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Five Wishes

What is Five Wishes?

Five Wishes is an easy-to-use legal document that lets you plan in advance for how you want to be cared for in case you become seriously ill. Some people refer to it as an "advance directive" because when you complete Five Wishes you give direction to you doctor and family, in advance, on how you want to be treated. There are five wishes in this document:

  • Wish One lets you choose the person you want to make decisions for you when you can’t make them for yourself. Lawyers call it a "durable power of attorney for health care."

  • Wish Two is a living will. It lets you put in writing the kind of medical treatment you want or don't want if you become seriously ill and can't communicate to anyone.

  • Wishes Three and Four let you describe in detail how you want to be treated so that your dignity can be maintained.

  • Wish Five gives you a chance to tell others how you want to be remembered, and to express other things that might be in your heart, like forgiveness.

Why should I fill out Five Wishes?

Without an advance directive like Five Wishes, you may have no control over important medical care decisions that will be made if you ever get seriously ill - such as whether to give you life-support treatment or aggressively treat your pain. You may think your wishes are similar to those of other people and that your loved ones and doctors will automatically know what you want when you are very ill. That’s not true. In reality, everyone has different wishes and yours won’t be followed unless you make them clear. For example, your dying process could be artificially prolonged even though you may have wanted a natural death. Not expressing your wishes can put your family, friends and doctor in the difficult position of guessing what kind of treatment you want, which could lead to disagreements. Completing Five Wishes gives you control over your care and peace of mind for you and your loved ones.

When do I need to use Five Wishes?

The best time to fill out Five Wishes is before you face a health crisis. The best place to fill out Five Wishes is at home – not a hospital. You never know when you are going to need Five Wishes, and many people put it off until it’s too late. If you are over age 18, you should complete Five Wishes now. If you are married, both you and your spouse need to fill out your own Five Wishes.

When does Five Wishes take effect?

You will always make your own health care decisions if you are able to talk with your doctor and understand what is being said. Five Wishes only takes effect when you are too ill to communicate. So if you have a stroke and can’t speak, or are in a coma, then your Five Wishes, and the person you chose to be your health care agent, can help direct your care with your doctor.

Is Five Wishes a legal document?

Yes. It was written with the help of the American Bar Association’s Commission on the Legal Problems of the Elderly. It is legally valid under the advance directive statutes in most states (see list on page 3 of the Five Wishes document). Just follow the directions when you sign it.

What if I don’t live in a Five Wishes state?

There are some states that require you to use their own legal forms to express your wishes and so you should use their forms and sign those forms. But you should also fill out Five Wishes because it can help make clear to your family, friends and doctor what you want.

How do I use Five Wishes?

Take the following steps to use Five Wishes:

  • Review the document
  • Fill it out
  • Follow directions for signing it
  • Discuss it with your health care agent and doctor and give each of them a copy
  • Make sure a copy of your Five Wishes is placed in your medical file by your doctor
  • Discuss Five Wishes with your family and friends and give them a copy

Does filling out Five Wishes guarantee that my wishes will be followed?

Your doctor is required to follow your wishes according to the laws of your state. Each state has its own rules and conditions that a doctor must observe, and so your doctor has the final word on when your living will takes effect. To do all you can to have your wishes followed, make sure your do three things:

  1. Pick a health care agent (Wish One), tell him or her about your wishes and confirm they will speak for you if you ever get sick.
  2. Tell this person that hospitals, hospices and nursing homes have ethics committees that can help settle any disagreements with doctors or family members.
  3. Discuss your wishes with your doctor, family and friends before you get sick.

Which is better to have: a living will or a health care agent?

The health care agent and the living will go hand-in-hand, and you are usually better off with both. You need to have a health care agent there to speak for you when you can’t speak for yourself, and you need a living will that expresses in writing your wishes. When you are sick, your medical condition can be very complicated and can change suddenly. The law generally requires your agent to make decisions that he or she feels you would have made if you could talk. The more information your agent has, the better.

What if I fill out Five Wishes and later change my mind?

You can change your wishes any time you want. It is a good idea to review and update your Five Wishes at least once a year. You may want to do that more often if your health changes or you change your mind. When you make changes, be sure to inform your health care agent, family, friends and doctor. Destroy all out-of-date copies of the document and distribute copies of your new Five Wishes.

If I am seriously ill, what can I do to make sure that I won’t be in pain?

Most people who are very sick want to be kept comfortable and alert, and surrounded by friends. Great progress has been made in our health care system to treat illnesses, but unfortunately there can be more attention paid to your treatment than your comfort. So make it very clear to you doctor, health care agent and family that you don’t want to be in pain.

Do I have to have my Five Wishes notarized?

Not unless you live in one of the few states that is listed in the notarization section of Five Wishes. Simply follow the directions on the signature page and you’ll be safe.

What if I travel a lot? Will my Five Wishes be honored wherever I go?

If you travel a lot, take a copy of Five Wishes with you in case you become seriously ill. Your document will be legally valid in any of the states listed on page 3 of Five Wishes. If you travel to a state that is not listed, then you still may be protected by your Five Wishes document. Most states have laws that are designed to honor your wishes no matter how you express them. But to be safe, if you are going to be staying for an extended period of time in a non-Five Wishes state, then it’s a good idea to fill out that state’s required forms.

Who developed Five Wishes?

Five Wishes was created by the non-profit Aging with Dignity, a leading advocate for the needs of elders and those who care for them. Aging with Dignity founder Jim Towey created Five Wishes with the help of doctors, nurses, lawyers and other experts in end-of-life care to help people of all ages get the treatment they want if they get seriously ill. Jim is an attorney who worked twelve years for Mother Teresa of Calcutta and worked one year in her home for the dying in Washington, D.C. His experiences with Mother Teresa and her home are why Five Wishes looks at the personal, emotional, and spiritual needs of a person - and not just the medical ones. This is important because people are most concerned about maintaining comfort and dignity when they are very sick.

What if I have more questions?

You may talk with a lawyer or health care professional for advice. If you want more information, you can visit the Aging with Dignity website.




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