What is Five Wishes?

Five Wishes is a legal form published by an American nonprofit organization to help people prepare an advance medical directive to address what should happen if they become ill and are no longer able to make decisions for themselves. The Aging With Dignity organization introduced the first version in 1996 and has made several changes to the form to make it usable in as many states as possible as a binding legal document. People can obtain copies from this organization or through hospitals, hospice organizations, and similar groups.

This document contains five sections covering various aspects of end of life care. The first is the designation of a person to act as a health-care proxy in the event someone is incapacitated. The second discusses the kind of care the person wishes to receive, ranging from minimal comfort care to every lifesaving measure possible. Both of these parts of the Five Wishes document are legally binding, and it is important to make sure the form is recognized in a given jurisdiction.

The next three sections discuss spiritual and personal matters. The third section addresses the comfort needs of the patient, discussing the kind of comfort care she wishes to receive. The fourth covers how the patient wants to be treated by other people, and the fifth discusses things the patient wants friends and family to know. These can include details for a funeral or memorial along with personal notes to individual people.

The Five Wishes document acts as a living will detailing the patient’s wishes about specific aspects of medical care, along with giving a person health-care power of attorney to make decisions. It also covers matters not normally discussed in the standard legal forms people use for advanced directives. When people use a Five Wishes form, they should check to see if their state recognizes the form. If it does not, they need to use the state’s preferred legal document, although they can also prepare a Five Wishes to supplement it.

It is important to be aware that hospitals use a variety of terminology to discuss various aspects of end of life care, and it is important to be as specific as possible. Rather than just saying “no extraordinary measures,” for example, people should spell out what that means. A person might be willing to go on antibiotics to treat an infection, but not to go on a ventilator, for instance. The more detailed the document, the better health-care providers will be able to respect the wishes of the patient.