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Published on August 20, 2015

A living will “with a heart and a soul”A living will “with a heart and a soul”

Jim Touhey worked side by side with Mother Theresa as both a fulltime volunteer and legal counsel. Years later, inspired by her life, he created “Five Wishes” – which today has been adopted in 42 states, including Massachusetts, as a living will “with a heart and a soul.” It’s available in 27 languages, including Braille.

The Five Wishes are:

  • Who you want to make healthcare decisions for you when you can’t make them
  • The kind of medical treatment you want or don’t want
  • How comfortable you want to be
  • How you want people to treat you
  • What you want your loved ones to know

“It’s a tool you can fill out at any time in your life to get you thinking about what you may or may not want if you cannot speak for yourself at the end of life,” explains Sarah Endres, Hospice Operations Manager at the Visiting Nurse Association (VNA) of Cape Cod.  “It eliminates the bedside guessing game.”

“You certainly can fill it out alone, but the VNA suggests you complete it with your family and loved ones including children so everyone understands what are your wishes,” Endres said. “It leads to important conversations before you are in crisis in the hospital. It can make all the difference in the world.”

It’s critical, too, that it be shared with your doctors so that they understand your wishes precisely.

“The key is communication, she stressed. “The Five Wishes take effect when your doctor decides you cannot medically speak for yourself.”

When signed and witnessed by two people, the Five Wishes is a fully legal document endorsed by the American Bar Association’s Commission on the Law and Aging. At the same time, it must be accompanied by a healthcare proxy and advanced directive for your healthcare provider.

“The difference is that the Five Wishes lets you get into much more detail,” explains Endres.

That begins with Wish One – who you choose as your health care agent. “It explains that you want somebody who you have confidence can communicate for you if you can’t for yourself, and who will advocate for you to make sure your wishes are known and followed.

Wish Two relates to pain control and life-support treatment. It addresses everything from food and water to CPR and major surgery to blood transfusions, dialysis and antibiotics – anything that keeps you alive.

This section lets you explicitly state that you want life support if your doctor believes it can help, but to stop if it is not helping.

“It is difficult to go through this document,” Endres says. “But when you have the conversation – as hard as it is- you feel better afterwards. It gives you space to add anything else that is important to you.”

Wishes Three through Five are what make this document –compared with a normal living will – unique. “It speaks to the personal, spiritual and emotional wishes,” said Endres.

Wish Five is about how comfortable you wish to be at the end of life. It speaks to everything from pain medication to staying clean and dry; of religious readings or music played and poems read. “You can be very creative here. Maybe you want your pet nearby,” she explained.

Wish Four lets you describe how you want people to treat you. It talks about those people you want with you; whether you want your hand held or people praying for you. In some cases, it’s explicitly stating who should not be allowed to visit.

Wish Five, in my opinion is the hardest to go through,” says Endres. “It speaks to what you want your loved ones to know. It may involve people you want to make peace with, or things you have not communicated about yet. It speaks to whether you want a memorial service or not.

Will all this guarantee your wishes will be followed?

If you fill out the Five Wishes form properly, it is witnessed by two people and they are communicated to your healthcare agent and doctor, the answer is yes. Endres notes that only four states require the Five Wishes be notarized; and while Massachusetts is not among them, it can be done for peace of mind.

Endres also cautions that your Five Wishes form should be easy to locate. Make sure loved ones know who has a copy of it. Consider a card for your wallet alerting emergency health providers such as EMT’s alerting them where to locate your Five Wishes and who is your healthcare agent.

To obtain a Five Wishes form, call or email the VNA of Cape Cod at 508-957-7400

You can view a copy of the Five Wishes form here.