Content Navigation
In moments of uncertainty, having a plan can provide peace of mind. The Five Wishes document is a powerful tool designed to help individuals express their medical and personal preferences in the event they cannot communicate those wishes themselves. It allows you to designate a trusted person to make healthcare decisions on your behalf, ensuring that your values and desires are respected. This form also addresses the type of medical treatment you want or do not want, how comfortable you wish to be, and how you want to be treated by others during a serious illness. Additionally, it offers a space for you to share important messages with your loved ones, making it clear what you want them to know. Five Wishes is not just a legal document; it is a compassionate guide that encourages open conversations with family and healthcare providers, alleviating the burden of making difficult choices during challenging times. Valid in many states, this document can be easily completed by anyone over the age of 18, making it accessible to a wide audience. By taking the time to fill out this form, you empower yourself and your family to navigate healthcare decisions with confidence and clarity.
5 Wishes Document Example
M Y W I S H F O R :
The Person I Want to Make Care1Decisions for Me When I Can’t
The Kind of Medical Treatment2 I Want or Don’t Want
How Comfortable3 I Want to Be How I Want People4 to Treat Me What I Want My Loved5 Ones to Know
Print Your Name
Birthdate
1
T here are many things in life that are out of our hands. This Five Wishes document gives you a way to control something very important — how
you are treated if you get seriously ill. It is an
What Is Five Wishes?
Five Wishes is the first living will (also called an advance directive) that talks about your personal, emotional, and spiritual needs as well as your medical wishes. It lets you choose the person you want to make health care decisions for you if you are not able to make them for yourself. Five Wishes lets you say exactly how you wish to be treated if you get seriously ill. It was written with the help of the nation’s leading experts in
How Five Wishes Can Help You And Your Family
• It lets you talk with your family, friends and |
they won’t have to make hard choices |
doctor about how you want to be treated if |
without knowing your wishes. |
you become seriously ill. |
• You can know what your mom, dad, |
|
|
• Your family members will not have to guess |
spouse, or friend wants. You can be there |
what you want. It protects them |
for them when they need you most. You will |
if you become seriously ill, because |
understand what they really want. |
How Five Wishes Began
For 12 years, Jim Towey worked closely with Mother Teresa, and, for one year, he lived in a hospice she ran in Washington, DC. Inspired by this
2
Who Should Use Five Wishes
Five Wishes is for anyone 18 or older — married, single, parents, adult children, and friends. More than 40 million people of all ages have already used it. Because it works so well, lawyers, doctors, hospitals and hospices, faith communities, employers, and retiree groups are handing out this document.
People who use Five Wishes find that it helps them express all that they want and provides a helpful guide to family members, friends, care givers and doctors. Most doctors and health care professionals know they need to listen to your wishes no matter how you express them.
Five Wishes In My State
Five Wishes was created with help from the American Bar Association’s Commission on Law and Aging. If you live in the District of Columbia or most states you can use Five Wishes and have the peace of mind to know that it substantially meets your state’s requirements under the law. If you live in one of four states (Kansas, New Hampshire, Ohio, or Texas) you can still use Five Wishes but may need to take an extra step. Find out more at FiveWishes.org/states.
How Do I Change To Five Wishes?
You may already have a living will or a durable power of attorney for health care. If you want to use Five Wishes instead, all you need to do is fill out and sign a new Five Wishes as directed. As soon as you sign it, it takes away any advance directive you had before. To make sure the right form is used, please do the following:
• Destroy all copies of your old living will or |
• Tell your Health Care Agent, family |
durable power of attorney for healthcare. |
members, and doctor that you have filled out |
Or you can write “revoked” in large letters |
a new Five Wishes. Make sure they know |
across the copy you have. Tell your lawyer |
about your new wishes. |
if he or she helped prepare those old forms |
|
for you. |
|
3
WISH 1
The Person I Want To Make Health Care Decisions For Me
When I Can’t Make Them For Myself.
I f I am no longer able to make my own health care decisions, this form names the person I choose to
make these choices for me. This person will be my Health Care Agent (or other term that may be used in my state, such as proxy, representative, or surrogate). This person will make my health care choices if both of these things happen:
•My attending or treating doctor finds I am no longer able to make health care choices, AND
•Another health care professional agrees that this is true.
