Free 5 Wishes Document PDF Template

1. What is the Five Wishes Document?

   The Five Wishes document serves as a comprehensive living will that addresses not only medical decisions but also personal, emotional, and spiritual wishes. It is unique because it empowers individuals to outline the type of care they prefer if they become seriously ill and are unable to communicate their desires. By completing this document, a person can specify their health care decision-maker, the medical treatment they wish to receive or avoid, their comfort level, how they want to be treated by others, and any final thoughts or messages for their loved ones. Created with input from The American Bar Association's Commission on Law and Aging and leading experts in end-of-life care, the Five Wishes document is easy to complete and is recognized and valid under the laws of most states once properly signed.

2. Who should use the Five Wishes Document?

   Any person aged 18 and older can, and ideally should, use the Five Wishes document. This includes individuals who are married, single, parents, adult children, and friends. It has been utilized by over 19 million people across various ages, demonstrating its universal applicability and effectiveness. Legal, medical, and religious organizations, among others, distribute it, highlighting its broad acceptance. It enables a proactive approach to planning for future health care scenarios, ensuring individuals' wishes are known and honored.

3. Is the Five Wishes Document recognized in all states?

   The Five Wishes document substantially meets the legal requirements for a living will in 42 states and the District of Columbia. If you reside within these jurisdictions, the document can grant peace of mind, knowing it is recognized and can be used to express your health care preferences. However, if your state is not listed, while some medical providers may still respect the wishes outlined in the document, it may not meet the technical legal requirements of your state. Despite this, many find it a valuable guide for their loved ones and health care providers and use it in conjunction with their state's legal form to ensure their wishes are thoroughly expressed.

4. Can I change my Five Wishes Document once it's completed?

   Yes, you have the right to modify or revoke your Five Wishes document at any time. To do so, you should destroy all copies of the current document and communicate the change to your chosen health care agent, family members, and doctor. If you decide to create a new Five Wishes document, signing the new version automatically revokes any previously completed directives. It's crucial to clearly communicate any changes to ensure your current wishes are known and will be followed.

5. How do I choose the right person to make health care decisions for me?

   Picking a health care agent is a significant decision. This person should be someone who knows you well, cares about you, and is emotionally stable enough to make difficult decisions under pressure. They should be at least 18 years old and must not be your health care provider or an employee of a health or residential care facility that is serving you (unless they are a close relative). It's essential to discuss your wishes with them thoroughly and ensure they are willing and able to act on your behalf if needed. Family members might be an obvious choice, but it's important to consider the emotional difficulty they may face in making such decisions. Sometimes, a close friend might be better suited to serve in this role.

Completing the Five Wishes document provides a unique opportunity to make your healthcare preferences known. However, there are common errors many people make when filling out this form. Avoiding these mistakes ensures your wishes are understood and respected.

1. Not providing clear contact information for the chosen Health Care Agent and any alternates. Ensuring phone numbers and addresses are current and legible is crucial.
2. Choosing a Health Care Agent without discussing their willingness or ability to take on this responsibility. It’s essential that the person selected agrees to serve in this capacity.
3. Being vague about the type of medical treatment wanted or not wanted. Specifics help healthcare providers understand your wishes in different situations.
4. Failing to detail how comfortable you wish to be, particularly regarding pain management, which can be critical in ensuring your end-of-life care is as you desire.
5. Omitting instructions on how you want people to treat you, thus leaving room for interpretations that may not align with your preferences.
6. Not being specific about what you want your loved ones to know, which may include funeral arrangements, messages of love, or life lessons to be passed on.
7. Overlooking the need to regularly review and possibly update the document. Life changes, such as marriage, divorce, or the death of a chosen Agent, can impact the relevance of your current selections.
8. Not properly signing and having the document witnessed as required, which can challenge its validity.
9. Assuming the form is automatically legally valid in all states. While Five Wishes meets the legal requirements in many states, verifying its acceptance in your specific state is important.
10. Forgetting to distribute copies of the completed form to important parties, including the Health Care Agent, family members, and doctors, which might hinder your wishes being honored.

