The nature of hospice brings important end-of-life conversations to the forefront. Final wishes, healthcare proxies, medical decisions and more are documented when creating an individualized care plan. But you don’t have to wait until hospice to get your affairs in order. In fact, an accident or health crisis can affect anyone at any age, sometimes only for the short term; thus, creating an advance directive before it’s needed is wise.

That’s where resources like Five Wishes come in; the guide helps you document a health care surrogate, choices for medical treatment, comfort and care wishes, and important sentiments you want your loved ones to know. According to their website, more people have used Five Wishes for their living will or advance directive than any other document, to the tune of 40 million people. It bypasses legalese with easy-to-understand language to help outline wishes in areas that matter most – personal, emotional and spiritual, as well as the medical and legal. 

Sadly, only 20 to 30 percent of the population has completed an advance directive and don’t receive the care they want at the end of life. Documents like Five Wishes are a gift to yourself and your loved ones, caregivers, doctors, and other healthcare professionals. It helps remove the guesswork and the guilt when the time comes.

What are the Five Wishes?

Instead of starting from scratch, Five Wishes allows you to check boxes, circle a preference, or write a few simple statements outlining your preferences should a health crisis occur. The Five Wishes are:

  1. The person you want to make your care decisions when you can’t, often referred to as the healthcare agent, proxy, representative, or surrogate.
    • Includes decisions about tests, treatments, admission to hospice or care facilities, firing/hiring healthcare workers, nutrition, medical records, insurance benefits, and more.
  2. The kind of medical treatment you do or don’t want.
    • Outlines desired comfort measures, life-support treatment, Do Not Resuscitate orders, feeding, and more.
    • Covers contingencies for comas, severe brain damage, and nearness of death.
  3. How comfortable you want to be.
    • Involves pain management, personal care, hygiene, and emotional and spiritual support.
  4. How you want to be treated by others.
    • Outlines wishes around visitors, religious support, environment, desires to stay at home, and more.
  5. What you want your loved ones to know.
    • Expresses love, forgiveness, family dynamics, funeral wishes, burial or cremation directives, and other thoughts or practical decisions about death and dying.

Is Five Wishes a Legal Document?

Yes, Five Wishes is legally valid in almost every U.S. state. (Some states require additional documentation, including Texas.) Five Wishes works like a living will, advance directive, or healthcare power of attorney. The Five Wishes booklet is designed for those ages 18 and older, but the website offers documents for children and adolescents/young adults as well.

Two witnesses must sign the document, and some states require notarization. If you have a current living will or other documents, but want it replaced with an updated Five Wishes plan, you’ll need to destroy or clearly mark “revoke” on the old documents, signed and dated. Then inform your healthcare agent and family of your new Five Wishes plan. Keep the original signed document accessible in your home, then give copies to your healthcare proxy and healthcare providers.

Go to the Five Wishes website for a sample document, state requirements, and more important resources.

History and More

Five Wishes was created by Aging with Dignity Founder Jim Towey, who worked alongside Mother Teresa as legal counsel and trusted friend and advisor. The booklet was created with the help of healthcare experts and the American Bar Association. Read more on the Five Wishes organization’s history and mission.

Offering simplicity and clarity, the Five Wishes program provides a roadmap embraced by families, community groups, faith communities, medical and legal providers, and businesses who participate in our Five Wishes at Work program. This includes Heart to Heart Hospice.

This valuable tool paves the way for needed conversations that creates a hospice environment filled with dignity and well-informed care. Consider filling out your Five Wishes plan today — your family and future self will be grateful you did.