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5 Wishes Document - Usage Guidelines

The Five Wishes document offers a unique opportunity to articulate your preferences for medical treatment, comfort, personal interactions, and final wishes should you find yourself unable to communicate those decisions. This comprehensive tool addresses not only the medical but also the personal, emotional, and spiritual needs, ensuring your voice is heard even when you cannot speak for yourself. It’s a straightforward process to complete, needing only straightforward inputs like checking boxes, circling options, or writing brief notes. Here’s how to efficiently fill out this form:

1. Print your name and birthdate at the beginning of the document to identify yourself as the person making these wishes.
2. Choose your Health Care Agent. Begin with Wish 1 by naming the person you trust to make healthcare decisions for you if you're incapacitated. This step involves:
   1. Filling out the name, address, city/state/zip, and phone number of your first choice for a Health Care Agent.
   2. Listing alternative agents as backups in the event your first choice cannot serve. This includes their names, addresses, and phone numbers.
3. Consider the qualifications for your Health Care Agent. Ensure this person is not your healthcare provider or affiliated professionally in a way that could present a conflict of interest. They should be at least 18 years old (or older in some jurisdictions like Colorado) and not an employee or relative of someone who is providing your health care.
4. Specify what medical treatments you want or don’t want, reflecting your personal wishes for your healthcare under various circumstances.
5. Describe how comfortable you want to be, focusing on pain management, personal grooming, or other specifics concerning your comfort levels during illness.
6. Articulate how you wish to be treated by others and any spiritual, religious, or emotional support you prefer, highlighting the importance of personal interactions and emotional well-being.
7. State what you want your loved ones to know. This could include final wishes, messages of forgiveness, personal reflections, or instructions for after death, such as organ donation.
8. Review the document carefully. If you change your mind about anything, the form instructs you to either destroy it or write “Revoked” across the sections you wish to change, emphasizing the importance of keeping your Five Wishes current and reflective of your true desires.

Completing your Five Wishes document is a thoughtful process that encourages you to consider deeply personal preferences and communicate them clearly to your loved ones and healthcare providers. This ensures that your wishes are honored, and your loved ones have peace of mind knowing they are acting in accordance with your desires.

What is the Five Wishes Document?

The Five Wishes Document is a comprehensive advance directive that goes beyond traditional living wills. It allows individuals to specify their personal, emotional, and spiritual needs in addition to their medical wishes should they become seriously ill and unable to make decisions for themselves. This document enables one to appoint a health care agent, state medical treatment preferences, outline comfort measures, express how they wish to be treated by others, and communicate what they want their loved ones to know. Formulated with assistance from The American Bar Association's Commission on Law and Aging and leading experts in end-of-life care, it is designed to be easy to complete.

Who should use Five Wishes?

Five Wishes is suitable for anyone aged 18 or older, regardless of marital status, parenthood, or health. Since its creation, over 19 million people across various age groups have utilized it to articulate their care preferences. It is endorsed and distributed by a broad spectrum of professionals and organizations in the healthcare, legal, religious, and retiree communities due to its effectiveness in facilitating important conversations and decisions about end-of-life care.

In which states is Five Wishes recognized?

Five Wishes meets the legal requirements for an advance directive in the District of Columbia and 42 states. These include, but are not limited to, states like California, Florida, New York, and Texas. In states not listed, individuals may still find Five Wishes valuable for expressing their care preferences. It can be used alongside state-specific legal forms to ensure wishes are known and can serve as a guide for families and healthcare providers, even if not formally recognized by state law.

How can Five Wishes help you and your family?

Five Wishes facilitates clear communication about how you wish to be treated if you become seriously ill, preventing the need for your loved ones to make difficult decisions without knowing your preferences. It allows family members, friends, and doctors to understand your wishes in advance, providing peace of mind and ensuring that your care aligns with your values and desires.

How was Five Wishes created?

