Five WisheS - A Living Will Document

Five Wishes Online

Five Wishes, America's most popular living will, is changing the way people talk about, and plan for, care at the end of life. More than 18 million copies of Five Wishes are in circulation across the nation, distributed by more than 35,000 organizations. This document meets the legal requirements in 42 states, including New Jersey and is useful in all 50. (Source: Aging with Dignity)

Five Wishes is written in everyday language and helps people express their wishes in areas that matter most — the personal and spiritual in addition to the medical and legal. It also helps you describe what good care means to you, whether you are seriously ill or not. It allows your caregiver to know exactly what you want.

Click here for Five Wishes FAQs.

Five Wishes lets your family and doctors know:

  • Who you want to make health care decisions for you when you can't make them.
  • 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.


Five Wishes document


Request a hard Copy of Five Wishes

Click the mailbox to send us an email with your home mailing address. We'll get a hard copy of Five Wishes in the mail to you within 24-48 hours. This is provided at no charge as a service to our community and as part of our Timely Conversations initiative.

  • Also available in Spanish, French, Hindu, and Gujarati
  • Voicing My Choices available for adolescents and teens

 

FIVE WISHES Living Will | ONLINE form 

You can also fill out Five Wishes Online via the creator's website. Five Wishes Online lets you create, access, change, and print your living will. Anywhere. Anytime. When you register, you will have access for free for one year as part of  Samaritan's Timely Conversations initiative. Click the link below, create a log-in, and begin the process of filling out your living will. Once completed, print the pages and distribute them your family and healthcare providers.

Click here to start your online
Five Wishes Living Will.


A Gift to Your Family

Completing Five Wishes is a gift to your family, friends and your doctor because it keeps them out of the difficult position of having to guess what kind of treatment you want or don’t want.

Families also use the Five Wishes document to help start and guide family conversations about care in times of serious illness. Five Wishes is helpful for all adults – everyone over 18 years old – and anyone can start the conversation within a family. Sometimes it begins with grandparents and other times it is the younger family members who bring up the topic.

Regardless of your age, you can bring this gift to your family.

5 Wishes living willFIVE WISHES FAQ

Is Five Wishes a legal living will document?

Yes. It meets the legal requirements for an advance directive in 42 U.S. states and the District of Columbia. In the other eight states your completed Five Wishes can be attached to your state’s required form. Five Wishes is legal in New Jersey, Pennsylvania, and Delaware.

Why should I complete Five Wishes?

A living will, like Five Wishes, is a way for you to give consent for certain situations where you might want or not want treatment. You can appoint someone to make decisions for you, if you can't do so for yourself. It gives you a better chance of having your wishes carried out, when you can't speak for yourself.

When is the best time to complete Five Wishes?

The best time is before you need it. Everyone, at any age, should think about making an advance directive.

How will my doctor know that I filled out Five Wishes?

Once you finished filling out Five Wishes, talk about it with your doctor.  Also tell people close to you that you have it and where it's kept (not locked up where no one can find it!). Give copies to your healthcare agent, family members, and friends.

Can I change my advance directive?

Yes, at any time while you are competent to do so. In fact, it's recommended to do so every 10 years or if you have a major health change, family change, or experience the death of a loved one.

What is life-sustaining medical treatment?

Life-sustaining medical treatment is anything mechancial or artificial that sustains, restores, or substitutes for a vital body fuction and would prolong the dying process for a terminally ill patient. Examples include: CPR, artifical respiration like a ventilator, dialysis, among others.

What is a "do not resuscitate" order?

Do Not Resusciate, or DNR, is an order written by a doctor telling the healthcare team taking care of you that CPR is not tobe used if your heart or breathing stops.

additional information on advance directives:

American Bar Association "Myths and Facts about Healthcare Advance Directives"

This article addresses many myths surrounding advance directives relating to health care options, state forms, legal-binding, and more. Click here to read now >>

 

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Dr. Stephen Goldfine, Chief Medical Officer“There are some conversations that should take place more than once around the kitchen table, not in the hospital ICU.”

- Dr. Stephen Goldfine

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Samaritan Healthcare & Hospice

Samaritan is South Jersey's leading provider of hospice and palliative care.
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