Five Wishes Provides Easy Legal Document for Care Requests

Angela Manhart, 9/10/2012

The Five Wishes document brings a solution to end-of-life care that only costs a few dollars, allowing seniors or any individual to have clear instructions and long-term health care wishes well organized and legally documented.  This allows family members, medical professionals and loved ones to know their wishes for end-of-life care should they become unable to be their own advocate. Developed in 1997, Five Wishes was written with the assistance of The American Bar Association’s Commission on the Legal Problems of the Elderly.  

Hospice care, for those who are terminally ill, enlightened Jim Towey to create the Five Wishes document, as a result of his experience working in a hospice for a year.  He envisioned a way for those incapacitated by serious illness to have a way to communicate their health care wishes to both caregivers and family members through a document that is prepared prior to a major health concern occurring.

Since its creation, the Five Wishes document has now been written in 26 languages and is available online.  It is currently a valid, legal advance directive in 42 states. The document guides you to determine how you would handle five situations involving your end-of-life care:

  1. The Person I want to Make Care Decisions for Me When I Can't
  2. The Kind of Medical Treatment I Want or Don't Want
  3. How Comfortable I Want to Be
  4. How I Want People to Treat Me
  5. What I Want My Loved Ones to Know

Senior home care agency owner Steven Wolf, Owner of Pendeo Home Care, reveals the value of having health care wishes in place before care is needed:

In his experience of owning a senior home care agency, he has found that most clients he provides home care for do possess a Power of Attorney (POA) or a Five Wishes document.
While he does not require a client to have either a POA or a Five Wishes, he always clarifies who is in charge of paying the caregiving bills and who is the primary contact for making decisions concerning the client’s care.  This person, however, is not always necessarily the client’s POA.

If the client has no children or close family members, Steven finds that the client is often the one who takes charge of their own search for senior care.  When the one in need of care has dementia or Alzheimer’s, however, there is always someone else involved in their search for care, whether it be a neighbor or a friend.

Steven recommends that every individual have a care plan or Five Wishes document beginning at the age of 50, although he notes that the average age that people start considering long-term care options is 58.  

His main suggestion for individuals is to make one’s health care wishes known “the earlier, the better.”  He further stresses that other people in the individual’s life should be helping them to consider care options long before a caregiving agency needs to address them.  
He notes that a document such as Five Wishes is useful in acute cases in which a very sudden need for caregiving arises.  A gradual need for care can be better arranged with consultations and meetings with caregivers that ensure the client’s wishes are being addressed, but a sudden need for care may not allow time to take such precautions.  In this case, a Five Wishes document can better express the client’s wishes for health care treatment if they are unable to state them themselves.  

Essentially, Steven confirms that he addresses through his client intake questioning three of the five wishes included in the Five Wishes which are:

  • Health Care Agent: confirming the client's wish that pertains to choosing a "health care agent" to make medical decisions for the individual
  • Medical Treatment: confirming the wish that pertains specifically to medical treatment
  • Informing Family: confirming the wish that includes what an individual wants their family to know

However, Steven acknowledges that his questions do not address such personal matters as the degree of physical and mental comfort the client wants from others during their care.  

Furthermore, tax attorney Michael Goldberg looked over a Five Wishes and gave his opinion that while a Five Wishes can act as sufficient documentation for a living will - a living will covers an individual’s wishes concerning their definition of life support and in what situations they would want life support either left on or turned off - a Power of Attorney is still needed to handle finances while an individual is incapacitated. 

He explains the difference between a will and a trust, stating that a will asserts where an individual’s estate will go after their death.  A trust, however, exclusively disperses funds and offers the advantage of not needing to go through the court system like a will requires. 

To address the concern of knowing whether an individual was of sound mind when signing a legal document – whether it be a will or Five Wishes – two witnesses are required to affirm their presence at the signing and vouch for the mental acuteness of the signer.    

Five Wishes is a great option for those who want a simple, succinct legal advance directive for their health care needs.  It clearly defines the owner’s definitions of adequate health care and life support, saving family members from having to guess as to what the individual would have wanted when making difficult health care decisions.  You may also want to research senior care options to learn about the nursing homes and senior care agencies in your area as you plan ahead for potential senior care needs.

You may purchase the Five Wishes document online or order for $5.00 per document, with discounts available when you purchase 25 or more.

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