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What You Need to Know about Mom and Dad’s Final Wishes

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Her mother’s sudden stroke and cancer diagnosis took Ella and her family by surprise. Within days, Ella’s mother, Joan, was in a coma and, before long, doctors were talking about taking away the feeding tube that was sustaining her life. It soon became apparent that not all family members were on the same page.

Ella and her dad wanted to continue with the feeding tube until, as Ella’s dad put it, “God takes her home.” Another sister didn’t want to prolong what she thought was the inevitable. While the debate ensued, their mother passed away. So no decision had to be made. But knowing what Joan would have wanted before her illness may have saved Ella and her family some tense moments and harsh words.

The Five Wishes document can help your loved ones express how they would want to be treated if they are seriously ill and unable to speak for themselves. It is unique among all other living will and health agent forms because it looks to all of a person's needs: medical, personal, emotional and spiritual. 

These Five Wishes also encourage individuals to discuss their wishes with family and physicians:

  1. Who your loved ones want to make healthcare decisions when they can't make them for themselves. This section is an assignment of a health care agent (also called proxy, surrogate, representative, or health care power of attorney.) This person makes medical decisions if someone is unable to speak for themselves. For example, Joan could have designated her husband to decide what to do before a coma took away her ability to speak for herself.
  2. The kind of medical treatment someone wants or doesn’t want. This section is a living will, a definition of what life support means and whether an individual would want that. Ella’s mother may have never wanted a feeding tube in the first place but, without her having discussed this in advance, it was difficult for her family to know.
  3. How comfortable your loved one wants to be. This section addresses matters of comfort care – what type of pain management your parents or loved ones would like, personal grooming and bathing instructions, and whether they would like to know about options for hospice care, among other forms of care. Ella’s family never knew what Joan thought about hospice or any type of pain management.
  4. How you want people to treat you. This section speaks to personal matters, such as whether your loved ones would like to be at home and, for example, whether they would like someone to pray at their bedside. It wasn’t possible for Joan to be at home at the end of her life, but it could be helpful for you to know what your parents would prefer.
  5. What you want your loved ones to know. This section deals with matters of forgiveness, how you wish to be remembered and final wishes regarding funeral or memorial plans. As you’re discussing these issues with family, check out these five ways to create a personalized memorial service. 

There are a few states in which Five Wishes does not yet meet the legal requirements. These states either require a specific state form or that the person completing an advance directive be read a mandatory notice or "warning." Residents of these states can still use Five Wishes to put their wishes in writing and communicate their wishes to their family and physician. Most healthcare professionals understand they have a duty to listen to the wishes of their patients no matter how they are expressed.

Five Wishes was created by the national non-profit organization Aging with Dignity, and originally distributed with support from a grant by The Robert Wood Johnson Foundation, the United States largest philanthropy devoted exclusively to health and healthcare. More than 11 million copies of Five Wishes have been distributed worldwide through a network of 15,000 plus organizations. With support from the United Health Foundation, Aging with Dignity has introduced Five Wishes translated into 20 new languages.

For more information, or to obtain copies of the 11-page Five Wishes booklet and other resources, contact Aging with Dignity at 888-5 WISHES (594-7437) or visit their website. Bulk orders of 25 or more are only $1 per copy.

Learn more about how to begin the Final Wishes conversation and check out these six tips to get started on a final years plan. For more tips about talking with your parents or senior loved ones on a variety of subjects, see these additional resources or contact your nearest Home Instead office.

Last revised: December 8, 2010

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Thoughts and stories from others
  1. March 11, 2016 at 7:20 pm | Posted by Abby Dees

    Please think carefully about using the 5 Wishes document. It looks great on the surface but it has many potential problems. First of all, it is written vaguely, which may lead to potential litigation around the meaning of the form. Second, the form is potentially internally inconsistent if you choose any provisions the ask for food, life support or water to be removed. It allows you to specifically choose what you'd like in various scenarios, but earlier language (presented as a fixed part of the form, rather than a choice) states that no action that may hasten the end of life may be taken (I don't have the form in hand, but that is the gist of it). It is deeply flawed and may result in an unintended outcome.

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    • March 24, 2017 at 6:32 am | Posted by Chris

      Five Wishes has never been successfully challenged in a court of law. It is a legal document recognized as a stand-alone instrument in 42 states. Lawyers like to attack it because of it's simplicity and lack of legalese, but it works and provides comfort to those families that use it. That's why it's been distributed by the tens of millions around the world. The non-profit that created and distributes Five Wishes is called Aging With Dignity and was founded on the principals lived out by Mother Teresa of Calcutta. For more, read this great article about it's founder: http://www.davisenterprise.com/features/yolo-hospice-lessons-from-mother-teresa/

      Reply

  2. December 3, 2014 at 8:20 pm | Posted by Jay

    I want abs with strong arms

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  3. October 26, 2013 at 7:04 pm | Posted by Diane Hampel

    Would like more info on the 5 Wishes. Dealing with a loved one with a terminal disease and how to talk to them about end-of-life decisions. We are a "Family of Denial" and I guess that's what is so hard to bring up the critical conversions. Thanks, Diane

    Reply

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