Inspired by his experiences working with Mother Teresa and residing in a hospice, Jim Towey sought to create a tool to help individuals and families plan ahead and cope with serious illness. The result was Five Wishes, which has gained widespread recognition and support for its holistic approach to end-of-life planning, addressing not just medical concerns but also the personal, emotional, and spiritual needs of the individual.

How do I change to Five Wishes from another advance directive?

If you already have a living will or a durable power of attorney for health care but wish to switch to Five Wishes, you must complete and sign the Five Wishes document as instructed. This action automatically revokes any prior directives. To ensure clarity and prevent confusion, it's advised to destroy all copies of former documents, inform your health care agent, family members, and physician of the change, and make certain they are aware of your new wishes as stated in Five Wishes.

What should I consider when choosing my Health Care Agent in the Five Wishes Document?

When selecting a Health Care Agent, choose someone you trust deeply, who understands you well, and is willing and capable of enforcing your care preferences. This person must be at least 18 years old and should not be your healthcare provider or connected to a health or residential care facility you are using. It’s essential to discuss your wishes with them to ensure they are comfortable with and willing to take on this responsibility.

Can the Five Wishes Document be modified?

Yes, you can update or alter your Five Wishes Document at any time to reflect changes in your preferences. This may involve selecting a new Health Care Agent, altering your care wishes, or revising how you wish to be treated and remembered. To make changes, a new document must be completed, signed, and witnessed according to the instructions, and any previous versions should be discarded or clearly marked as revoked to prevent confusion.

Is Five Wishes easy to complete?

Yes, Five Wishes is designed to be user-friendly, with clear instructions and options for expressing your care preferences simply by checking boxes, circling options, or writing a few sentences. It encourages thoughtful consideration of your wishes but does not require legal knowledge or complex decision-making, making it accessible for individuals to complete without professional assistance.

1. Failing to choose a Health Care Agent who is both willing and able to execute the outlined wishes is a common mistake. Many individuals assume a family member or friend is the best choice without having a detailed conversation about the responsibilities and emotional burden it may entail. It’s crucial that the person selected is not only trustworthy but fully informed and agreeable to take on this role.

2. Another frequent error is not being specific enough about the kind of medical treatment desired or not desired. The document allows for detailed preferences regarding treatments that can prolong life, relief from pain, and other medical interventions. Broad statements can lead to interpretations that might not align with the person’s true desires.

3. Many people neglect to adequately detail how they wish to be made comfortable. Comfort care includes more than just pain management; it encompasses aspects such as personal grooming, surroundings, and environmental preferences. Leaving these out can result in care that is misaligned with the person’s wishes.

4. Omitting instructions on how they want to be treated by others and what they want their loved ones to know is also a mistake. These preferences can significantly impact the emotional and psychological well-being of both the individual and their families during difficult times.

5. A common oversight is not discussing their wishes with the chosen Health Care Agent or not providing the agent with a copy of the Five Wishes document. This document only becomes effective if the Health Care Agent is aware of its existence and understands the person’s wishes clearly.

6. Finally, failing to keep the Five Wishes document in an easily accessible place can hinder its use when needed. If healthcare providers, family, or the Health Care Agent cannot find or access the document in an emergency, they might not be able to comply with the person's wishes.

By avoiding these mistakes, individuals can ensure their healthcare preferences are well understood and respected, making their experience and that of their family's as aligned with their desires as possible.

Complementing the Five Wishes document, several other forms and documents are commonly used to ensure one's health care and personal preferences are honored meticulously. This list includes essential legal documents that can play a pivotal role in one's life, particularly when facing significant health challenges.

