Free 5 Wishes Document PDF Form

What is the Five Wishes document?

The Five Wishes document allows individuals to express how they want to be treated in case they become seriously ill and can't make decisions for themselves. It encompasses personal, emotional, and spiritual needs along with medical wishes, letting you choose the person to make healthcare decisions on your behalf. Created with input from experts in end-of-life care, it's designed to be straightforward to use, requiring only the completion of simple steps to express your wishes.

Who should use the Five Wishes document?

Five Wishes is suitable for anyone over the age of 18, regardless of their marital status, whether they are parents, adult children, or friends. It has been embraced by over 19 million people of various ages, and is recommended by professionals across legal, medical, and faith communities, as well as by employers and retiree groups. Its universal applicability makes it a valuable tool for anyone wishing to plan ahead for their healthcare.

Is the Five Wishes document legally valid in my state?

The Five Wishes document meets legal requirements in the District of Columbia and 42 states. If you live in one of these areas, completing the document gives you peace of mind that your wishes are legally protected. For those in other states, while it might not meet specific legal criteria, many still use it alongside state-approved forms. It's widely respected by healthcare providers for its comprehensive approach to expressing care wishes.

How can I change to Five Wishes if I already have a living will?

If you wish to switch to Five Wishes from another form of advance directive like a living will or durable power of attorney for health care, simply complete and sign the Five Wishes document. Upon signing, it replaces any previous directives. It’s important to destroy old documents, inform your health care agent, family members, and doctor of the change, ensuring everyone is aware of your current wishes.

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

Choosing a health care agent is a decision that requires careful consideration. The ideal candidate knows you well, respects your wishes, and is capable of making tough decisions during emotional times. This person must be at least 18 years old and should not be your health care provider or associated with a care facility you use. Make sure to discuss your wishes with them and confirm they are willing and able to take on this responsibility.

1. Not choosing the right Health Care Agent: One of the common mistakes people make is not picking the right person to act as their Health Care Agent. It's crucial to select someone who knows you well, understands your wishes, and is willing to advocate for them. Ideally, this should be a person who is emotionally stable, available, and capable of making tough decisions under stress. Additionally, failing to have a conversation with the chosen individual about your wishes and confirming their willingness to take on this responsibility can lead to issues down the line.

2. Incomplete instructions or wishes: Another mistake is providing vague or incomplete instructions regarding the medical treatment you want or don't want, how comfortable you want to be, how you want people to treat you, and what you want your loved ones to know. Being clear and explicit about your end-of-life care can prevent ambiguity and ensure your wishes are honored. This means taking the time to think carefully about each aspect of your care and being detailed in your document.

3. Not updating the document: Life circumstances and relationships change, and so might your wishes. Failing to periodically review and update your Five Wishes document can result in an outdated plan that doesn't reflect your current preferences or situation. It's essential to revisit the document regularly or after significant life events (such as marriage, divorce, the death of a chosen agent, or a change in health status) to make necessary adjustments.

4. Not distributing copies to the right people: Completing the document is a significant first step, but it's equally important to ensure that the right people have copies. This includes your Health Care Agent, family members, close friends, and your doctor. If the document is hidden away or people are unaware of its existence, your end-of-life wishes are likely not to be followed. A common mistake is not having this critical conversation or assuming that having the document stored somewhere is enough.

The Five Wishes Document provides a comprehensive approach to discussing and documenting one's preferences concerning medical treatment, comfort, personal relationships, and final wishes. This document empowers individuals by ensuring their wishes are respected even when they cannot communicate them directly. To complement the Five Wishes Document, several other forms and documents are frequently used to create a well-rounded plan for end-of-life care and beyond. Understanding these documents will provide further clarity and support in executing a person's final wishes.

• Living Will: A document that outlines specific medical treatments an individual wishes to receive or not receive in the event they are unable to communicate their decisions due to a serious illness or incapacitation.
• Durable Power of Attorney for Health Care: Assigns a trusted person to make health care decisions on behalf of the individual in case they become unable to make those decisions themselves.
• Last Will and Testament: Specifies how an individual's assets and estate should be distributed after their death. It also may appoint a guardian for minor children.
• Financial Power of Attorney: Grants a trusted individual the authority to handle financial affairs, such as managing bank accounts and assets, on behalf of the individual.
• Do Not Resuscitate (DNR) Order: A medical order indicating that an individual does not want to undergo CPR or other life-saving measures if their heart stops or if they stop breathing.
• Organ and Tissue Donation Registration: Documents an individual's wishes regarding organ and tissue donation for transplantation or medical research after death.
• Funeral Planning Declaration: Allows individuals to specify their preferences for funeral arrangements, including burial or cremation, type of service, and other related wishes.
• Guardianship Designation: Appoints a guardian to make decisions on behalf of the individual should they become incapacitated, covering aspects beyond health care, such as living arrangements and daily care.
• Advance Directive: A broad term that encompasses documents like living wills and durable powers of attorney for health care, specifying an individual’s preferences for treatment and care in situations where they cannot make decisions for themselves.

