Five Wishes is an advance directive created by the nonprofit Aging with Dignity that meets the legal requirements for a living will and healthcare proxy in 46 states and the District of Columbia. To understand what Five Wishes is and how you complete it: the form walks you through five sections covering who decides for you, which treatments you want, how you want to be kept comfortable, how you want to be treated as a person, and what you want your family to know, and you make it legally binding by signing it before two qualifying witnesses (or a notary, depending on where you live).
What sets it apart from a standard state living will is scope. Most state forms stop at the medical mechanics. Five Wishes keeps going into comfort, dignity, and personal messages, all inside one legally recognized document.
The Five Sections You’ll Fill Out
The form is organized around five questions, moving from the strictly medical to the deeply personal.
- Wish 1 asks who makes decisions for you. You name a healthcare agent (sometimes called a proxy or power of attorney for healthcare) who steps in if you can’t speak for yourself, plus one or more backups.
- Wish 2 asks what medical treatment you want or don’t want. You indicate preferences on life-support measures like CPR, mechanical ventilation, tube feeding, and dialysis. The form walks you through specific scenarios so you aren’t guessing at medical terminology.
- Wish 3 asks how comfortable you want to be. Pain management, skin care, music, being kept clean and groomed. The things clinical forms rarely ask about.
- Wish 4 asks how you want people to treat you. Praying together, holding your hand, reading aloud, simply being present.
- Wish 5 is for personal messages. Funeral preferences, words of forgiveness, anything you want your family to have in writing.
Wishes 1 and 2 are the parts that give the document its legal weight as an advance directive. Wishes 3 through 5 are what most state-mandated forms leave entirely to conversations that may never happen or get remembered differently by different family members.
Where Five Wishes Is Legally Recognized
Five Wishes satisfies the statutory requirements for an advance directive in 46 states and the District of Columbia. In those places, it carries the same legal weight as any state-issued living will or healthcare proxy form.
Four states require an extra step: New Hampshire, Kansas, Ohio, and Texas.1Aging with Dignity. Five Wishes – FAQs If you live in one of those, you can still use Five Wishes to communicate your preferences, but you may need to attach it to or complete it alongside your state’s official form to satisfy local execution rules. Healthcare providers in those states routinely look to it for guidance even so.2Aging with Dignity. States
If you split time between states, make sure your form complies with the requirements of each state where you regularly receive medical care. The digital version customizes itself to your state’s rules, which helps.3Aging with Dignity. For Myself – Five Wishes Most states have reciprocity statutes that recognize an out-of-state directive if it was validly executed where it was signed, but the details vary, and terms that mean one thing in your home state can be interpreted differently elsewhere.
How to Complete the Form
Anyone 18 or older can complete Five Wishes. You don’t need a lawyer, and the language is deliberately written so you don’t need a medical or legal background either. A little preparation makes the process much more useful.
Before You Start
Know the full legal names and current contact information of the people you want as your healthcare agent and backup agent. More importantly, have a real conversation with them first. Being someone’s healthcare proxy can mean deciding whether to continue life support. Agreeing to that is a serious commitment, and springing it on someone after the fact defeats the purpose. Your agents should understand your values, not just see their names on a form.
Think through your positions on specific treatments before you check any boxes. CPR, mechanical ventilation, tube feeding, and dialysis each have different implications depending on your medical condition. Your primary care doctor can walk you through realistic scenarios so your choices are informed rather than abstract.
Getting the Form
A printed copy of Five Wishes costs $5.4Aging with Dignity. Five Wishes The digital version, which you can complete and sign online, costs $7.50 and allows unlimited revisions with no time limit.3Aging with Dignity. For Myself – Five Wishes The digital version also tailors itself to your state’s specific requirements, which is particularly useful if you live in one of the four states that need additional steps.
Signing It So It’s Legally Valid
Filling in the form is only half the job. For Five Wishes to carry legal weight, you need to sign it in front of two adult witnesses who watch you sign and can confirm you did so voluntarily and with a clear mind.1Aging with Dignity. Five Wishes – FAQs Witnesses don’t need to read your wishes or agree with your choices. They just need to see you sign.
Most states disqualify certain people from serving as witnesses. The exact rules vary, but common restrictions bar your healthcare agent, your doctor or anyone on your medical care team, relatives by blood or marriage, and anyone who stands to inherit from you. If you’re in a hospital or nursing home when you sign, some states require a patient advocate or ombudsman to be one of the witnesses. The safest approach is to choose two witnesses who have no personal or financial connection to you.
Some states accept notarization as an alternative to witnesses, and a few require it in addition. Where notarization is involved, the fee typically runs between $2 and $25 for a standard acknowledgment. The witness instructions on the Five Wishes form itself are tailored to your state’s requirements, so follow them closely.
After You Sign: Sharing and Storing
A signed Five Wishes that nobody can find during an emergency is essentially worthless. Distribute copies strategically.
Give one to your healthcare agent and one to your backup agent. Give one to your primary care physician and ask that it be added to your medical record. If you use a patient portal like MyChart, many health systems now let you upload advance directive documents directly to your electronic health record, which makes the information accessible to any provider within that system.
Keep the original somewhere easy to access. Not a safe deposit box, which may be locked when it’s needed most. A fireproof home safe or a clearly labeled folder that your family knows about works better. Some people also carry a wallet card noting that they have an advance directive and where to find it, which can alert first responders to check for the document. Several states maintain electronic advance directive registries that give healthcare providers quick access when you can’t communicate and the paper copy isn’t handy; check whether your state offers one.
Updating or Revoking the Document
You can change or cancel your Five Wishes at any time as long as you’re mentally competent when you do it. Most states recognize several methods: signing and dating a written statement that you’re revoking it, physically destroying the document, stating out loud that you revoke it, or completing a new advance directive that conflicts with the old one.
The catch is that revocation only takes effect once the people relying on the document actually know about it. If you tear up your copy at home but your doctor and healthcare agent still have the old version on file, they’ll follow those instructions. Whenever you make a change, notify everyone who has a copy and retrieve or destroy the old versions if you can.
One automatic trigger: in many states, a divorce automatically revokes any designation of your former spouse as your healthcare agent. Don’t count on that doing the work for you; if your marital status changes, update the document explicitly. Major life events are good prompts to review your form more broadly. A new diagnosis, a marriage, the death of a named agent, or a shift in your values about end-of-life care are all reasons to revisit the choices you made.
What Five Wishes Won’t Do
A few boundaries are worth knowing before you rely on the document.
Five Wishes is not a DNR or POLST. A Do Not Resuscitate order or a Physician Orders for Life-Sustaining Treatment form is a medical order signed by a physician that tells paramedics what to do right now. An advance directive like Five Wishes tells your family and doctors what you want, and it only takes effect once you’re in a medical facility and a doctor has evaluated your condition. If someone calls 911, paramedics are legally required to attempt resuscitation and transport you to a hospital unless there’s a signed POLST or out-of-hospital DNR in place. If your goal is to avoid CPR at home in a medical emergency, you need both documents, not just Five Wishes.
Pregnancy can override the document. More than 30 states have laws that partially or completely override an advance directive if the patient is pregnant. In seven states, a pregnant person’s directive is entirely invalidated for the duration of the pregnancy, regardless of what the document says. If this could apply to you, consider adding explicit instructions about treatment while pregnant and make sure your healthcare agent knows your wishes on that topic specifically. An attorney in your state can advise on the local rules.
Spending 30 minutes with the form while you’re healthy is what makes the difference. The people who care about you don’t end up guessing during the worst moments of their lives, and the choices on the page are yours.