Advance Healthcare Planning
Kentucky Advance Healthcare Directive

Kentucky Advance Healthcare Directive


Jennifer Mcgee


Updated on  

March 24, 2023

9 Mins


When a person chooses to make a Living Will, along with the Medical Power of Attorney, these two legal documents become an Advance Directive. 

An Advance Directive may include your sign, names of witnesses, their signatures, etc. in adherence to your state’s requirements. Every state has different requirements to be followed. Some states ask for witnesses and notaries, others look for different criteria to be followed. 

Likewise, some states consider Living Will and Advance Directive as different and separate documents, whereas others consider both documents the same. In some states, Living Will and Advance Directive are used interchangeably. 

In this article, you will get a complete guide for making an Advance Directive for Healthcare in Kentucky.  

Legal Requirements for a valid Advance Directive

  • Written by the grantor/declarant (i.e. the maker of an Advance Directive): Yes
  • Grantor must be:
  • Above the age of 18 years: Yes
  • Sound mind and memory: Yes
  • Signed by the grantor: Yes
  • Signed by Proxy/Agent: No
  • Proxy/agent accepts his role in writing: No
  • Witness required: Yes
  • Number of witnesses: 2
  • Signed by the witnesses: Yes
  • Number of documents required: 1 
  • Other names for a Living Will in Kentucky: Healthcare Instructions
  • Other names for a Healthcare Power of attorney in Kentucky: Appointment of Healthcare Agent
  • Proxy can decide on mental health issues: No
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Who can be your witnesses in the Kentucky Advance Directive?

Anyone can be your witness in Kentucky if;

  • He is an adult i.e., above 18 years of age, and
  • He is a sound-minded person which means that he can understand the consequences of making an Advance Directive and the laws applied to it.

Your witnesses cannot be:

  • Your healthcare proxy/agent,
  • your supervising health care provider/ his employer,
  • the operator or an employee of a healthcare facility where you’re receiving care,
  • a person related to you by blood or a  person entitled to a share in the estate on your death, and
  • someone directly financially responsible for your medical care.
Advance Directive Kentucky

Who can be your Proxy in the Kentucky Advance Directive?

Anyone can be your Proxy/Surrogate in Kentucky if

  • He is an adult i.e., above 18 years of age, and
  • He is a sound-minded person which means that he can understand the consequences of making an Advance Directive and the laws applied to it.

Who cannot be your Proxy/Surrogate:

  • your supervising health care provider, 
  •  if you are receiving care at a community care facility/residential care facility then its operator or its employee.
  •  if you are receiving care  at a health care institution then its employee.


  • the proxy/surrogate is related to you by blood, marriage, or adoption, or
  • the proxy/surrogate is a member of the same religious order (for example, if you are both priests in the same order)

Other than the above legal requirements, the Proxy/Agent should be:

  • Trustable to adhere to your wishes and intentions.
  • Trustable to defend you if there’s any disagreement about your medical care.
  • He wanted to be your Attorney in Fact of his own free will to take care of your health affairs.
  •  He should not be your doctor or one of the caretakers.

Note: You can appoint an Alternate Proxy as well. The alternative Proxy/Agent will step in if the first person you name as a proxy is unable, unwilling, or unavailable to act for you or if you decide to revoke his authority.

Notarization required for Kentucky Advance Directive?

You can either get an Advance Directive executed by signing the form in presence of the witnesses or get your signature notarized by signing an acknowledgment in front of the public notary.

Learn about the requirements of Kentucky Last Will and Testament and Kentucky Last Will and Testament Template.

When does an Advance Directive come into effect in Kentucky?

In Kentucky, an Advance Directive becomes legally valid but doesn’t come into effect on signing the form by the grantor, proxy, and witnesses. 

An Advance directive comes into effect only when the doctor declares that you are incapable of deciding on your own and have become debilitated due to illness or injury.

Note: Your Kentucky Advance Directive will not be effective in any medical crisis or emergency unless you are declared incapacitated to understand and communicate your wishes and consent by your doctor.

How can an Advance Directive be revoked?

You can revoke or terminate your Kentucky Advance Directive (other than the designation of your agent) at anytime by:

  • A written revocation, 
  • An oral revocation in presence of two witnesses, (at least one of them is your healthcare provider)
  • Tearing, burning, and obliterating or destroying the document in any other way or directing any other person to write on your behalf.

How to amend or change an Advance Directive? 

You can make changes or amend your Advance Directive at any time in Kentucky but once it was witnessed and signed you have to remake a new document with the required changes. It is recommended to go through, double-check, and make sure of everything before signing the Advance Directive.

Kentucky rules for pregnancy after making your Advance Directive

Kentucky state laws mention that a pregnant grantor’s preferences in the Advance Directive to withhold the life-prolonging treatments will not be honored if it is possible that the fetus is viable and could develop to the point of live birth with continued application of life-sustaining treatment.

Unless it is medically declared that such procedures will not allow the baby to be born, will be physically harmful to you, or will prolong severe pain that cannot be alleviated through medication.