• Living Will: This document specifies your wishes regarding medical treatment if you become unable to communicate or make decisions. It covers situations not specifically addressed in the Five Wishes document, focusing on life-sustaining treatments and measures you want or don't want.
• Durable Power of Attorney for Health Care: Similar to the first wish in the Five Wishes document, this legal document designates a person to make health care decisions on your behalf when you're unable to do so. However, it might be more legally-focused and specific about the scope of decisions the appointed person can make.
• Do Not Resuscitate Order (DNR): A critical medical order telling health care providers not to perform CPR if your breathing stops or if your heart stops beating. It's a specific directive used in medical settings, unlike the broader wishes outlined in the Five Wishes document.
• Medical Power of Attorney: While similar to a Durable Power of Attorney for Health Care, this document explicitly grants your agent the power to make a wide range of health care decisions, not just those related to life-sustaining treatment. This distinction might be important in jurisdictions with specific requirements or terminologies.
• Polst Form (Physician Orders for Life-Sustaining Treatment): This form takes your wishes about life-sustaining treatment and converts them into medical orders to be followed by your health care team. It's filled out with your doctor and can complement your Five Wishes document by ensuring your preferences are understood and respected by medical personnel.

Each of these documents has its specific role and importance. They work in tandem with the Five Wishes document to provide a comprehensive legal framework that respects your health care preferences. Together, they offer peace of mind to you and your loved ones by ensuring that your wishes are clearly expressed and legally protected.

• Living Will: Like the Five Wishes document, a living will allows individuals to outline their medical treatment preferences should they become incapable of making decisions themselves. It focuses on end-of-life care, specifying what measures should or should not be taken.

• Durable Power of Attorney for Health Care: This document is similar to the First Wish in the Five Wishes document, where one appoints a health care agent. The principal difference is that the Durable Power of Attorney specifically grants an agent the authority to make all healthcare decisions, not just those about life-sustaining treatment, should someone become incapacitated.

• Do Not Resuscitate (DNR) Order: A DNR order is a medical order that tells health care providers not to perform CPR if a patient's breathing stops or if the patient's heart stops beating. The Five Wishes document covers a broader scope but can include a patient's desire for a DNR status as part of their medical treatment preferences.

• Medical Orders for Life-Sustaining Treatment (MOLST) or Physician Orders for Life-Sustaining Treatment (POLST): These documents go beyond a living will or DNR order by translating a patient's wishes into medical orders that are to be followed by health care providers. Like the Five Wishes, they are designed for those at an advanced stage of illness or frailty but focus more on immediate, actionable medical orders.

• Advance Health Care Directive: This is a broader term that can encompass both a living will and a health care power of attorney, similar to what the Five Wishes document provides. It allows individuals to lay out their health care preferences and appoint a decision-maker.

• HIPAA Release Form: The Health Insurance Portability and Accountability Act release form doesn't directly deal with one's wishes for treatment but allows designated individuals to access one's medical records. While Five Wishes doesn’t explicitly act as a HIPAA release, it complements such forms by providing detailed insights into one’s care preferences to those who are granted access.

• Organ and Tissue Donation Registration: This specifies one's wishes regarding the donation of organs and tissues after death. While distinctly different in purpose, the Five Wishes document can include one's preferences about organ donation, making both documents essential components of end-of-life planning.

When undertaking the important step of completing the Five Wishes document, a guide designed to help express how one wishes to be treated in the event of serious illness, certain considerations are paramount for ensuring that one's intentions are clearly communicated and legally recognized. Here, a compilation of advised actions (what one should do) and cautionary measures (what one shouldn't do) will aid in the process:

• DO ensure that the individual chosen as the Health Care Agent is at least 18 years of age or older, equipped with the emotional stability, understanding of the declarant’s wishes, and determination necessary to advocate on their behalf.
• DO discuss your choices and wishes in detail with the person you are appointing as your Health Care Agent before completing the document to ensure they are willing and able to undertake this responsibility.
• DO use clear and specific language when detailing your medical wishes, comfort levels, how you want to be treated, and what you want your loved ones to know to avoid ambiguity.
• DO review and comply with the legal requirements specific to your state to ensure the document is valid and enforceable.
• DO keep a signed copy in a place where it can be easily accessed by your Health Care Agent, family members, or any other significant parties.
• DO NOT appoint someone as your Health Care Agent without their knowledge or consent. This role is crucial and requires prior discussion and agreement.
• DO NOT fill out the document in haste without thoroughly considering each wish and its potential implications.
• DO NOT leave sections incomplete or assume that others will know your wishes without them being explicitly expressed in the document.
• DO NOT forget to update the document as your health condition, treatment preferences, or personal circumstances change.

