You may have heard of an advance directive as a way to put healthcare wishes in writing for a time when you cannot speak for yourself. Five Wishes is one type of advance directive, but it covers more than medical treatment decisions alone.
It also gives you a place to name the person you want making healthcare decisions, describe what comfort means to you, share personal or spiritual preferences, and leave information for the people close to you.
So what is Five Wishes, and how does it work?
What Is the Five Wishes Advance Directive?
Five Wishes was created by the non-profit organization Aging with Dignity. The organization says it created the document with input from doctors, nurses, lawyers, and others involved in end-of-life care.
The Five Wishes FAQ explains that the document addresses medical and legal decisions along with personal, emotional, and spiritual needs.
Five Wishes is not simply a worksheet used to prepare another living will. The completed document is itself an advance directive. Its five-part structure brings several types of planning into one place.
What Are the Five Wishes?
The five sections cover different parts of future care.
Wish 1: Who can make healthcare decisions for me?
This section allows someone to choose a healthcare agent who can make decisions if that person cannot make them independently.
Wish 2: What kind of medical treatment do I want or not want?
This is the living will portion of the document. It addresses preferences about medical treatment and life-support decisions.
Wish 3: How comfortable do I want to be?
This section focuses on physical comfort and care preferences.
Wish 4: How do I want people to treat me?
This part addresses personal, emotional, and spiritual concerns. It gives someone a place to communicate wishes that may not appear in a more traditional list of medical treatment choices.
Wish 5: What do I want my loved ones to know?
The final section allows someone to leave messages, preferences, and other information for family members and people close to them.
Together, the five sections cover both healthcare decisions and personal wishes that may matter during serious illness.
Is Five Wishes a Living Will?
Five Wishes includes a living will, but it covers more than a living will alone.
Wish 2 addresses medical treatment choices. Wish 1 allows someone to name a healthcare agent.
The other sections address comfort, personal and spiritual preferences, and information for loved ones.
That means Five Wishes combines several parts of advance care planning into one document rather than focusing only on treatment choices.
When Does Five Wishes Take Effect?
Completing Five Wishes does not mean someone gives up the ability to make their own healthcare decisions. According to Five Wishes, a person continues to make their own decisions while they can communicate with their doctor and understand the information involved.
The advance directive becomes relevant when the person can no longer make or communicate those decisions. At that point, the written wishes and the healthcare agent named in the document can help guide care.
That distinction matters with any advance directive. The purpose is to prepare for a future situation in which someone cannot speak for themselves, not to replace their decisions while they remain able to make them.
Is Five Wishes a Legal Document?
Five Wishes describes its document as a legal advance directive. The organization says it meets advance directive requirements in most states, while some states have additional requirements.
Signing and witnessing rules can also vary by state. Five Wishes provides state-specific instructions with the document. Since advance directive laws are state-specific, someone using Five Wishes should follow the requirements that apply where they live.
Who Can Complete Five Wishes?
Five Wishes says adults age 18 and older can complete the document. A person does not have to wait until a serious diagnosis or health crisis to think about advance care planning.
The point of an advance directive is to record preferences while the person can still consider those choices and communicate them clearly.
Five Wishes also recommends reviewing the document after major life changes. Changes in health, relationships, family circumstances, or personal preferences may affect decisions someone made earlier.
An update may involve more than treatment preferences. A healthcare agent’s contact information may change, or the person originally selected may no longer be the right choice.
What If You Want to Create Five Wishes?
If Five Wishes sounds like a document you may want to use, start by reviewing the form and the requirements that apply in your state. You can also speak with your estate planning attorney if you have questions about whether Five Wishes fits with your existing healthcare planning or what steps you should take to complete it properly.
They can help explain how the document works in your state and answer questions about your broader advance care planning.
Who Should Have a Copy?
Completing the document is only part of the process. The people who may need to rely on it should know it exists. Five Wishes recommends discussing the completed document with the healthcare agent and doctor. It also recommends giving them copies.
The organization also suggests making sure the doctor has a copy in the medical record. Family members and others who may become involved in care can also be told about the document.
If the document changes later, updated copies should replace older versions. The same principle applies to any advance directive. The current version needs to be available to the people who may need it.
Why Does Five Wishes Include Personal Preferences?
One of the things that makes Five Wishes distinctive is that it does not stop with medical treatment choices.
Someone may care about comfort, dignity, spiritual beliefs, how they want people around them to behave, or what they want loved ones to know. Those wishes may not answer a medical question, but they can still matter during serious illness.
By including those topics, Five Wishes gives someone another way to explain what matters to them beyond specific treatments or procedures.
Five Wishes Is One Approach to Advance Care Planning
Five Wishes is one way to put healthcare decisions and personal wishes in writing. Its five-part structure includes the choice of a healthcare agent, living will instructions, comfort preferences, personal and spiritual concerns, and information for loved ones.
Someone may come across Five Wishes through a healthcare provider, hospice organization, community program, attorney, or while researching advance directives independently.
Understanding what the document is can make it easier to see how it fits into the broader advance care planning process.
Source
Five Wishes, “Frequently Asked Questions,” Read the full article here.