Parts of the Kentucky Advance Directive Form

Part 1: Appointment of Healthcare Agent

You can fill this form out and provide all the details. The appointment of the Healthcare Proxy/Agent and his details will be filled along with the instructions for the Proxy/Agent to follow.

Kentucky Advance Directive Sample Form


I, (print name), designate ____________________________________ (name of surrogate) as my health care surrogate to make health care decisions for me in accordance with this directive when I no longer have decisional capacity. If the person I name above refuses or is not able to act for me, I designate __________________________________________ (name of alternate surrogate) as my health care surrogate. When making health-care decisions for me, my surrogate should think about what action would be consistent with past conversations we have had, my treatment preferences as expressed in this or any other document where I have recorded my wishes, my religious and other beliefs and values, and how I have handled medical and other important issues in the past. 

If what I would decide is still unclear, then my surrogate should make decisions for me that my surrogate believes are in my best interest, considering the benefits, burdens, and risks of my current circumstances and treatment options. I give the following instructions as further guidance to my surrogate:


Part 2: Treatment Preferences

This section states your wishes regarding medical care when your doctor determines that either: 

  • that you are terminally ill and to prolong artificially your life you would need artificial life-sustaining procedures or your death will occur with or without the use of life-sustaining procedures, or 
  • that you are in a persistent vegetative state.

Kentucky Advance Directive Sample Form


A. Surrogate Decision-Maker 

[   ] I authorize my surrogate, designated above, to withhold or withdraw artificially provided nourishment or fluids, or other life prolonging treatment, if the surrogate determines that withholding or withdrawing is in my best interest; but I do not mandate that withholding or withdrawing. (Do not complete B or C, below, if you initial this choice). 

B. Life-Prolonging Treatment 

[   ] I direct that life-prolonging treatment be withheld or withdrawn, and that I be permitted to die naturally with only the administration of medication or the performance of any medical treatment deemed necessary to alleviate pain. 

[   ] I DO NOT authorize that life-prolonging treatment be withheld or withdrawn. 

C. Artificially-Provided Nutrition and Hydration 

[   ] I authorize the withholding or withdrawal of artificially provided food, water, or other artificially provided nourishment or fluids. 

[   ] I DO NOT authorize the withholding or withdrawal of artificially provided food, water, or other artificially provided nourishment or fluids.

D. Organ and Tissue Donation 

[   ] I authorize the giving of all or any part of my body upon death for any purpose specified in KRS 311.185. 

[   ] I DO NOT authorize the giving of all or any part of my body upon my death. 

Part 3: Execution

You must sign in the presence of two witnesses. The details of the witnesses along with their signs are also required. 

Kentucky state laws require the grantor to sign the form in presence of  witnesses or he can give an acknowledgment before the public notary. 

Kentucky Advance Directive Sample Form



Signed this ______day of _________, 20 __. (date) (month) (year) 

Signature of the grantor: 

Printed Name: Address of the grantor: 

WITNESSES In our joint presence, the grantor, who is of sound mind and eighteen years of age, or older, voluntarily dated and signed this writing or directed it to be dated and signed for the grantor. 

Signature of witness: 

Date: Address of witness: Printed Name: 

Signature of witness:

 Date: Address of witness: 


NOTARY _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ STATE OF KENTUCKY ) ) ss County of ) Before me, the undersigned authority, came the grantor who is of sound mind and eighteen (18) years of age, or older, and acknowledged that he voluntarily dated and signed this writing or directed it to be dated and signed as above. 

Done this ______ day of ____________, 20 .

Give photocopies of the signed original to your agent and alternate agent, doctor(s), family, close friends, clergy, and anyone else who might become involved in your health care. If you enter a nursing home or hospital, have photocopies of your document placed in your medical records. 

Be sure to talk to your agent(s), doctor(s), clergy, family, and friends about your wishes concerning medical treatment. Discuss your wishes with them often, particularly if your medical condition changes.

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Frequently Asked Questions

What is advanced health care directive Kentucky?

An Advance Directive is a legal-written document about your future medical care. It is a gift to family members and friends so that they won't have to guess what you want if you no longer can speak for yourself.

What is the difference between advance care planning and an advance directive?

The Advance Directive is a formalized version of your Advance Care Plan. An Advance Directive is a document through which you plan your healthcare and your preferences for your future care.

What makes an advance decision invalid?

An advance decision may only be considered valid when you're aged 18 and have the capacity to make and understand your decision when you made it and its consequences. If these conditions are not fulfilled, your Kentucky Advance Directive will not be valid.

Do advance directives have nothing to do with mental capacity?

An advance directive documents provide how you would like to be treated in the future if you can't decide for yourself due to any disease or accident. You can only make an advance directive if you have the mental capacity otherwise it will not be honored and valid.

What are the 2 major challenges with advance directives?

Advance directives have limitations. For example, an older adult may not fully understand treatment options or recognize the consequences of certain choices in the future. Sometimes, people change their minds after expressing advance directives and forget to inform others.
Jennifer Mcgee
Parent to five young children. Estate Planning, Probate, and Family Law Attorney. Volunteer with Victim’s Advocates in the local sheriff's department...
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Jennifer Mcgree
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