May 4, 2026

Skeleton Key to Life, Part 4- Health & Personal Care Directives

Terra L. Sickler, Esq.

Founder, TWIG DIVISION

Part 4– Health & Personal Care Directives: Protecting Your Voice

A sudden medical crisis can strike without warning and is the most effective reality check, especially when it includes a brush with Death itself. However, healthcare is one of the most overlooked areas of planning. Imagine being unable to speak for yourself after an accident or illness, who will make decisions about your care? Without written directives, Florida law fills the gap — but the outcome may not align with your values.

Health and personal care directives solve this problem by ensuring your voice is heard, even when you cannot speak. In Florida, state law provides the framework for living wills, healthcare surrogate designations, and related orders. This post explains what these documents are, why they matter, and what lessons we’ve learned from Florida case law.

Why Health Directives Are Essential.

Protecting Your Autonomy—Florida law recognizes the right of competent adults to make decisions about their own healthcare (F.S. § 765.102). By documenting your wishes, you ensure those decisions continue to be respected if you lose capacity.

Preventing Family Conflict—In the absence of clear guidance, family members may fight over treatment decisions. These disputes can fracture relationships and prolong suffering.

‍Case Example: The Terri Schiavo case (In re Guardianship of Schiavo, 851 So. 2d 182 (Fla. 2d DCA 2003)) is one of the most infamous guardianship disputes in U.S. history, precisely due to Schiavo had no written directive. Years of litigation followed, pitting her husband against her parents, while the courts tried to infer her wishes, all the while she was on life support.

Reducing Legal Costs and Delays—Without directives, a court may need to appoint a guardian to make decisions on your behalf under F.S. Chapter 744. Guardianship proceedings are expensive, invasive, and time-consuming — and they remove control from both you and your family.

The Living Will.

A living will is a written declaration of your wishes regarding life-prolonging procedures if you are in a terminal, end-stage, or persistent vegetative condition, as drafted pursuant to F.S. § 765.302.

Pursuant to statute, a living will must be signed in the presence of two witnesses, one of whom is not a spouse or blood relative (F.S. § 765.302(1)). A living will applies totreatments like mechanical ventilation, artificial nutrition and hydration, and resuscitation.

For example, if you state in your living will that you do not want artificial nutrition and hydration when in a vegetative state, healthcare providers and your surrogate are legally bound to follow that directive.

Designation of Healthcare Surrogate

A healthcare surrogate designation names someone to make medical decisions on your behalf as provided by F.S. § 765.202. The designated surrogate can access medical records, consult with doctors, and make all healthcare decisions you could make, if competent. The option exists to allow the surrogate to act immediately upon signing, rather than only upon incapacity.

Why It Matters

If you do not name a surrogate, decision-making falls to the statutory list under F.S.§ 765.401, which prioritizes spouse, adult children, parents, siblings, and other relatives.This default may not reflect your wishes, especially in blended families or estranged relationships. Further issues could arise and cause court intervention, in the event family members disagree.

Do Not Resuscitate Orders (DNRs)

A DNR is separate from a living will. It is a physician-signed order that directshealthcare providers not to perform CPR if your heart stops. This protection is provided by F.S. § 401.45(3) and must be on the yellow Florida Department of Health DH Form 1896.

Typically, this is most appropriate for patients with terminal conditions or advanced directives declining aggressive life-saving measures. However, it can be used for anyone who has decided to live out their final days without medical intervention.

HIPAA Authorizations

Even with a surrogate designation, medical providers may hesitate to release records without explicit HIPAA authorizations.

Federal Law: 45 C.F.R. § 164.502(g) allows disclosure of protected health information to personal representatives, if authorized.

Estate Planning attorneys routinely prepare HIPAA releases, alongside healthcare directives, to eliminate barriers in emergencies. It may seem redundant, but these protections are beneficial and can expedite obtaining necessary healthcare information, if dealing with multiple healthcare providers.

Long-Term Care Planning

Directives should also consider long-term care scenarios, including nursing home placement or home health care.

This is important for Medicaid Eligibility. Federal law limits asset transfers within five (5) years of applying for Medicaid (42 U.S.C. § 1396p). Planning in advance can prevent issues, including Medicaid “claw-back” of any monies transferred within that period of time.

Insurance Options: Long-term care insurance policies (regulated under F.S. Chapter 627, Part XVIII) can reduce reliance on public benefits. Proper planning allows you to express preferences for long-termliving arrangements while ensuring financial eligibility for needed care.

Careful consideration should be given to this type of planning, and re-evaluated if and when there is a change in life circumstances.

Practical Guidance

It is important to communicate early; talk with family and your designated surrogateabout your values and preferences. Be sure to review and update directives ever 3-5 years, or after major life events such as marriage, divorce, or diagnosisof a severe illness. Its also a good idea to ensure copies of your directives are provided to your surrogate, physician, and attorney. Originals should be kept in a safe but accessible place.
**Some directives include specific instructions related to faith traditions or ethical beliefs.

Checklist: Core Health Directives

Living Will (F.S. § 765.302)
Healthcare Surrogate Designation (F.S. § 765.202)
HIPAA Authorization (45 C.F.R. § 164.502(g))
Do Not Resuscitate Order (DNR) (F.S. § 401.45, DH Form 1896)
Long-term care planning strategy (Medicaid/insurance)

Conclusion

Health and personal care directives are not simply forms — they are acts of love. By documenting your wishes, you spare your family from agonizing uncertainty,protect your dignity, and ensure the law respects your voice even in silence. The Terri Schiavo case showed the devastating consequences of failing to plan. Your family should never be left to guess. With the right directives, you control your healthcare journey and relieve your loved ones of that burden.

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Estate planning goes deeper than most people realize — follow this series to build a complete legal and financial shield around everything you've worked for. CONTINUE READING THIS SERIES below:

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About the Author: Terra L. Sickler, Esq. is one of the founders of the law firm Twig, Trade, & Tribunal, PLLC, in Fort Lauderdale Florida. She practices Dirt (real estate law) and Death (estate planning and probate). She can also be found @the.Terra.attorney providing legal insights on real life & death issues that we will all face, one day.

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