If my state has a different way of finding that I am not able to make health care choices, then my state’s way should be followed.
The Person I Choose As My Health Care Agent Is:
|
|
|
First Choice Name |
|
Phone |
|
|
|
Address |
|
City/State/Zip |
If this person is not able or willing to make these choices for me, OR is divorced or legally separated from me, OR this person has died, then these people are my next choices:
Second Choice Name
Address
City/State/Zip
Phone
Third Choice Name
Address
City/State/Zip
Phone
Picking The Right Person To Be Your Health Care Agent
Choose someone who knows you very well, cares about you, and who can make difficult decisions. A spouse or family member may not be the best choice because they are too emotionally involved. Sometimes they are the best choice. You know best. Choose someone who is able to stand up for you so that your wishes are followed. Also, choose someone who is likely to be nearby so they can help when you need them. Whether you choose a spouse, family member, or friend as your Health Care Agent, make sure you talk about these wishes and be sure that this person agrees to respect and
follow your wishes. Your Health Care Agent should be at least 18 years or older (in Colorado,
21 years or older) and should not be:
• Your health care provider, including the owner or operator of a health or residential or community care facility serving you.
• An employee or spouse of an employee of your health care provider.
• Serving as an agent or proxy for 10 or more people unless he or she is your spouse or close relative.
4
I understand that my Health Care Agent can make health care decisions for me. I want my Agent to be able to do the following: (Please cross out anything you don’t want your Agent to do that is listed below.)
• Make choices for me about my medical care or services, like tests, medicine, or surgery. This care or service could be to find out what my health problem is, or how to treat it. It can also include care to keep me alive. If the treatment or care has already started, my Health Care Agent can keep it going or have it stopped.
• Interpret any instructions I have given in this form or given in other discussions, according to my Health Care Agent’s understanding of my wishes and values.
• Consent to admission to an assisted living facility, hospital, hospice, or nursing home for me. My Health Care Agent can hire any kind of health care worker I may need to help me or take care of me. My Agent may also fire a health care worker, if needed.
• Make the decision to request, take away, or not give medical treatments, including artificially- provided food and water, and any other treatments to keep me alive.
• See and approve release of my medical records and personal files. If I need to sign my name to get any of these files, my Health Care Agent can sign it for me.
• Move me to another state to get the care I need or to carry out my wishes.
• Authorize or refuse to authorize any medication or procedure needed to help with pain.
• Take any legal action needed to carry out my wishes.
• Donate useable organs or tissues of mine as allowed by law.
• Apply for Medicare, Medicaid, or other programs or insurance benefits for me. My Health Care
Agent can see my personal files, like bank records, to find out what is needed to fill out these forms.
• Listed below are any changes, additions, or limitations on my Health Care Agent’s powers.
If I Change My Mind About Having A Health Care Agent, I Will
• Destroy all copies of this part of the Five Wishes |
• Write the word “Revoked” in large letters across |
form. OR |
the name of each agent whose authority I want to |
• Tell someone, such as my doctor or family, that I |
cancel. Sign my name on that page. |
|
|
want to cancel or change my Health Care Agent. |
|
OR |
|
5
WISH 2
My Wish For The Kind Of Medical Treatment
I Want Or Don’t Want.
I believe that my life is precious and I deserve to be treated with dignity. When the time comes that
I am very sick and am not able to speak for myself, I want the following wishes, and any other directions I have given to my Health Care Agent, to be respected and followed.
What You Should Keep In Mind As My Caregiver
• I do not want to be in pain. I want to be |
• I do not want anything done or omitted by my |
comfortable. Wish 3 says what can be done to |
doctors or nurses with the intention of taking |
make me comfortable. |
my life. |
• I want to be offered food and fluids by mouth if it is safe for me to eat and drink. I want to be kept clean and warm.
What
In Case Of An Emergency
If you have a medical emergency and ambulance personnel arrive, they may look to see if you have a Do Not Resuscitate form or bracelet. Many states require a person to have a Do Not Resuscitate form filled out and signed by a doctor if you choose not to be
resuscitated. This form lets ambulance personnel know that you don’t want them to use
6
Here is the kind of medical treatment that I want or don’t want in the four situations listed below. I want my Health Care Agent, my family, my doctors and other health care providers, my friends, and all others to know these directions.
