Advance Directives in Ohio: A 72-Hour Guide for Families

If you are reading this, your mom or dad is probably in a hospital bed in Cleveland or Columbus or Cincinnati, and a social worker has just used a phrase you have not heard before. Advance directive. Health care power of attorney. Living will. Code status. The doctors need an answer in the next day or two, and the answer depends on a piece of paper that may or may not exist.

This page is the one you wish you had found first. It tells you what the document is called in Ohio, who is allowed to decide if there is no document, where to look for one, and what the next 72 hours are likely to ask of you. It is written for the family on the elevator going up to the ICU, not for the lawyer in the office.

Ohio recognizes two separate documents that together act as a complete advance directive. Most Ohio adults sign both at the same time, often using a single packet published by the Ohio State Bar Association.

The first is the Health Care Power of Attorney, governed by Ohio Revised Code Chapter 1337 (specifically R.C. § 1337.11 through § 1337.17). This document names a person, called the agent, to make medical decisions when your parent cannot. The agent can consent to surgery, agree to or refuse a feeding tube, choose a nursing home, authorize hospice, and (with limits) decide about life-sustaining treatment.

The second is the Living Will Declaration, governed by Ohio Revised Code Chapter 2133. This document speaks directly to the medical team about life-sustaining treatment when your parent is either terminally ill or permanently unconscious. It is narrower in scope than the Health Care Power of Attorney, but it is the document an ICU physician will reach for when the question is whether to continue a ventilator.

Five Wishes, the popular nationally-distributed booklet from Aging with Dignity, is valid in Ohio when ordered with the Ohio statutory-language attachment. Ohio is one of four states (with New Hampshire, Kansas, and Texas) that requires this attachment. Aging with Dignity ships the attachment automatically when the booklet is ordered for an Ohio resident.

If your parent never signed a Health Care Power of Attorney and never signed a Living Will, the hospital does not get to pick a decision-maker, and you do not either. Ohio statute does. The relevant section is R.C. § 2133.08, which lists who can consent to withholding or withdrawing life-sustaining treatment when no advance directive exists.

The priority order is:

1. The legal guardian of the patient (if one has been appointed by a court).
2. The patient's spouse.
3. An adult child of the patient. If there is more than one adult child, a majority of those reasonably available decides.
4. The patient's parents.
5. An adult sibling of the patient. If there is more than one adult sibling, a majority of those reasonably available decides.
6. The nearest adult related to the patient by blood or adoption who is not described above.

The statute is strict about this order. A close friend, a long-term partner who is not legally married, or a stepchild who never adopted does not appear on the list. That gap is one of the most painful realities of an emergency without paperwork, and it is the strongest argument for completing a Health Care Power of Attorney now, while everyone is well.

Most Ohio adults who completed an advance directive have a copy in one of five places. Check them in this order, because the easiest ones are also the most likely.

1. The hospital admissions packet. If your parent has been admitted to this hospital before, the directive may already be scanned into the electronic medical record. Ask the floor nurse or the social worker to look.
2. The primary care doctor's chart.Most Ohio primary care offices keep a copy of the advance directive in the patient's chart. Call the office and ask them to fax or send a copy to the hospital.
3. A home filing cabinet or desk drawer. Most people store the signed original with their will, their birth certificate, and their Social Security card.
4. A safe-deposit box. Common but inconvenient in an emergency, because the bank may require a court order to open the box without the named holder.
5. The estate-planning attorney's file. If your parent worked with an attorney on a will or trust, that attorney almost certainly has a copy of the advance directive on file.

In a typical Ohio hospital admission for an older adult, five questions tend to land on the family within the first three days. Knowing they are coming makes it easier to face them.

Code status. Does your parent want CPR if their heart stops? Does your parent want to be put on a breathing machine? Ohio hospitals will ask this question on admission, and the default is full code (everything done). If your parent has a Living Will and a separate DNR (Do Not Resuscitate) order, bring both. A Living Will alone is not a DNR order; the medical team needs the DNR signed by a physician.

Feeding tube. If your parent cannot swallow safely after a stroke or a serious illness, the team may ask about a feeding tube. The Ohio Living Will Declaration explicitly addresses nutrition and hydration, so the document itself often gives the answer.

Hospitalization versus hospice.If the underlying illness is terminal, the question may be whether to keep treating in the hospital or move to hospice. Hospice care can happen at home, in a nursing facility, or in a free-standing hospice house. Your parent's wishes (in the Living Will or as understood by the agent) drive this choice.

Who is the agent. If there is a Health Care Power of Attorney, confirm with the hospital that the named agent is on file and can be reached. If the agent is unreachable, the named alternate steps in.

Discharge plan. Once your parent is medically stable, the question becomes where to go next. Home, with home health. A skilled nursing facility for short-term rehab. A long-term care facility. Hospice. The advance directive informs this conversation but does not decide it; that is what the discharge planner is for. Search Ohio facilities to compare options.

Sitting in a hospital waiting room is a strange place to think about your own mortality. It is also the most clarifying. Most people who watch a parent go through this resolve, sometimes inside the first day, that they will not put their own children through the same ambiguity. The way to keep that resolution is to act on it before the feeling fades.

Tonight or tomorrow, complete your own Health Care Power of Attorney and Living Will Declaration. The Ohio State Bar Association publishes a fillable packet that covers both documents and is accepted at every Ohio hospital. It takes about twenty minutes. The packet walks you through naming an agent, choosing an alternate, and telling your future medical team whether you would want life-sustaining treatment if you were terminally ill or permanently unconscious.

Once it is signed, name your agent out loud. Tell them. Send them a copy. Send a copy to your primary care doctor. Tape one to the inside of a kitchen cabinet where someone will find it if they need it. The document does not work if no one knows it exists.

• Ohio State Bar Association: Living Wills and Health Care Powers of Attorney The official lay-language explainer plus the standard advance directive packet (Health Care Power of Attorney and Living Will Declaration).
• Ohio Revised Code Chapter 1337 The Health Care Power of Attorney statute (R.C. § 1337.11 through § 1337.17).
• Ohio Revised Code Chapter 2133 The Living Will and surrogate decision-maker statute (R.C. § 2133.08 governs the surrogate hierarchy when no advance directive exists).
• Ohio Department of Aging: Long-Term Care Ombudsman Free advocacy if you have a complaint or concern about a nursing facility, assisted living, or home care provider in Ohio.
• Ohio State Bar Association: Lawyer Referral Service If your situation needs a lawyer, this is the official referral path.