Advance Directive Arkansas: How to Set Up Your Parent's End-of-Life Plan

Your parent's doctor just asked whether they have an advance directive on file, and you realize nobody in the family has discussed end-of-life preferences. That conversation feels impossible — but without a legal document in place, Arkansas physicians make decisions based on statutory defaults that may not reflect what your parent actually wants.

An advance directive in Arkansas is a single document that combines two functions: a living will (end-of-life treatment preferences) and a healthcare power of attorney (designating someone to make medical decisions). The state calls this combined document the Advance Care Plan.

What an Arkansas Advance Directive Covers

The Advance Care Plan form, published by the Arkansas Department of Health, lets your parent:

• Appoint a healthcare agent — a primary and alternate person authorized to consent to treatments, choose care facilities, and communicate with medical staff
• Outline living will instructions — specific preferences about life-sustaining treatment, artificial nutrition, hydration, and resuscitation
• Set activation conditions — under Arkansas Code § 20-6-103(d), the agent's authority only activates once a licensed physician formally determines the parent lacks capacity, unless the document specifies otherwise

The healthcare agent can make decisions about hospitalizations, medications, surgery, and residential placement. They cannot, however, manage bank accounts or real estate — that requires a separate durable financial power of attorney.

Signing and Witness Requirements

Arkansas law provides two options for executing an advance directive:

Option 1: Notarization. Your parent signs the form before a licensed Arkansas notary public.

Option 2: Two witnesses. Your parent signs in front of two competent adults who also sign the document. Arkansas imposes strict witness restrictions:

• Witness 1 cannot be the designated healthcare agent
• Witness 2 cannot be the agent, cannot be related to the parent by blood, marriage, or adoption, and cannot be entitled to any portion of the parent's estate

Either option is legally valid. However, hospitals and care facilities tend to process notarized documents faster because staff can verify authenticity without contacting witnesses.

How to Complete the Form

1. Download the official Advance Care Plan form from the Arkansas Department of Health website
2. Have your parent designate a primary healthcare agent and at least one alternate
3. Complete the living will section — mark specific preferences about life support, ventilators, and comfort care
4. Sign the form using either the notary or two-witness method
5. Distribute copies immediately to your parent's primary care physician, the local hospital records department, and every designated agent

Keep the original in a fireproof safe or other secure location. Do not store it only in a bank safe deposit box — the box may be inaccessible during an emergency when the document is needed most.

Out-of-State Validity

If your parent executed an advance directive in another state before moving to Arkansas, it remains valid. Under Arkansas Code § 20-6-103(h), an advance directive executed outside Arkansas is honored as long as it complied with either Arkansas law or the laws of the state where it was signed.

This matters for families who relocated for retirement or to be closer to caregiving children.

The POLST Form: When an Advance Directive Isn't Enough

For parents with advanced illness, an advance directive may not translate quickly enough into actionable medical orders. Arkansas offers the Physician Orders for Life-Sustaining Treatment (POLST) form — a physician-signed medical order that travels with your parent and is binding on emergency personnel.

A POLST differs from an advance directive because it is a clinical order, not a planning document. The attending physician and the patient (or their legal healthcare agent) both sign it, and it goes into the active medical chart. Emergency responders follow POLST instructions immediately, without needing to interpret advance directive language.

Common Mistakes to Avoid

Waiting until a crisis. Your parent must have mental capacity to execute an advance directive. Once a physician determines they lack capacity, the document cannot be created — the family's only option becomes court-supervised guardianship.

Confusing a healthcare directive with a financial POA. An advance directive covers medical decisions only. To manage your parent's finances, bank accounts, and property, you need a separate durable power of attorney under Arkansas Code Title 28, Chapter 68.

Filing without distributing copies. A signed advance directive that sits in a drawer is functionally useless. Every healthcare provider who treats your parent needs a copy on file.

The Arkansas Power of Attorney & Guardianship Kit for Aging Parents includes both the healthcare advance directive and the financial power of attorney, along with step-by-step instructions for executing each document correctly under Arkansas law.

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