Close To Death:
If my doctor and another health care professional both decide that I am likely to die within a short period of time, and
oI want to have
oI do not want
oI want to have
In A Coma And Not Expected To Wake Up Or Recover:
If my doctor and another health care professional both decide that I am in a coma from which I am not expected to wake up or recover, and I have brain damage, and
oI want to have
oI do not want
oI want to have
Permanent And Severe Brain Damage And Not Expected To Recover:
If my doctor and another health care professional both decide that I have permanent and severe brain damage, (for example, I can open my eyes, but I can not speak or understand) and I am not expected to get better, and life‑support treatment would only delay the moment of my death (choose one of the following):
oI want to have
oI do not want
oI want to have
In Another Condition Under Which I Do Not Wish To Be Kept Alive:
If there is another condition under which I do not wish to have
7
T he next three wishes deal with my personal, spiritual, and emotional wishes. They are important to me. I want to be treated with dignity near the end of my life, so I would like people to do the things written in Wishes 3, 4, and 5 when they can be done. I understand that my family, my doctors and other health care
providers, my friends, and others may not be able to do these things or are not required by law to do these things. I do not expect the following wishes to place new or added legal duties on my doctors or other health care providers. I also do not expect these wishes to excuse my doctor or other health care providers from giving me the proper care asked for by law.
WISH 3
My Wish For How Comfortable I Want To Be.
(Please cross out anything that you don’t agree with.)
• I do not want to be in pain. I want my doctor to give me enough medicine to relieve my pain, even if that means I will be drowsy or sleep more than I would otherwise.
• If I show signs of depression, nausea, shortness of breath, or hallucinations, I want my care givers to do whatever they can to help me.
• I wish to have a cool moist cloth put on my head if I have a fever.
• I want my lips and mouth kept moist to stop dryness.
• I wish to have warm baths often. I wish to be kept fresh and clean at all times.
• I wish to be massaged with warm oils as often as I can be.
• If I am not able to control my bowel or bladder functions, I wish for my clothes and bed linens to be kept clean, and for them to be changed as soon as they can be if they have been soiled.
• I wish to have personal care like shaving, nail clipping, hair brushing, and teeth brushing, as long as they do not cause me pain or discomfort.
• I wish to have religious or spiritual readings and
• I wish to know about options for hospice care to provide medical, emotional, and spiritual care for me and my loved ones.
WISH 4
My Wish For How I Want People To Treat Me.
(Please cross out anything that you don’t agree with.)
• I wish to have people with me when possible.
I want someone to be with me when it seems that death may come at any time.
• I wish to be visited by a chaplain or clergy.
• I wish to be cared for with kindness and cheerfulness, and not sadness.
• I wish to have my hand held and to be talked to when possible, even if I don’t seem to respond to the voice or touch of others.
• I wish to have others by my side praying for me when possible.
• I wish to have the members of my faith community told that I am sick and asked to pray for me and visit me.
• I wish to have pictures of my loved ones in my room, near my bed.
• I wish to have my favorite music played when possible until my time of death.
• I want to die in my home, if that can be done.
• I wish to be called by my name. Please call me:
8
WISH 5
My Wish For What I Want My Loved Ones To Know.
(Please cross out anything that you don’t agree with.)
• I wish to have my family and friends know that I love them.
• I wish to be forgiven for the times I have hurt my family, friends, and others.
• I wish to have my family, friends, and others know that I forgive them for when they may have hurt me in my life.
• I wish for my family and friends and caregivers to respect my wishes even if they don’t agree with them.
• I wish for my family and friends to look at my dying as a time of personal growth for everyone, including me. This will help me live a meaningful life in my final days.
• I wish for my family and friends to know that I do not fear death. I think it is not the end, but a new beginning for me.
• I wish for all of my family members to make peace with each other before my death, if they can.
• I wish for my family and friends to think about what I was like before I became seriously ill. I want them to remember me in this way after my death.
• I wish for my family and friends to get counseling if they have trouble with my death. I want memories of my life to give them joy and not sorrow.
