Living Will Addendums: 4 Documents That Could Strengthen Your Advance Directive

You've done everything right. You filled out your living will, named your healthcare agent, and filed everything properly.

But then an emergency happens, and you're rushed to a hospital affiliated with a religious organization. The hospital's policies might conflict with what you wrote in your living will. Your family is there holding your paperwork, wondering if your wishes will be honored.

Or imagine this: You're in the ICU after an emergency. Without written documentation clearly stating who your designated support person is, hospital staff might not know who to include in care discussions or who to give medical updates to, especially if you have a non-traditional family structure.

These are the kinds of situations where your basic living will might not be enough.

What Are Addendums?

An addendum is an additional document you attach to your living will that provides more detail about your wishes. The Texas living will (Directive to Physicians and Family or Surrogates) form has a section for additional requests where you can list particular treatments you do or do not want in specific circumstances. It's also where you can reference any addendums you've created.

Your living will needs to be clear, concise, and quick to read in case of an emergency. Addendums let you dive a little bit deeper and get into that deeper context about your values and preferences.

Here's something important to be aware of: these addendums appear to be advisory rather than strictly binding. Your living will itself is the controlling legal document. You'll want to confirm with an estate attorney exactly what weight they carry in your state.

The Four Addendums We Cover (Links found below under Resources)

1. Personal Values & Care Preferences

This addendum documents your detailed wishes about specific treatments and circumstances. You can use either the Emory Healthcare Critical Conditions Planning Guide (Pages 15-24) or the Compassion & Choices "My Particular Wishes for Therapies That Could Sustain Life" form (Pages 21-23 & 25-26).

2. Dementia Directive

A dementia directive outlines your specific care wishes if you develop dementia. We covered this in detail in Episode 33, so we won't go deep today. Compassion & Choices has a Dementia Values & Priorities Tool in their toolkit that you can use (Pages 27-32).

3. Sectarian Healthcare Directive

This addendum addresses situations where you might be admitted to a healthcare institution whose religious or moral policies could potentially conflict with your living will. It states that your admission doesn't constitute implied consent to procedures that conflict with your directive, and includes instructions for transfer to another facility if needed. Compassion & Choices has a template for you to use (Page 35).

4. Hospital Visitation Authorization

This addendum names the specific people you want as your designated visitors and support persons. It's particularly helpful if you're unconscious or can't speak when you arrive at the hospital.

This can matter for people in non-traditional family structures - LGBTQ+ couples, those with close friends they consider family, or people estranged from biological relatives.

For us, with our daughter living in a different state, she does have family around, but she doesn't have us there or her brother. So her fiance or the family that are there could really use this form to help her out. Compassion & Choices has a template to use (Page 39).

How Do Medical Staff Use Addendums?

You might be wondering, "If doctors need information fast, how do pages of addendums help?"

Based on what we've learned from an estate attorney webinar, in an emergency, medical staff look first at your main living will for quick, clear directives. After the immediate crisis or when they're making long-term care decisions, then they may reference the addendums for additional guidance to make sure that your wishes are followed.

Formatting Your Addendums

We suggest each addendum include a clear heading, for example:

"ADDENDUM TO DIRECTIVE TO PHYSICIANS AND FAMILY OR SURROGATES"

Title: [Your addendum topic]

This document should be read together with my Directive to Physicians and Family or Surrogates under Texas Health & Safety Code Chapter 166. This addendum is intended to guide my physicians, family members, and medical decision makers in understanding my values, priorities, and preferences regarding medical treatment and end-of-life care. This document does not replace my Directive. In the event of any inconsistency, my Directive is the controlling document.

Action Steps Before Our Next Episode

• Download the Compassion & Choices (C&C) toolkit
• Complete the Emory Guide (if not already complete from the prior episode) OR C&C Values Toolkit
• Select & complete relevant addendums
• Add the suggested heading or heading advised from your attorney
• Use blue ink if handwriting
• Do NOT sign yet - wait for next episode

Resources

Emory Healthcare Critical Conditions Planning Guide (Pages 15-24): https://ethics.emory.edu/what-we-do/programs/health/critical.html

Compassion & Choices (C&C) Toolkit (English/Spanish): https://compassionandchoices.org/resource/eoldgt/

• Personal Values (pages 21-23 & 25-26)
• Dementia Directive (pages 27-32)
• Sectarian Healthcare Directive (page 35)
• Hospital Visitation Authorization (page 39)

Episode 57 (Part 1) - Living Will Series: https://youtu.be/sq7asB8MhUM

Episode 33 - Dementia Directives: https://youtu.be/cH9Jc_8LNlE

Texas Legal Help Resources

If you have complicated family situations, complex medical conditions, or significant assets to coordinate, you'll want to consult an estate planning attorney. Some attorneys offer reduced-cost initial consultations.

• Certified Lawyer Referral: https://www.texasbar.com/Content/NavigationMenu/ForThePublic/DoYouNeedaLawyer/CertifiedLawyerReferralServices1/default.htm
• Texas Law Help: https://texaslawhelp.org/directory
• Phone: (800) 252-9690
• Chat: https://texaslawhelp.org/ask-a-question
• Walk-in clinics: https://texaslawhelp.org/legal-events-and-clinics

Key Takeaways

✅ Addendums provide deeper context beyond your basic living will

✅ They appear advisory rather than strictly binding - confirm with an estate attorney

✅ Medical staff reference your main living will first, then they might reference addendums for more information

What's Next

In our next episode, we'll walk through completing the Texas living will form itself, including witness requirements, notarization, and signing everything together.

Listen to the full episode of Thoughtful Planning: 🎙️ Apple Podcasts | Spotify | YouTube | Amazon Music

Questions? Email us at [email protected]

Remember: Every chapter you write today shapes your legacy tomorrow.

Disclaimer: We are not attorneys, financial advisors, or medical professionals. Everything shared is for educational purposes only. For complex situations or legal advice, consult an estate planning attorney in your state.