Advance Directives and 5 Wishes: Now Is the Time to Make Your Wishes Known

As health officials work furiously to address and contain the impact of COVID-19, individuals and families can do their part by naming to their loved ones what they would want if faced with a serious or life-threatening illness. A living will (also called an advance directive) identifies the kind of medical care you want or don't want in times of serious illness. If you haven't had those conversations yet, now is the time.

Please note the importance of:

1) Having these conversations with family in advance of a time when you are sick and unable to speak for yourself about your care. Regardless of age or health, such circumstances can happen very quickly.

2) Documenting the conversation. Each state or province has its own requirements for what qualifies as a legal document. Usually, healthcare workers cannot sign as a witness in a hospital. The Five Wishes documents this in a gentle way; other documents are the particular state's approved Durable Medical Power of Attorney forms, Advanced Care Planning forms, or an attorney's version of the Durable Power of Attorney form. 

3) Making a signed document available electronically—including as an email to oneself and the patient advocate, among others one designates—so it can be sent or printed anywhere, especially under emergency circumstances.

The Five Wishes is a particular living will or advance directive that talks about your personal, emotional, and spiritual needs as well as your medical wishes. It lets you choose the person you want to make healthcare decisions for you if you are not able to make them for yourself, saying how you wish to be treated if you get seriously ill. Written with the help of experts in end-of-life care and easy to use, all you do is check a box, circle a direction, or write a few sentences.

The Five Wishes asks you to name:

• The person you want to make care decisions for you when you can't
• The kind of medical treatment you want or don't want
• How comfortable you want to be
• How you want people to treat you
• What you want your loved ones to know

Because of the COVID-19 pandemic, Aging with Dignity has made the Five Wishes document available online to individuals at no cost. Use it for yourself. Use it for your parents, spouse, siblings, adult children, extended family, and friends.

Finally, a special thank you to RCA disability advocates Mana Hashimoto and Gerri Yoshida for modeling this in 2019 by introducing the Five Wishes document to their congregation, the Japanese American United Church, and making it available in English and in Japanese.

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Canada recognizes two kinds of advance directives. In one, you choose who you would want to make these decisions for you. In the other, you give instructions about what decisions you would want made, or you describe your values and beliefs to guide a decision-maker about what you would have wanted in a given situation. In some parts of Canada, you can only do the first kind; in some, you can do both. A number of publicly funded initiatives exist to promote advance care planning and to encourage people to appoint "substitute decision-makers" who make medical decisions and can give or withhold consent for medical procedures according to the patient's pre-expressed wishes when the patient becomes incapable of doing so themselves.

For more information on COVID-19 from Disability Concerns, please read this article: Disability Concerns Resources for COVID-19.