• After my death, I would like my body to be
(circle one): buried OR cremated.
• My body or remains should be put in the following location:
• The following person knows my funeral wishes:
If anyone asks how I want to be remembered, please say the following about me:
If there is to be a memorial service for me, I wish for this service to include the following (list music, songs, readings, or other specific requests that you have):
It is important for my health care providers to know what matters most to me. I wish for them to know the following:
Please use the space below for any other wishes. For example, you may want to donate any or all parts of your body when you die. You may also wish to designate a charity to receive memorial contributions. Or you may want to give instructions on what should be done with your social media or other electronic records. Please attach a separate sheet of paper if you need more space.
9
Signing My Five Wishes
Please make sure you sign your Five Wishes in the presence of two witnesses.
I, |
|
, ask that my family, my doctors, and other health care providers, my |
friends, and all others, follow my wishes as communicated by my Health Care Agent (if I have one and he or
she is available), or as otherwise expressed in this form. This form becomes valid when I am unable to make decisions or speak for myself. If any part of this form cannot be legally followed, I ask that all other parts of this form be followed. I also revoke any health care advance directives I have made before.
|
|
|
|
|
Signature |
|
|
|
Address |
|
|
|
|
|
|
|
|
|
|
Phone |
|
Date |
|
Address (cont.) |
|
|
|||
|
|
Witness Statement • (2 witnesses needed):
I, the witness, declare that the person who signed or acknowledged this form (hereafter “person”) is personally known to me, that he/she signed or acknowledged this [Health Care Agent and/or Living Will form(s)] in my presence, and that he/she appears to be of sound mind and under no duress, fraud, or undue influence.
I also declare that I am over 18 years of age (19 in Alabama) and am NOT:
• The individual appointed as (agent/proxy/ surrogate/patient advocate/representative) by this document or his/her successor,
• The person’s health care provider, including owner or operator of a health,
• An employee of the person’s health care provider,
• Financially responsible for the person’s health care,
• An employee of a life or health insurance provider for the person,
• Related to the person by blood, marriage, or adoption,
• A beneficiary of any legal instrument, account, or benefit plan of the person, and,
• To the best of my knowledge, a creditor of the person or entitled to any part of his/her estate under a will or codicil, by operation of law.
(Some states may have fewer rules about who may be a witness. Unless you know your state’s rules, please follow the above.)
Signature of Witness #1
Printed Name of Witness
Address
Phone
Signature of Witness #2
Printed Name of Witness
Address
Phone
Notarization • Only required for residents of Missouri, North Carolina, South Carolina, and West Virginia
If you live in Missouri, only your signature should be notarized. If you live in North Carolina, South Carolina or West Virginia, you should have your signature, and the signatures of your witnesses, notarized.
STATE OF___________________________________COUNTY OF________________________________
On this _____ day of __________________, 20_____, the said ________________________________________________________,
_______________________________, and ______________________________, known to me (or satisfactorily proven) to be the person named in
the foregoing instrument and witnesses, respectively, personally appeared before me, a Notary Public, within and for the State and County aforesaid, and acknowledged that they freely and voluntarily executed the same for the purposes stated therein.
My Commission Expires:
Notary Public
10
File Breakdown
| Fact Name | Description |
|---|---|
| Purpose | The Five Wishes document allows individuals to express their personal, emotional, and medical preferences for care in the event they become seriously ill. |
| Legal Validity | Once completed and signed, Five Wishes is valid in most states across the U.S., providing a legal framework for advance care planning. |
| Governing Law | In states like California and Florida, Five Wishes complies with specific state laws regarding advance directives and living wills. |
| Target Audience | Anyone aged 18 or older can use Five Wishes, including married individuals, single persons, and parents, ensuring that diverse needs are met. |
| Ease of Use | The form is designed to be straightforward, requiring users to check boxes, circle options, or write brief notes to convey their wishes clearly. |
Guide to Using 5 Wishes Document
Filling out the Five Wishes document is a straightforward process that allows you to express your preferences regarding medical care and personal treatment in case you become seriously ill. After completing the form, make sure to sign and date it to ensure it is valid. Once done, share your wishes with your family and healthcare providers to ensure everyone is informed.
