This article was written by Denise Baxter-Powell, an Assistant State Director for Caregiver Homes of Massachusetts.

Not many of us want to have a serious discussion about the consequences of a serious illness. Many of us have wills, trusts and feel comfortable with those legal documents. ‘Five Wishes’ is a different document with more of the personal and emotional needs of a person’s wants in writing. ‘Five Wishes’ is a document that expresses your personal, emotional and spiritual needs at a very vulnerable time. It is a document that allows you to express exactly how you wish to be treated if you are seriously ill.

The document ‘Five Wishes’, was written with help from the American Bar Association’s Commission on Law and Aging for anyone over 18 years of age. Lawyers, doctors, hospitals, and hospice organizations are handing out this document to their patients. The form is easy to use.

Wish #1 – When I can no longer make Health Care decisions for myself:

You are asked to identify a health care agent and then proceed to answer questions on the form.

Wish #2 – My wish for the kind of Medical Treatment I want or do not want:

• If I am close to death…
• If I am in a coma….
• If I have a diagnosis with permanent or severe brain damage….

What kinds of advanced treatments would you want? The form gives choices for each circumstance.

Wish #3 – My Wish for How Comfortable I want to be:

• I do not want to be in pain
• I wish for religious readings
• I wish for personal care
• I wish for music to be played around me…

Wish #4 – My Wish for How I want people to Treat Me:

• I wish for someone with me at all times
• I wish to hear prayers
• I wish to die at home…

Wish #5 – My Wish for What I Want My Loved ones to know:

• I wish to have my family know I love them…
• I wish my family and friends can respect my wishes even if they do not agree with me…
• After death, I would like my body buried … or cremated….

This document is signed and witnessed by two (2) individuals.

The important thing is to talk with your family or health care agent. Keep a copy in a special place and with your physician. Once you sign this document it replaces a living will or durable power of attorney for health care. Tell your lawyer if he or she helped prepare those old forms for you.

You may get a copy of this document at www.agingwithdignity.org or by calling 888-594-7437.