Five Wishes

Five Wishes

 America’s most popular advance directive puts you in charge

  by Paul Malley

August 4, 2010 

There are more than 14 million copies of the Five Wishes advance directive in national circulation, distributed by more than 23,000 partner organizations. Five Wishes, called “the living will with a heart and soul,” deals with important medical and legal issues, but unlike other advance directives, also deals with the personal, family and spiritual issues that people say matter most. Five Wishes is also an effective discussion guide because it helps start and structure an often difficult conversation and because it frames the discussion in terms of comfort, preserving dignity and family cohesion. Five Wishes is easy to understand and use because it is written in everyday language and avoids confusing medical and legal jargon. Five Wishes has quite literally changed the way Americans think about, discuss and plan ahead of a serious illness. 

Five Wishes History 

Five Wishes was created in 1997 by the national non-profit organization Aging with Dignity. Its founder, Jim Towey, served as legal counsel to Mother Teresa of Calcutta for 12 years until her death. He also served as a full-time live-in volunteer at her home for AIDS patients in Washington, D.C. “Even in those most humble of surroundings, people’s needs were met and their God-given human dignity affirmed,” Towey noted. “That’s the inspiration for Aging for Dignity and Five Wishes.” The Five Wishes are: 

  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

Wish 1 allows you to legally designate your health care agent (the person you trust to make medical decisions for you if you cannot) and to give that person direction in making life-support decisions (Wish 2). Wish 1 is also known as a “durable power of attorney for health care” and is a legal grant of authority under state law when doctors have determined you can’t speak for yourself. You can also expand or limit your health care agent’s powers using Five Wishes. Wish 2 considers the most common end-of-life scenarios and gives options for accepting or refusing life support.
Wishes 3, 4 and 5 are what make Five Wishes unique. In them you essentially create a detailed instruction guide for how you wish any pain managed and how you wish to be cared for. It could be having pictures of grandchildren in the room, that you want (or don’t want) people bedside, or any other smaller, simpler things that are just as important. Many people start with Wish 5 and work their way backwards!
Five Wishes is the closest thing there is in America to a national advance directive. It meets the legal requirements of 42 states, but it is useful and used in all 50 states because it helps people come to their own decisions about what good end of life care means to them. The remaining non-Five Wishes states mandate official forms, wording or warnings in order for the advance directive to meet state legal requirements. Why must residents of those states be required to jump through these additional hoops? Why must they have to use government words and forms to express their own wishes?
With the addition of German, Hebrew and Italian in late 2009, Five Wishes is now available in 26 languages and in Braille. Individual copies are $5 each, but only $1 each in quantities of 25 or more. Five Wishes and Five Wishes-related resources are distributed by doctors, nurses, hospitals, hospices, health systems, places of worship, attorneys, financial planners and others, or it can be ordered directly from Aging with Dignity.
Every adult age 18 and older should have an advance directive. These life and death decisions are simply too important to be left to others, or worse, to strangers appointed by a court.
 (Paul Malley is President of Aging with Dignity, a national non-profit organization that created and distributes Five Wishes. Contact him at P.O. Box 1661, Tallahassee, FL 32302. For more information, go to or call (888) 5-WISHES.)

For a FREE copy of Five Wishes contact Mark Lamartina at This email address is being protected from spambots. You need JavaScript enabled to view it.