The Goal of Five Wishes

By Bernard A. Krooks, 

Certified Elder Law Attorney

A popular and widely promoted document is called the “Five Wishes,” which assists you in memorializing your wishes in the event you are seriously ill and unable to speak for yourself. The Five Wishes document is an advance health care directive developed by an attorney, with input from doctors, health care providers and professionals, with the goal of making their form useful, useable, and universal. Five Wishes can be purchased either in an electronic version or in a paper form as a workbook. The electronic version allows you to make changes as your thoughts evolve over time. The whole point here is to make these decisions while you can just in case you may not be able to make them later. According to the Five Wishes website, more than 40 million Americans have used this document. Five Wishes is valid in New York state, available in 30 languages and available in braille. 

Keep in mind that memorializing your wishes in the event you are seriously ill, and end of life planning is much more than what type of care you want to receive when the time comes, it’s about who you want to spend the time with and what will bring you and your family comfort and peace.  The reality is that when someone is on their death bed, they rarely want to talk about how the stock market is doing.

As a patient in a hospital or other health-care setting, you have the right to make your own choices and decisions about medical care and the treatment you receive. If you are incapacitated and not able to make those decisions, New York state law has a list of people who may be empowered to make certain health-care decisions for you. However, the people listed, and the order of priority may not be in accordance with your wishes. Also, you may think that your loved ones and doctors will know what you want if you are seriously ill, but the truth is we all have different thoughts on this, and it is important to make your wishes known in advance. The only way to ensure that you have the people you want making health-care decisions for you in the event you cannot make them yourself is to have proper health-care advance directives in place:  a Living Will and a Health Care Proxy. 

While one of the goals of Five Wishes was to make this entire process simpler, it is still a legal document, and it is important for you to understand what you are signing and the consequences of that signature. For example, when you sign the Five Wishes document you may revoke any prior health-care advance directive you have. That might not be what you want to do. So, if you already have a living will and a health care proxy, be careful. It might be best to have your existing documents in place, as well as the Five Wishes document. 

Moreover, you might later revoke your Five Wishes document by signing a new advance directive at a lawyer’s office, or online. We frequently hear of clients signing the advance directive form offered to them at hospital intake, or at their doctor’s office. They may have forgotten that they have already signed perfectly valid (and possibly more comprehensive) advance directives in their lawyer’s office. 

Even if you decide not to sign the Five Wishes document, it can still be useful to you in helping you develop your thoughts on these complicated and uncomfortable issues since it was designed for regular folks. For that reason, it can be a great tool to help you think through these issues. Even if you sign the Five Wishes document, you may still feel that you also need a Health Care Proxy and Living Will. These documents may include more specific language about mental health care issues, your status as an organ donor (or not), or other items that may be important to you.

 Finally, it is extremely important that you talk to the people will be making these decisions for you if you cannot make them yourself, including making sure that your health care providers have a copy of these documents. By doing so, you will increase the likelihood that your wishes will be carried out.

Bernard A. Krooks, Esq., is a founding partner of Littman Krooks LLP. He was named 2021 “Lawyer of the Year” by Best Lawyers in America® for excellence in Elder Law and has been honored as one of the “Best Lawyers” in America since 2008. He was elected to the Estate Planning Hall of Fame by the National Association of Estate Planners & Councils (NAEPC). Krooks is past Chair of the Elder Law Committee of the American College of Trust and Estate Counsel (ACTEC). (914-684-2100  www.elderlawnewyork.com)