In essence, the Five Wishes Document serves as a cornerstone in planning for future health care and personal matters. Nevertheless, it is most effective when used in conjunction with other legal and medical documents that cover a wider range of circumstances and decisions. Together, these documents ensure a comprehensive approach to end-of-life planning, providing peace of mind to both the individual and their loved ones. It is advisable to consult with legal and medical professionals when completing these documents to ensure that they accurately reflect the individual’s wishes and comply with state laws.

• The Living Will is similar to the Five Wishes Document because it allows a person to state their preferences for end-of-life medical care. However, while a living will generally focuses on medical treatments and life-sustaining measures, Five Wishes extends into personal, emotional, and spiritual wishes.

• The Durable Power of Attorney for Health Care (DPOA-HC) closely resembles the Five Wishes Document in its functionality of appointing a health care agent to make medical decisions on the individual's behalf when they are unable to do so. Five Wishes integrates this aspect into its comprehensive approach, covering more than just the designation of an agent.

• The Health Care Proxy shares similarities with the Five Wishes Document by enabling individuals to nominate someone (a proxy) to make health care decisions for them if they're incapacitated. Like the Five Wishes, it's about making sure someone trusted can speak for the patient.

• The Medical Orders for Life-Sustaining Treatment (MOLST) or Physician Orders for Life-Sustaining Treatment (POLST) have parallels with Five Wishes, in that both documents guide medical treatment based on patient preferences. However, MOLST/POLST forms are more focused on immediate medical orders rather than the broader scope of wishes covered in the Five Wishes document.

• The Do Not Resuscitate (DNR) Order overlaps with the Five Wishes Document in the aspect of specific medical instructions—specifically, the wish not to have CPR if the heart stops or if breathing ceases. While the DNR is very specific, Five Wishes allows for this decision within a wider context of personal directives.

• The Advance Health Care Directive is akin to the Five Wishes Document by acting as a legal tool to outline a person's healthcare preferences and appoint someone to speak for them. The Five Wishes can be considered a type of advance directive, yet it's distinctive for its holistic and detailed approach.

• Organ Donor Registration forms are similar to a section within the Five Wishes Document that addresses the donation of organs and tissues. While organ donor forms are typically standalone documents, the Five Wishes incorporates this choice into its broader discussion of end-of-life wishes.

• HIPAA Release Form bears resemblance to Five Wishes in the sense that both can include permissions for certain people to access one's medical records. While the Five Wishes document largely focuses on end-of-life care preferences, it can also specify who can speak to doctors and view health information.

• The Psychiatric Advance Directive (PAD) is related to the Five Wishes Document since both allow individuals to express how they wish to be treated in specific medical situations. However, PADs focus on mental health crises, specifying treatments, medications, and hospital preferences, showcasing the Five Wishes Document’s broader applicability.

When completing the Five Wishes Document, an integral tool for planning your healthcare future, it's essential to approach it with meticulous care and understanding. Here is a list of dos and don'ts to guide you through this process effectively:

• Do take your time to carefully consider each of the five wishes and how you want them to reflect your healthcare preferences.
• Do have an open and honest conversation with the person you are considering as your Health Care Agent to ensure they are willing and able to fulfill this role according to your wishes.
• Do make sure that the person you choose as your Health Care Agent is someone you trust implicitly, who understands you well, and is likely to be available in the event of an emergency.
• Do discuss your wishes with your family, friends, and healthcare providers to ensure they are aware of your preferences and the existence of your Five Wishes document.
• Do keep the document in a safe but easily accessible place, and ensure that your Health Care Agent, family, and healthcare providers know where it is.
• Do not choose a Health Care Agent without discussing it with them first. They need to be aware of and comfortable with their responsibilities.
• Do not fill out the form in a hurry without giving considerable thought to each wish and its implications.
• Do not leave any sections blank. If a specific wish does not apply or you prefer not to make a choice, indicate this clearly to avoid any confusion later.
• Do not forget to update your Five Wishes document if your preferences or circumstances change. This includes any changes in your relationship with your designated Health Care Agent.
• Do not assume that doctors in states not listed will automatically refuse to honor your Five Wishes document. Many healthcare professionals respect patients' wishes, regardless of the form used, but it's important to have a conversation with your providers.