Completing the Five Wishes document is not only a matter of legal preparation but also a deeply personal process that allows individuals to reflect on their values, desires, and the legacy they wish to leave behind. It is an act of consideration and love, providing peace of mind to oneself and those one holds dear.

Many people have misconceptions about the Five Wishes Document, which can lead to confusion or misuse. It's important to address these misunderstandings:

• It's Legally Binding in Every State: While the Five Wishes Document is legally valid in 42 states and the District of Columbia, it may not meet specific legal requirements in all states. Always verify its validity in your state.
• Only for the Elderly: This document is beneficial for anyone over the age of 18. Serious illness can affect anyone at any time, making it important for adults of all ages to express their wishes.
• Replaces a Will: The Five Wishes Document focuses on health care decisions and personal matters towards the end of life, not the distribution of assets or estate planning. A separate will is necessary for those purposes.
• Too Complicated to Execute: The form is designed to be straightforward and user-friendly, requiring just a few steps to complete. It encourages personal reflection and conversation with loved ones about your wishes.
• Only Covers Medical Treatment: Beyond medical treatment preferences, the Five Wishes Document also addresses personal, emotional, and spiritual needs, as well as how you wish to be treated and what you want your loved ones to know.
• Doesn’t Allow for a Proxy: One of the core functions of the document is to let you appoint a Health Care Agent - someone who makes decisions on your behalf if you're unable to do so yourself.
• It's Irrevocable: You can change your Five Wishes at any time by completing a new document, destroying the old one, and informing your Health Care Agent and any relevant parties about the update.
• No Need to Discuss with Family: Communication with your family, friends, and designated Health Care Agent about your wishes outlined in the document is essential. It ensures that your preferences are understood and respected.

Clearing up these misconceptions can help ensure that the Five Wishes Document is used effectively and as intended, providing peace of mind to you and your loved ones.

The Five Wishes Document serves as a comprehensive tool enabling individuals to specify their preferences regarding medical treatment, comfort, and care in the event they become unable to communicate their wishes. Here are nine key takeaways about filling out and using this important form:

• Five Wishes is applicable and legally valid in the District of Columbia and 42 states, providing a harmonized approach to living wills by incorporating personal, emotional, and spiritual needs along with medical preferences.
• It is designed for anyone 18 years or older, regardless of their health status, allowing them to appoint a Health Care Agent to make decisions on their behalf if they are unable to do so.
• The document facilitates open discussions with family, friends, and healthcare providers, ensuring that an individual's wishes are known and respected.
• To use Five Wishes as your advance directive, simply fill out the document as directed, sign it, and inform your healthcare provider, family members, and anyone else involved in your care.
• If you have previously completed a different advance directive form, such as a living will or a durable power of attorney for health care, signing the Five Wishes document will revoke the earlier document.
• The person chosen as a Health Care Agent should be someone who knows you well, who you trust to make difficult decisions, and who will advocate for your wishes. They must be at least 18 (or older in some states).
• The document also allows you to express your wishes on how you want to be treated and what you want your loved ones to know, covering aspects like pain management, personal grooming, and communication.
• If your state is not among the listed ones where Five Wishes meets legal requirements, it's recommended to complete it alongside your state's legal form to ensure your wishes are followed as closely as possible.
• It is crucial to keep the document accessible; inform your Health Care Agent, family members, and healthcare providers where it is located, and consider giving copies to them for reference.

By completing the Five Wishes Document, you take a proactive step in managing your healthcare preferences, providing a compassionate guide for your loved ones and healthcare professionals to follow, ensuring your wishes are respected and carried out.