Avoiding these mistakes when completing your Five Wishes document ensures that it accurately reflects your healthcare preferences and can be a valuable guide for your loved ones and healthcare providers.

The Five Wishes document is a comprehensive advance directive that addresses a wide spectrum of concerns, extending beyond the traditional medical directives to include personal, emotional, and spiritual desires at the end of life. It is an important tool for expressing how one wishes to be cared for in their final days, but it is often one piece of a broader estate and health care planning puzzle. People who consider their future care through the lens of the Five Wishes document might also need to integrate other forms and documents to ensure a well-rounded approach to end-of-life planning. Here is a brief overview of six additional forms and documents commonly used alongside the Five Wishes document.

• Durable Power of Attorney for Health Care: This legal document names a health care agent to make medical decisions on behalf of an individual if they become unable to do so. It is similar to the first wish in the Five Wishes document but is more widely recognized as a standard legal form.
• Living Will: A

• Living Will: Like the Five Wishes document, a living will allows a person to state their preferences for medical treatment if they become unable to make decisions for themselves due to illness or incapacity. Both documents guide family members and healthcare providers in making care decisions aligned with the individual's wishes.

• Durable Power of Attorney for Health Care (DPOA-HC): This legal document, similar to the First Wish, lets an individual appoint someone else to make healthcare decisions on their behalf if they are unable to do so. Both documents aim to ensure that someone trusted by the individual has the legal authority to make health care decisions that reflect the person's values and preferences.

• Do Not Resuscitate (DNR) Order: A DNR is a medical order indicating that a person does not want to receive CPR if their heart stops or if they stop breathing. The Five Wishes document also covers this territory by letting an individual express their wishes about the types of life-sustaining treatments they would or would not want, in a broader and more personalized context.

• Health Care Proxy: Similar to the role designated in the First Wish of the Five Wishes document, a health care proxy allows an individual to appoint another person to make healthcare decisions for them if they can't make decisions themselves. Both ensure that healthcare decisions will be made by a chosen representative according to the individual’s preferences.

• Physician Orders for Life-Sustaining Treatment (POLST): POLST is designed for seriously ill patients and specifies the types of medical treatment they wish to receive towards the end of life. Like the Five Wishes, it can include instructions about CPR, ventilation, antibiotic use, and feeding tubes, providing clear communication of personal healthcare wishes directly to medical personnel.

• Medical Orders for Scope of Treatment (MOST): A MOST form specifies which medical treatments a seriously ill person wishes to receive or avoid. The similarity with the Five Wishes lies in their mutual goal of documenting treatment preferences to ensure they are honored, though MOST tends to be more medically detailed and used in specific medical conditions.

• Advance Directive: An advance directive is a broader term encompassing documents like living wills and durable powers of attorney for health care, which allow individuals to specify their healthcare preferences and appoint decision-makers. The Five Wishes document serves as a comprehensive advance directive by combining elements of both, detailing treatment preferences and appointing a health care agent in a single form.

Completing the Five Wishes document is a critical step in planning for future medical care and should be approached with careful consideration. Below, find guidance on what to do and what not to do when filling out this form.

1. Discuss your wishes with the person you are considering as your Health Care Agent before naming them in the document. This ensures they are willing and prepared to fulfill your wishes.

2. Be as specific as possible when detailing your medical treatment preferences. Clarity here can prevent ambiguity and ensure your wishes are followed.

3. Consider all aspects of your care by addressing not only medical treatments but also your personal, emotional, and spiritual needs.

4. Review and update your Five Wishes document regularly or after any significant life changes. This ensures the document always reflects your current wishes.

5. Keep the completed and signed document in a place where it can be easily accessed by your Health Care Agent, family members, or doctors. Inform these individuals about where the document is stored.

1. Do not choose a Health Care Agent without discussing it with them first. It’s crucial they are aware of and agree to take on this responsibility.

2. Do not leave any sections blank. If a specific wish does not apply to you, indicate this clearly to avoid any confusion later on.

3. Do not rely on verbal agreements or assumptions. Make sure everything is documented and formally witnessed as required by your state laws to ensure validity.

