Five Wishes

Five Wishes is a way of listing some of the things you might want at the end of your life.  It is coordinated by Aging with Dignity, an American nonprofit organisation and has  become known as the “living will with heart and soul”.  It is reported to have helped literally millions of people plan for the quality of care at the end of life and was inspired by the work that Mother Teresa did with the dying. In the UK we would refer to this as an Advance Directive and Statement of Wishes.

Five Wishes encompasses personal, emotional and spiritual needs as well as medical ones and is legally accepted in many parts of the United States.  The organisers hold workshops to start this process although anyone can do it.  In the workshops they will advocate that you work in pencil to emphasise that these plans can be changed at any time before they are signed. Not forgetting that you can rewrite, change or revoke part or all of them after that if you’d like to.

Wish One identifies the person you want to make health care decisions for you if you can’t.  You may have already done this through a Lasting Power of Attorney (LPA) but it helps to have all these things in one place.  If you don’t have someone nominated then these decisions will be made by the medical staff who are required to act in your best interests.  They may talk to your next of kin but the final decision rests with the doctors.

Wish Two is to state what kinds of medical treatment you want or don’t want.  In the UK you cannot demand treatment but you can suggest what you prefer.  But you can absolutely say what you don’t want.  However be very careful not to have conflicting statements as by default doctors will choose the more aggressive option.  So if you say you don’t want any interventions, it will be confusing if you then say you want to be tube fed.

Wish Three is about how comfortable you want to be.  This can include things like warmth, light, music, hair brushing etc.

Wish Four is how you want people to treat you:  Would I like my hand held?  Would i like to be alone sometimes?  Do I want spiritual support? Would I like to be read to?  This could include who would treat you – would you be in a hospice or at home.

Wish Five is what you would want your loved ones to know.  This can be as profound as “I am not scared of dying” or as basic as “forgive me for lying about crashing your car”.  It might also specify whether you want to be cremated or buried.  It might also be an opportunity to tell them that they are loved.

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If you choose to complete this process formally you will need to ensure it is signed and witnessed and that people know where it is.  Even if you don’t want to write all this down there is a lot of food for thought. After all, if we can’t have our own way when we’re dying, when can we?

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