Five Wishes

Standard forms for a Living Will and Designation of Health Care Surrogate are available online at www.myfloridalegal.com, along with additional information on advance directives and end-of-life planning. Keep in mind that each state may have its own advance directive forms and it is best to use those for your state of residence.

Five Wishes is a unique living will document that, not only addresses your choice for a health care surrogate and the kind of medical treatment you want or don't want, but also offers you an opportunity to express your personal, emotional and spiritual wishes. Written in language that is easy to understand, Five Wishes can help you think through and talk about what you want for yourself at the end of life, both with loved ones and with your doctor. The document was created by Aging With Dignity, a nonprofit organization that works to promote better care for people at the end of life.

Hospice of Marion County provides copies of Five Wishes at no charge to members of our community who live in Marion County. To request your free copy, please call 352-873-7440 or e-mail lvarner@hospiceofmarion.com. If you would like to order Five Wishes, please visit www.agingwithdignity.org or call 1.888.5.WISHES.

Click on the Five Wishes cover page to view a non-printable version of this living will.

The above information on advance directives is provided as a courtesy and should not be relied upon as legal advice. There are statutory provisions that address and set forth specific requirements for each of the advance directives listed above that are not discussed in this general information. You should consult an attorney regarding such requirements and any questions you may have regarding your legal rights and responsibilities.

What are Advance Directives?

This web page contains general information about advance directives. Because laws and regulations vary from state to state and are subject to change, this cannot take the place of legal counsel. This web page is also not intended as a substitute for the expertise and judgment of qualified healthcare professionals.

They could be a living will or a durable power of attorney for healthcare, also known as a healthcare proxy. Either document allows you to give directions about your future medical care.

It's your right to accept or refuse medical care. Advance directives can protect this right if you ever become mentally or physically unable to choose or communicate your wishes due to an injury or illness.

Advance Directives are valuable tools, they can help:

• You protect your right to make medical choices that can affect your life.
• Your Family avoid the responsibility—and stress—of making difficult decisions.
• Your Physician by providing guidelines for your care.

All patients have rights. These include the right to:

• Privacy—Your personal and medical information is confidential. Medical records and communications with your physician must be kept private.
• Informed Consent —You physician must clearly explain the advantages and risks of any procedures, tests, or treatments. You must give your permission for such care. You have the right to refuse any treatment.
• Information About Your Condition—You must be kept up to date about your medical condition, treatments and chances for recovery.
• Information About Advance Directives—In most cases, advance directives and your rights as a patient must be explained to you.

Advance Directives can protect people in extreme conditions. These people may not be able to communicate due to:

• Irreversible Brain Damage or brain disease, which can affect their ability to think as well as communicate
• Permanent Coma (or other unconscious states), which can leave them unconscious and without hope of recovery
• Terminal Illness—a condition from which a person is expected to die within a short period of time (these illnesses may lead to brain damage and loss of consciousness)

Advance Directives can limit life-prolonging measures when there's little or no chance of recovery. For example, advance directives may enable patients to make their feelings known about:

• Cardiopulmonary Resuscitation (CPR)—Used to restore stopped breathing and/or heartbeat.
• Intravenous (IV) Therapy—Used to provide food, water, and/or medication through a tube placed in a vein.
• Feeding Tubes—Inserted through the nose, throat, etc., to provide nutrition.
• Respirators—Machines used to keep patients breathing.
• Dialysis— A method of cleaning patients' blood by machine, when kidneys no longer work properly.

Advance Directives can address pain relief, too—either requesting or refusing it.

Understanding the two types of Advance Directives:

• Living Wills—These are written instructions that explain your wishes regarding health care should you have a terminal illness. They're called "living" wills because they take effect while a patient is still alive.
• Durable Power of Attorney for Healthcare—In a written document, you can name a person (called a proxy) to make decisions for you if you become unable to do so.

Even if your state does place limits on living wills, you may want one in addition to a durable power of attorney for health care. This may express your wishes as completely as possible. Your state may have special forms to use.

How do you create Advance Directives?

Our "user-friendly" Advanced Directives is called "Five Wishes." Hospice of Marion County will provide this document at no cost. To request one, call 352-873-7440 today, or email our Community Outreach Department.

Some special issues you may want to consider:

• "Do Not Resuscitate" (DNR) Orders—A DNR order allows you to refuse attempts to restore heartbeat. Discuss this option with your physician.
• Organ Donation—Advance Directives can state your wishes to donate specific organs. (or your entire body)
• Specific Treatments and Procedures—In addition to pain control, you mat request or refuse tube feeding, and other medical procedures.