- Begin by printing your name and birthdate at the top of the form.
- Identify the person you want to make health care decisions for you if you cannot do so. Write their name, phone number, and address in the designated area.
- If your first choice is unavailable, list your second and third choices, including their contact information.
- Clearly indicate your preferences regarding medical treatment. Mark what you want or do not want.
- Specify how comfortable you want to be during treatment. Consider any specific requests you have.
- Express how you would like people to treat you during this time. This may include your preferences for communication and support.
- Write down what you want your loved ones to know. This can include messages of love, guidance, or anything else you feel is important.
- Review the completed form for accuracy. Make sure all sections are filled out according to your wishes.
- Sign and date the form at the bottom to validate it.
- Distribute copies of the signed document to your chosen health care agent, family members, and healthcare providers.
Get Answers on 5 Wishes Document
What is the Five Wishes document?
The Five Wishes document is a unique type of living will that addresses not only medical decisions but also personal, emotional, and spiritual needs. It allows individuals to express their preferences regarding healthcare and how they wish to be treated if they become seriously ill. By designating a Health Care Agent, you ensure that someone you trust will make decisions on your behalf when you cannot. This document is user-friendly, requiring you to simply check boxes, circle options, or write a few sentences to convey your wishes.
Who should consider using the Five Wishes document?
Anyone who is 18 years or older can benefit from completing a Five Wishes document. This includes married individuals, single people, parents, adult children, and friends. More than 19 million people across various demographics have utilized this document to articulate their healthcare preferences. It is particularly useful for those who want to ensure their loved ones are aware of their wishes during difficult times.
How does Five Wishes differ from other advance directives?
Five Wishes stands out because it encompasses not only medical decisions but also personal preferences about comfort, treatment, and interaction with loved ones. While traditional living wills focus solely on medical interventions, Five Wishes addresses the emotional and spiritual aspects of care. This holistic approach makes it easier for families to understand and honor their loved one's desires.
Is Five Wishes legally binding?
Yes, the Five Wishes document is legally binding in the District of Columbia and 42 states. To ensure its validity, it must be filled out and signed according to state laws. While some states may have specific requirements, the document is designed to meet the legal standards of most jurisdictions. It is advisable to check your state's regulations to confirm its acceptance.
What should I do if I want to change my existing advance directive to Five Wishes?
If you currently have a living will or a durable power of attorney for healthcare and wish to switch to Five Wishes, simply complete and sign the new Five Wishes document. This action will revoke any previous directives. To ensure clarity, it is recommended that you destroy all copies of the old document and inform your healthcare agent, family members, and healthcare providers about your new wishes.
How can Five Wishes help my family during a health crisis?
Five Wishes can significantly ease the burden on your family during a health crisis. By clearly outlining your preferences, you eliminate the guesswork for your loved ones, allowing them to make informed decisions that align with your wishes. This document fosters open communication, ensuring that family members understand each other's desires. In times of stress, having a clear plan can provide comfort and guidance to those who care for you.
Common mistakes
Filling out the Five Wishes Document can be an important step in planning for future health care needs. However, many people make mistakes that can affect the validity of their wishes. One common mistake is failing to choose a specific person to make health care decisions. It is essential to name someone who understands your values and wishes. Without a clear choice, there may be confusion when decisions need to be made.
Another mistake is not discussing your wishes with the chosen health care agent. Some individuals assume that their loved ones will automatically understand their preferences. This assumption can lead to disagreements or uncertainty during critical moments. Open communication ensures that your agent knows how to advocate for you effectively.
Some people also neglect to sign and date the document properly. A signature is crucial for the form to be legally binding. Without it, the document may not hold up when needed. Additionally, forgetting to have witnesses sign can invalidate the document in some states. Always check the requirements for your state to ensure compliance.
Another frequent error involves not updating the document when circumstances change. Life events such as divorce, the death of a chosen agent, or changes in health can necessitate revisions. Failing to update the document can lead to outdated or unwanted decisions being made on your behalf.
Many individuals also overlook the importance of providing copies of the completed document to relevant parties. This includes your health care agent, family members, and doctors. Without these copies, your wishes may not be known when they need to be acted upon.