Following these guidelines when filling out the Five Wishes Document will ensure that your healthcare preferences are clearly stated and respected. It’s an act of love and responsibility towards yourself and those who care for you.

The Five Wishes Document is an important tool for planning healthcare decisions in case you're unable to make them yourself. Despite its significance, there are many misconceptions surrounding it. Understanding these misconceptions can help ensure your healthcare wishes are followed as you desire. Here are nine common misconceptions explained:

• It's only for the elderly. The Five Wishes Document is for anyone over the age of 18, not just for the elderly. Illnesses and accidents can happen at any age, making it important for everyone to have a plan in place.
• It's too complicated to complete. This document was specifically designed to be user-friendly. It guides you through stating your wishes in simple language, avoiding complex legal jargon.
• A lawyer must prepare it. While legal advice can be valuable in many situations, you do not need a lawyer to complete the Five Wishes Document. It is designed for you to fill out on your own, or with the help of family members or healthcare providers.
• It's legally binding in all states. The Five Wishes Document meets the legal requirements for an advance directive in 42 states and the District of Columbia. However, if you live outside these states, it might not legally replace state-specific forms though it can still serve as a guide for your caregivers and loved ones.
• My family knows what I want. Assuming family members know your wishes without explicitly communicating them can lead to confusion and stress during difficult times. Documenting your wishes ensures there's no ambiguity.
• It only covers end-of-life wishes. While it does include end-of-life care decisions, the Five Wishes Document also covers personal, emotional, and spiritual needs. It’s a comprehensive tool that addresses more than just medical treatments.
• Once completed, it cannot be changed. Your healthcare wishes may evolve over time, and the Five Wishes Document can be updated to reflect these changes. As soon as you sign a new document, it replaces any previous versions.
• It's the same as a living will or power of attorney. The Five Wishes Document is unique because it combines elements of a living will and a health care power of attorney while also addressing personal, emotional, and spiritual wishes not typically included in standard legal documents.
• Filling it out guarantees my wishes will be followed. While the Five Wishes Document is a powerful tool, ensuring your wishes are followed also depends on discussing them with your chosen healthcare agent and family members. Communication is key.

In conclusion, the Five Wishes Document is a valuable resource for anyone wishing to have a say in their healthcare decisions in the event they're unable to communicate. By dispelling these misconceptions, individuals can take control of their healthcare planning with confidence and peace of mind.

The Five Wishes Document is an important tool for anyone over the age of 18 to dictate their care preferences in serious medical situations. Here are seven key takeaways about filling out and utilizing this form:

• The document allows individuals to outline their medical, personal, emotional, and spiritual preferences in case they become unable to communicate their wishes directly.
• Upon completion and proper signing, the document is legally valid in the District of Columbia and 42 states, offering peace of mind that one's choices will be respected and followed.
• It appoints a Health Care Agent—the person trusted to make health care decisions on the individual's behalf should they be unable to make those decisions themselves.
• Flexibility is a key feature; the document specifies not only who can make decisions but also details the kind of medical treatment desired, how much comfort is prioritized, the manner in which the individual wishes to be treated, and what they want their loved ones to know.
• Communication with family, friends, and doctors about one's preferences is greatly facilitated, reducing the burden on loved ones to make difficult decisions during stressful times.
• If an existing living will or durable power of attorney for health care is in place, signing the Five Wishes Document will revoke those earlier directives, centralizing one's wishes into a single, comprehensive plan.
• Choosing the right Health Care Agent is crucial; this person should be over 18, deeply trusted, fully informed of the individual's wishes, capable of making tough decisions, and preferably located nearby to provide support when needed.

In essence, the Five Wishes Document empowers individuals by ensuring their healthcare preferences are known, respected, and legally recognized. It facilitates meaningful conversations with loved ones and healthcare providers, ultimately aiming to uphold the dignity and wishes of the individual during critical health situations.