4. Do not forget to consider the emotional and psychological aspects of your care. Comfort measures and how you want to be treated by others can greatly affect your well-being.

5. Do not keep your wishes a secret from your family or those closest to you. Sharing and discussing your wishes can help prevent conflicts and ensure your true desires are honored.

Understanding the Five Wishes document is crucial for ensuring your healthcare preferences are respected, but there are several misconceptions about this form. Let’s clear up some of the most common misunderstandings.

• It replaces the need for a will: The Five Wishes document is focused on healthcare decisions, not on financial affairs or estate planning. While it’s a form of living will, it doesn’t replace the need for a legal will that addresses the distribution of your assets.
• It’s legally binding in every state: While the Five Wishes document is recognized in most states, each state has its own laws regarding healthcare directives. It’s important to check whether your state recognizes the Five Wishes document or if additional forms are needed.
• It’s only for the elderly: This document is for anyone over the age of 18. Illness and accidents can happen at any age, and having a plan in place is important for everyone.
• It dictates medical treatment only: Five Wishes covers more than just medical treatments; it includes personal, emotional, and spiritual wishes concerning end-of-life care. This holistic approach ensures that your broader values are considered.
• Once completed, it can’t be changed: You can update or revoke your Five Wishes document at any time to reflect changes in your preferences or circumstances. Ensuring your document is current is an essential part of healthcare planning.
• A lawyer is required to complete it: While legal advice can be valuable, especially if you have questions about your state’s laws, you don’t need a lawyer to complete the Five Wishes document. It’s designed to be user-friendly and accessible.
• It covers funeral arrangements: The Five Wishes document focuses on healthcare and end-of-life care, not funeral details. Planning for funeral arrangements should be done separately.
• It includes a Do Not Resuscitate (DNR) order: While the Five Wishes document allows you to express your preferences for life-support treatment, a separate DNR order may be required to legally refuse resuscitation.
• Healthcare providers can disregard it: While most healthcare providers will respect your wishes as expressed in the Five Wishes document, discussing your wishes with them in advance and ensuring your document is available can help ensure your preferences are followed.
• It must be filled out in its entirety to be valid: While it’s beneficial to provide as much detail as possible, you can still complete and sign the document even if you haven’t made a decision on every single wish.

Understanding these misconceptions can help ensure that your Five Wishes document genuinely reflects your preferences and is used as intended in your healthcare planning.

When considering the creation and use of the Five Wishes Document, there are several key takeaways to understand. This document not only serves as a living will but also as a comprehensive plan that addresses one's personal, emotional, and spiritual needs in addition to medical wishes. Here are four crucial aspects to keep in mind:

• Selection of a Health Care Agent: It's paramount to choose someone who knows you well and who you trust to make medical decisions on your behalf if you're unable to make them yourself. This person, also known as a Health Care Agent, should be at least 18 years old and should not be your health care provider or an employee of a health facility where you are receiving care.
• State Validity: The Five Wishes Document is legally valid in the District of Columbia and 42 states. If you reside outside these locations, it's wise to complete the Five Wishes Document alongside your state's legal forms to ensure all bases are covered. This document encourages open communication about your wishes regardless of its legal status, offering peace of mind and guidance for families and healthcare providers.
• Revocation and Replacement: If you already have a living will or durable power of attorney for health care and decide to use Five Wishes instead, it's crucial to revoke any previous directives. This can be done by destroying all copies of old documents and clearly communicating your new wishes to family, friends, and healthcare providers.
• Comprehensive Care Planning: The Five Wishes Document goes beyond typical medical directives by allowing you to specify your comfort level, how you wish to be treated, and what you want your loved ones to know. This holistic approach ensures that your emotional and spiritual needs are considered, making it a valuable tool for end-of-life planning.

Utilizing the Five Wishes Document can significantly aid in ensuring that your healthcare and personal dignity are maintained according to your preferences. Open discussion with loved ones and healthcare providers about your wishes is encouraged to make sure everyone is informed and prepared to honor your choices.