By: Melody Dizon
Advance care planning conversations are often asked when you visit your doctor, go to the hospital or you fill out any medical forms. Because there are many things in life that are out of our hands, it is but important to talk about this highly sensitive topic to improve patient and family satisfaction with care, reduce unnecessary hospitalizations, and increase timely enrollment in hospice and palliative care. In addition, advance care planning conversations foster meaningful communication between you and your patients about healthcare preferences and what matters most to them. Patient say they want clinicians to be direct, honest, sensitive, and to explain why advanced care plans are important, yet most do not have an in-depth discussions with providers to help them decide their wishes for care.
What is five wishes? Five wishes is the first living will that talks about your personal, emotional and spiritual needs as well as your medical wishes. The five wishes document gives you a way to control something very important, how you’re treated if you get seriously ill. It is an easy to complete form that lets you say exactly what you want. Once it is filled out and properly signed it is valid under the laws of most states. It lets you choose the person you want to make healthcare decisions for you if you’re not able to make them for yourself. It was written with the help of the American Bar Association Commission on Law and Aging and the Nation’s leading experts in end-of-life care. All you have to do is check a box, circle a direction or write a few sentences. Five wishes lets your family, friends and doctors know what it is that you wish when time is nearing. Your family members will not have to guess what you want. It protects them if you become seriously ill, because they won’t have to make hard choices without knowing your wishes. You can know what your mom, dad, spouse or friend wants. You can be there for them when they need you most.
WISH ONE: The person I want to make healthcare decisions for me when I cannot make them for myself
If I am no longer able to make my own healthcare decisions, this form names the person I choose to make these choices for me. This person will be my healthcare agent or other term that may be used in my state such as proxy, representative or surrogate. This person will make my healthcare choices if both of these things will happen:
• My attending or treating doctor finds I am no longer able to make healthcare choices and
• Another healthcare professional agrees that this is true. WISH TWO: My wish for the kind of medical treatment I want or I do not want.
“I believe that my life is precious and I deserve to be treated and with dignity. When the time comes that I am very sick and not able to speak for myself, I want the following wishes and any other directions I have given to my healthcare agent, to be respected and followed.”
What you should keep in mind as my caregiver: (some examples are)
• I do not want anything done or admitted by my doctors or nurses with the intention of taking my life. • I want to be offered food and fluids by mouth and kept clean and warm.
• What life support means to me is that any medical procedure, device or medication to keep me alive.
WISH THREE: My wish for how comfortable I want to be: (some examples are)
• I do not want to be in pain, I want my doctor to give me enough medicine to relieve my pain, even if that means I will be drowsy or sleepy more than I would otherwise.
• If I show signs of depression, nausea, shortness of breath or hallucinations, I want my caregivers to do whatever they can to help me.
• I wish to have my favorite music played one possible until my time of death.
WISH FOUR: My wish for how I want people to treat me. (some examples are)
• I wish to have people with me when possible I want.
• I want someone to be with me when it seems that death may come anytime.
• I wish to have my hand held and to be talked to in people when possible, even if I don’t seem to respond to the voice or touch of others.
WISH FIVE: My wish for what I want my loved ones to know. (some examples are)
• I wish of my family and friends know that I love them.
• I wish to be forgiven and for the times I have hurt my family, friends and others. I wish of my family, friends and others know that I forgive them for when they may have hurt me in my life.
• I wish for all of my family members to make peace with each other before my death if they can.
• I wish for my family and friends to think about what I was like before became seriously ill, I want to remember me in this way after my death.
What to do after you complete five wishes:
Make sure the advance directive form is signed and witnessed for it to be valid and legal. Talk about your wishes with your healthcare agent, family members and others who care about you. Give them copies of your completed five wishes. Keep the original copy you signed in a special place in your home. Give your doctor a copy if you five wishes. Make sure it is put in your medical record. Be sure that the doctor understands your wishes and is willing to follow them. Ask him or her to tell other doctors who treat you and honor them. If you’re admitted to hospital or nursing home take a copy of your five wishes.
Though these things are hard to talk about and most of the time, we shove the issue under the rug, what’s more difficult is when the inevitable comes up, everyone ends up guessing, feels uncomfortable and sometimes fight over this matter. It’s is not the easiest of conversation but must be dealt with. I did mine. Have you?
Excerpts from fivewishes. org