some situations and no in others. "CPR after a sudden accident, but no CPR if I have a terminal diagnosis" is clear. "Do everything" or "do nothing" often is not.

A ventilator (breathing machine). You can accept it for a trial period, and ask for it to stop if you do not improve. The Karen Ann Quinlan case, the first famous US "right to die" case, began with a family asking to stop one.

Artificial nutrition and hydration. This means food and fluids through a tube or a drip. It can help people recover from an illness. Near the end of life, NIA says, studies show it does not meaningfully extend life. Some people still want it. Others want care focused on comfort.

Heart devices (ICDs). An ICD is a small device that shocks the heart back into rhythm. If you refuse other life support, a doctor may suggest turning it off. NIA advises writing down what you want if that happens.

Other choices many forms include:

Dialysis. A machine cleans your blood when your kidneys fail. Say whether you want it, and when you would want it stopped.

Pain relief and comfort. Many people write that comfort comes first, even if strong pain relief makes them sleepy. Our guide to palliative care explains what comfort care includes.

Organ and tissue donation. NIA suggests recording this choice too. Also sign up on your state registry.

Pregnancy. More than 30 states have laws that limit a directive during pregnancy. Seven states cancel a pregnant person's directive for the whole pregnancy: Alabama, Indiana, Kansas, Missouri, South Carolina, Texas and Wisconsin. Some states are moving the other way. Colorado removed its pregnancy rule in 2021, and Washington did the same in 2025 (Compassion & Choices). If this could apply to you, write your wishes clearly and check your state's current rule.

What are the legal requirements in my state?

Every state has its own rules, so read your form's instructions line by line. These are the common ones.

Age. You must be 18, or the age of majority in your state.

Witnesses. Most state forms ask for two adult witnesses. Many bar some people, such as your health workers, close relatives or anyone who will inherit from you.

A notary. Some states need a notary instead of witnesses, or as well. Real examples:

State	What the law asks for
Florida	Two witnesses. One must not be your spouse or a blood relative (Florida Statutes §765.302).
South Carolina	Two witnesses and a notary. The notary may also act as one witness (CaringInfo SC form).
Missouri	On The Missouri Bar's form, the health care directive (living will) part needs two witnesses. The health care power of attorney part needs a notary (The Missouri Bar).
Texas	The living will is called the Directive to Physicians and Family or Surrogates. You can use a notary instead of two witnesses. Electronic signatures are allowed if certain rules are met (Texas HHS).
New York	There is no living will law. Courts accept a living will if it gives "clear and convincing" evidence of your wishes. The state's main tool is the Health Care Proxy form (NY Courts Law Library; LawHelpNY).

Moving between states. A living will from one state does not always work in another. Some states honor out-of-state directives. Some do so only if they are similar to local law. Some have no clear answer. If you spend a lot of time in two states, CaringInfo suggests completing each state's form (CaringInfo).

What is changing. California's SB 1088 was signed on 28 September 2026 and starts on 1 January 2027. It makes the state's advance directive, DNR and POLST forms more consistent. It lets nurse practitioners and physician assistants sign DNR and POLST forms. It also accepts POLST forms made in other states (Senator Blakespear's office).

Where can I get a free living will form?

NIA says a lawyer can help but is not required (NIA). Before you pay any website, try these free routes:

• CaringInfo. Free forms and instructions for every state, plus Washington DC and Puerto Rico. You can fill in the PDF on screen, then print it to sign (CaringInfo).
• Your State Attorney General's office. Many post the official form online.
• Your local Area Agency on Aging. Find it through the Eldercare Locator on 800-677-1116.
• PREPARE for Your Care and The Conversation Project. Free online guides and forms. Veterans can also use a VA advance directive.
• Your hospital. Since December 1991, the federal Patient Self-Determination Act has required many hospitals to tell adult patients about advance directives on admission (Wikipedia). Ask for the social worker.

Five Wishes is a popular low-cost option. It adds comfort, spiritual needs and messages for loved ones. It meets legal requirements in 46 states and comes in 33 languages. The paper version costs $5 and the digital version $15 (Five Wishes). If you live in one of the other states, use your state's own form.

What mistakes make a living will fail?

A living will fails when it is unclear, unknown or out of date.

1. Vague words. Doctors and families read "no heroic measures" in very different ways. Name the treatment and the situation.
2. No talk with your doctor. Medicare covers this conversation as part of your yearly wellness visit (NIA). Ask your doctor to add the document to your medical record.
3. Locked away. A safe deposit box cannot help you in an emergency room at night.
4. No digital copy. Keep a secure scan you can open from your phone.

The biggest mistake is quieter: writing it, but never saying it out loud. NIA reports that, in one study, people guessed nearly 1 in 3 end-of-life decisions wrongly for a loved one (NIA).

Ellen Goodman, a Pulitzer Prize-winning writer, cared for her mother through years of Alzheimer's disease. They had never discussed end-of-life care. In the end, the decisions fell to Ellen. She later said:

"We talked about everything except one thing: how she wanted to live at the end of her life." (The Conversation Project)

She went on to co-found The Conversation Project in 2010. Its 2018 national survey found that 92% of Americans say this talk is important. Only 32% have had it (The Conversation Project). Our guide on how to talk to family about end-of-life wishes can help you start.

Which group are you in?

Who should get a copy, and when should I update it?

Once it is signed, give copies to your doctors and your proxy. Also give one to family who are likely to be with you in an emergency, and to your lawyer if you have one.

Keep the original somewhere people can find it. Some states run registries that store it for doctors. A wallet card can say where it is kept (NIA).

NIA suggests reviewing it at least once a year. Also review it after a major life change, such as a divorce, retirement, a move to another state or a big change in your health.

If you make a new version, tell your doctor. Collect the old copies so no one uses the wrong one. If you use a registry, update it too.

Do I also need a DNR or POLST form?

Maybe, if you are seriously ill. A living will states wishes. A DNR (do not resuscitate) order is a medical order in your chart. NIA says it helps to have one in hospital, even if your living will says no CPR. An out-of-hospital DNR tells paramedics.

A POLST form turns your wishes into portable medical orders that emergency teams can follow at once. It is for people who are seriously ill or very frail, and it is always optional (National POLST).

What if I do not live in the US?

The rules differ. In England and Wales, the paper is called an advance decision to refuse treatment. Unlike a US living will, it is legally binding if it follows the Mental Capacity Act and applies to the situation. To refuse life-sustaining treatment, it must be written down, signed by you and signed by a witness. It must also state clearly that it applies even if your life is at risk (NHS).

In Malaysia, a 2018 legal review found no specific law on advance decisions (Asian Bioethics Review). That means a written plan is not legally binding there. It still helps your doctors and family understand what you want.

What is one small step I can take this week?

You do not have to finish everything today. Start with one question.

If you could not speak tomorrow, who would your doctors call? Would that person know what you want?

If the answer is "I am not sure", that is your first step. The free end-of-life readiness check can show you what else is missing. Tonight, download your state's free form from CaringInfo. Then ask that person for a quiet half hour this week. Read the form together.

Preparing for this is not about expecting the worst. It is about keeping your voice in the room. Terri Schiavo's family spent seven years in court arguing about hers. You can leave yours on paper, for the people you love.