Advance Directive Nebraska: Forms, Rules, and How to Complete One

What an Advance Directive Means in Nebraska

Nebraska does not have a single statutory form called an "advance directive." The term is a practical shorthand for the combination of two separate legal instruments: a Power of Attorney for Health Care and a Living Will (declaration under the Rights of the Terminally Ill Act).

Each document serves a distinct purpose. The healthcare POA appoints a person — your agent — who can make medical decisions when your parent cannot. The living will states your parent's wishes about life-sustaining treatment, artificial nutrition, and hydration when a terminal condition is diagnosed. Together, they form a complete advance directive package that covers both the "who decides" and the "what I want" sides of end-of-life planning.

Some hospitals and attorneys in Nebraska use a combined form that merges both instruments into one document. This works fine legally, but each component still operates under its own statute with its own execution rules. Understanding those differences prevents execution errors that could invalidate part of the package.

The Two Components and Their Forms

Healthcare Power of Attorney (Form DC 6:13)

The Nebraska Judicial Branch provides the standard healthcare POA as Form DC 6:13. It must be signed by your parent and either:

• Acknowledged before a notary public, or
• Signed in the presence of two adult witnesses

Either method is valid. You do not need both. The witness option has restrictions: neither witness can be the named agent, the attending physician, or — unless they are a relative — an employee of the parent's healthcare provider.

The healthcare POA stays dormant until the attending physician determines in writing that your parent lacks the capacity to make or communicate healthcare decisions. Once activated, the agent can consent to or refuse treatments, choose providers, and authorize transfers between facilities.

Living Will

The living will must be signed and dated in the presence of two adult witnesses — the notary option is not available for this component. Neither witness can be a potential heir, someone financially responsible for the parent's care, the attending physician, or an employee of the physician. For nursing home residents, one witness must be a patient advocate or DHHS-designated ombudsman.

The living will addresses three specific types of intervention: life-sustaining treatment, artificial nutrition, and hydration. It activates only when the parent's condition is terminal and they cannot communicate their wishes.

Common Mistakes That Invalidate the Documents

Using the wrong witness for a nursing home resident. If your parent lives in a skilled nursing facility, the living will requires a patient advocate or ombudsman as one of the two witnesses. Family members often skip this step because they do not realize the rule applies. The easiest fix is to contact the facility's social worker and ask for the designated patient advocate.

Confusing the notary and witness rules. The healthcare POA lets you choose between a notary and witnesses. The living will requires witnesses only. Families who notarize the living will but skip the witnesses have an improperly executed document.

Failing to include a HIPAA release. Neither the healthcare POA nor the living will automatically gives your agent access to medical records. Federal HIPAA regulations require a separate disclosure authorization. Without it, a hospital can refuse to share lab results, imaging reports, or physician notes with your agent — even though that agent has the authority to approve the treatment those records describe. Nebraska DHHS Form MLTC-34 provides a standard disclosure template.

Naming a disqualified agent. The parent's attending physician, or any owner or employee of the care facility where the parent resides, cannot serve as healthcare agent unless they are a relative. Naming one of these disqualified individuals creates a document that looks valid on paper but may be challenged in the exact crisis when you need it most.

How to Keep the Advance Directive Current

An advance directive is not a one-and-done document. Review it after any major life change: a new diagnosis, a move to a different care facility, a change in family dynamics, or the death or incapacity of the named agent.

Both components can be revoked at any time. The healthcare POA is revoked by a written revocation signed by the parent, or by executing a new healthcare POA (which automatically supersedes the old one). The living will can be revoked by physical destruction, written revocation, or even an oral statement witnessed and documented in writing.

After any update, distribute copies to the healthcare agent, the parent's primary care physician, the hospital system (Nebraska Medicine, CHI Health, Bryan Health, or the local facility), and any relevant care facility. Keep the originals in a location the agent can access quickly — not a safe deposit box, which may be locked during the exact emergency when the documents are needed.

Building the Complete Legal Authority Package

An advance directive covers medical decisions, but it does not give anyone authority over bank accounts, property, Medicaid applications, or Social Security benefits. For the full scope of legal authority — including the durable financial POA, representative payee setup, and the guardianship process when capacity is already lost — the Nebraska Power of Attorney & Guardianship Kit walks through every step with Nebraska-specific statutory references and form instructions.

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