Some people may fill out the document in a hurry, leading to unclear or vague language. Specificity is key when expressing your wishes. General statements can lead to misinterpretation and confusion. Clear instructions help ensure that your preferences are understood and respected.
Finally, individuals sometimes forget to review the document periodically. As life changes, so too may your preferences regarding health care. Regularly revisiting the Five Wishes Document allows you to make necessary adjustments and ensures that it accurately reflects your current desires.
Documents used along the form
The Five Wishes document is a vital tool for anyone looking to express their healthcare preferences. However, it is often used alongside other important forms and documents that can help clarify and support your wishes. Here is a list of commonly used documents that complement the Five Wishes form.
- Durable Power of Attorney for Health Care: This document allows you to appoint someone to make healthcare decisions on your behalf if you become unable to do so. It focuses specifically on medical choices.
- Living Will: A living will outlines your preferences regarding medical treatment in situations where you cannot communicate your wishes. It typically addresses end-of-life care and life-sustaining measures.
- Do Not Resuscitate (DNR) Order: This order instructs medical personnel not to perform CPR if your heart stops or if you stop breathing. It is often used in hospital settings or at home to ensure your wishes are respected.
- Health Care Proxy: Similar to a durable power of attorney, a health care proxy designates a person to make healthcare decisions for you. This document can be useful if you do not have a durable power of attorney.
- HIPAA Authorization: This authorization allows designated individuals access to your medical records and information. It ensures that your healthcare agent can communicate effectively with medical providers.
- Advance Directive: An advance directive is a broader term that includes both living wills and durable powers of attorney for health care. It serves as a comprehensive guide to your healthcare preferences.
- Organ Donation Form: This form allows you to express your wishes regarding organ donation after your death. It can be included with other advance directives to ensure your wishes are clear.
- Personal Health Record: A personal health record is a document where you keep track of your medical history, medications, and healthcare preferences. It can be shared with your healthcare agent and providers.
- Funeral Planning Documents: These documents outline your wishes regarding funeral arrangements, burial, or cremation. They can ease the burden on your loved ones during a difficult time.
Using these forms in conjunction with the Five Wishes document can help ensure that your healthcare preferences are clearly communicated and honored. It is essential to discuss these documents with your family and healthcare providers to ensure everyone is on the same page.
Similar forms
The Five Wishes document is a powerful tool for expressing your healthcare preferences. It shares similarities with several other important documents that help individuals communicate their wishes regarding medical treatment and end-of-life care. Here’s a list of nine documents that are similar to the Five Wishes form, along with explanations of how they relate:
- Living Will: Like Five Wishes, a living will outlines your preferences for medical treatment in case you become unable to communicate. It typically focuses on specific medical procedures and interventions you do or do not want.
- Durable Power of Attorney for Health Care: This document designates someone to make healthcare decisions on your behalf if you are unable to do so. It shares the same goal as Five Wishes but may not cover personal, emotional, or spiritual wishes.
- Advance Directive: An advance directive is a broader term that includes both living wills and durable powers of attorney. It allows you to express your healthcare preferences, similar to the Five Wishes document.
- Do Not Resuscitate (DNR) Order: A DNR order specifically states that you do not want to receive CPR or other life-saving measures. While it is more focused than Five Wishes, both documents aim to ensure your wishes are respected in critical situations.
- Health Care Proxy: This document allows you to appoint someone to make medical decisions for you if you are incapacitated. It is akin to the health care agent designation in Five Wishes, focusing on decision-making authority.
- POLST (Physician Orders for Life-Sustaining Treatment): A POLST form translates your treatment preferences into actionable medical orders. It is similar to Five Wishes in that it addresses your wishes regarding life-sustaining treatments.
- Memorandum of Wishes: This informal document allows you to express your personal wishes regarding healthcare and end-of-life care. It complements formal documents like Five Wishes by providing additional context about your preferences.
- Funeral Planning Document: While focused on post-death arrangements, this document allows you to specify your wishes for funeral services and burial. It aligns with the holistic approach of Five Wishes in addressing your overall care and treatment.
- Spiritual Care Directive: This document outlines your spiritual and religious preferences for care during illness or at the end of life. It resonates with the emotional and spiritual components of Five Wishes, ensuring your beliefs are honored.
