When to Update Your Living Will: 7 Life Events That Should Trigger a Review

Creating a living will is an important first step. But it is just that — a first step. Your values, your health, your relationships, and your life circumstances change over time. A living will you created five years ago may no longer reflect who you are today or what you would want. Treating it as a “set it and forget it” document can leave your family with outdated instructions that no longer represent your wishes.

Here are seven life events that should prompt you to pull out your living will, review it, and update it if needed.

1. Marriage or divorce

Marriage and divorce are among the most significant legal events in a person’s life, and both have direct implications for your living will.

If you get married, you likely want your spouse to be your healthcare agent — or at least involved in your care decisions. If your living will names a parent or sibling as your agent, it is time to update.

If you get divorced, the urgency is even greater. In some states, a divorce automatically revokes any designation of your ex-spouse as your healthcare agent. In others, it does not. If your ex-spouse is still named in your living will and your state does not automatically revoke that designation, they could legally make your medical decisions. Review and update your documents immediately after a divorce.

2. A new medical diagnosis

Receiving a significant medical diagnosis — cancer, heart disease, diabetes, a neurological condition — often changes how people think about end-of-life care. What felt hypothetical becomes concrete. Treatments you might have reflexively refused may now seem worth considering. Conversely, treatments you once wanted may feel less appropriate in light of your diagnosis.

A new diagnosis is also an opportunity to add specificity to your living will. If you have been diagnosed with heart failure, for example, you can address scenarios specific to that condition — such as your preferences about cardiac assist devices or transplant eligibility. The more tailored your living will is to your actual medical reality, the more useful it is.

3. The death or incapacity of your healthcare agent

If the person you designated as your healthcare agent dies, develops a serious illness, moves far away, or is otherwise unable to serve, you need to designate someone new. A living will without a functioning healthcare agent leaves a critical gap in your advance care plan.

This is also why naming an alternate agent is so important. If your primary agent cannot serve, your alternate steps in automatically. But if you did not name an alternate — or if both your primary and alternate are unavailable — you need to update your document promptly.

4. A change in your relationship with your healthcare agent

Relationships evolve. The sibling who was your closest confidant five years ago may have drifted away. The friend you trusted completely may no longer be someone you would trust with medical decisions. If your relationship with your designated healthcare agent has changed significantly, it is time to reconsider.

Signs that you might need a different healthcare agent:

• You no longer communicate regularly with them
• You have had a significant falling out or trust has eroded
• They have expressed views about end-of-life care that conflict with yours
• They have demonstrated an inability to handle stress or make difficult decisions
• They have developed their own health challenges that might prevent them from serving

5. Moving to a different state

Living will requirements vary significantly from state to state. What constitutes a valid advance directive in one state may not meet the requirements in another. If you move to a new state, review your living will to ensure it complies with your new state’s laws.

Key things that vary by state:

• The number of witnesses required
• Whether notarization is required
• Who can and cannot serve as a witness
• Specific language or forms that are required or recommended
• Whether mental health treatment can be addressed in a living will
• How healthcare agent authority is defined and limited

Most states will honor an advance directive from another state if it was valid where it was created, but this is not guaranteed. Creating a new living will that meets your new state’s specific requirements is the safest approach.

6. After experiencing end-of-life care firsthand

Watching a loved one go through end-of-life care — whether it goes well or poorly — often changes how people think about their own wishes. Many people who have witnessed aggressive treatment at the end of life become more inclined toward comfort-focused care. Others who have seen a loved one die too quickly without treatment feel more strongly about wanting everything done.

These experiences are valuable because they transform abstract preferences into informed ones. If you have recently been through the experience of supporting a loved one at the end of life, take some time to reflect, and then review your living will to see if your preferences have changed.

7. Every five years, regardless

Even if none of the above events have occurred, it is good practice to review your living will at least every five years. People change. Medicine advances. Treatments that did not exist when you wrote your living will may now be available. Values that felt firm may have shifted gradually.

Set a calendar reminder — perhaps tied to a birthday ending in 0 or 5, or the anniversary of when you first created the document. Spend 15 minutes reading through it and asking yourself: “Does this still reflect what I want?” If yes, no action needed. If not, update it.

How to update your living will

Updating a living will is straightforward:

1. Create a new document reflecting your current wishes
2. Sign, witness, and notarize the new document according to your state’s requirements
3. Explicitly revoke the old document (most states allow this by simply destroying the old copies and stating that the new document supersedes all prior versions)
4. Distribute the updated version to your healthcare agent, physician, family members, and anyone else who had a copy of the old one
5. Retrieve and destroy old copies to prevent confusion

Do not simply cross things out or write in the margins of your existing document. A clean, freshly executed document eliminates any ambiguity about which version reflects your current wishes.