Each of these documents serves a unique purpose but shares the common goal of ensuring that your healthcare wishes are known and respected. Understanding these options can help you make informed choices about your future care.
Dos and Don'ts
When filling out the Five Wishes Document form, it is essential to be thorough and careful. This document allows you to express your medical and personal wishes in a way that can guide your loved ones and healthcare providers. Here are ten important things to keep in mind:
- Do: Read the entire document carefully before starting to fill it out.
- Do: Clearly print your name and birthdate at the top of the form.
- Do: Choose a health care agent who understands your wishes and is willing to advocate for you.
- Do: Discuss your preferences with your chosen health care agent to ensure they are comfortable with their role.
- Do: Sign and date the form in the presence of a witness, if required by your state.
- Don't: Rush through the form; take your time to think about your decisions.
- Don't: Leave any sections blank; if something doesn’t apply, indicate that it’s not applicable.
- Don't: Choose someone as your agent who may be unable to fulfill the role due to emotional ties or conflicts of interest.
- Don't: Forget to inform your family and healthcare providers about your completed document.
- Don't: Assume that verbal wishes are enough; written documentation is crucial for clarity.
By following these guidelines, you can ensure that your Five Wishes Document accurately reflects your desires and provides peace of mind for both you and your loved ones.
Misconceptions
Understanding the Five Wishes document can be crucial for ensuring that your healthcare preferences are respected. However, several misconceptions often arise about this important form. Here are eight common misunderstandings:
- Five Wishes is only for the elderly. Many people believe that only seniors need to complete this document. In reality, it is designed for anyone aged 18 or older, regardless of health status.
- Five Wishes is legally binding in every state. While Five Wishes is valid in many states, it does not meet legal requirements in all. It’s essential to check if your state recognizes it as a valid advance directive.
- Filling out Five Wishes means I will not receive life-saving treatment. This is not true. Five Wishes allows you to express your preferences for treatment, but it does not prevent you from receiving necessary medical care.
- Five Wishes is only about medical decisions. Although it covers healthcare choices, it also addresses personal, emotional, and spiritual needs, making it a comprehensive document.
- Once I complete Five Wishes, I cannot change it. You can change your Five Wishes at any time. Just destroy old copies and inform your healthcare agent about the updates.
- My family will automatically know my wishes. It’s a misconception that family members will guess your preferences. Five Wishes encourages open communication about your desires to avoid confusion during difficult times.
- Five Wishes is just a formality. Some people think it’s not necessary to complete this document. However, it plays a vital role in ensuring your wishes are honored, especially when you cannot speak for yourself.
- Only lawyers can help with Five Wishes. While legal advice can be beneficial, the form is designed to be easy to complete on your own. You can fill it out without needing a lawyer, although consulting one can provide additional peace of mind.
By addressing these misconceptions, individuals can better understand the importance of the Five Wishes document and how it can serve their needs and those of their families.
Key takeaways
Filling out and using the Five Wishes Document form can be a vital step in planning for your future health care. Here are key takeaways to consider:
- Understand the Purpose: The Five Wishes Document allows you to express your medical, emotional, and spiritual preferences in case you become seriously ill.
- Choose Your Advocate: You can designate a person to make health care decisions on your behalf if you are unable to do so yourself.
- Easy to Complete: The form is straightforward and requires you to check boxes, circle options, or write brief notes, making it accessible for everyone.
- Legal Validity: Once completed and signed, the document is valid in most states, providing peace of mind regarding your wishes.
- Family Communication: It encourages open discussions with family members, preventing them from having to make tough decisions without knowing your preferences.
- Wide Acceptance: Over 19 million people have used Five Wishes, and it is recognized by various professionals, including lawyers and health care providers.
- Revocation of Previous Documents: If you decide to use Five Wishes instead of an existing living will, you must destroy old copies to avoid confusion.
- Available in Multiple Languages: The document is accessible in 27 languages, making it inclusive for diverse communities.
- Age Requirement: Anyone aged 18 or older can use Five Wishes, making it suitable for adults, regardless of marital status or family structure.
By taking the time to fill out the Five Wishes Document, you empower yourself and your loved ones to make informed decisions aligned with your values and preferences.