'Five Wishes' Helps Prepare for Death, Dying

Posted: 1/13/2016

By Liz Dudas, Consultant for Ministry Development,
Glenmary Department of Pastoral Ministers and Pastoral Services

(Editor’s Note: Liz Dudas and department director Lorraine Vancamp make up Glenmary’s Department of Pastoral Ministers and Pastoral Services—missioners’ and mission members’ trusted, go-to resource for a wide range of educational needs, both ministerial and spiritual.)

We all know that there are two things in life we cannot ignore: death and taxes. We complain and talk a lot about taxes, but rarely do we talk about death. I have found that older people want and need to talk about death. So for the last two years, I have been offering “Five Wishes” workshops—open to Glenmary mission members and other mission-county residents—as a way to begin this conversation with their families and friends.

Five Wishes is a document written in everyday language that completes and complements state-approved advance health care directives. It helps people express their wishes regarding areas that matter most—the personal and spiritual—in addition to the medical and legal.

I first heard of Five Wishes last year when our local Public Broadcasting Service (PBS) television station produced a documentary series entitled Aging Matters. It was designed to open a community-based conversation about what older citizens need to do to optimize their quality of life, and what the community needs to do to prepare for the rapidly increasing number of older citizens and the care they will require.

In the documentary, an emergency room doctor shared his experience of having to make split-second life and death decisions for patients he did not know, realizing these decisions might not meet their wishes. He eventually became a geriatric doctor, who now counsels people and helps them make decisions concerning their health care and end-of-life issues.

I personally experienced the significance of Five Wishes last July, when my sister, Catherine, became seriously ill. Fortunately, she had completed her Five Wishes, and named my grandniece as her “health care agent.” Catherine was in the intensive care unit (ICU) for three weeks, most of that time on life support. When doctors could do nothing more for her and told Catherine she was dying, my grandniece and I carried out her wishes. She was able to die in comfort and with dignity, in the way she wanted. Her Five Wishes was her GIFT to us. We were able to carry out her decisions, knowing we were honoring and respecting her wishes.

Five Wishes was created by Dr. Tom Neal, who did volunteer work with Mother (now Blessed) Teresa of Calcutta in the United States and Mexico. Working with her and her religious sisters and seeing how they cared about the comfort and human dignity of the dying, he saw the importance of people’s planning for serious illness and death. He designed Five Wishes as a tool for people to use as a dignified approach to life’s end. 

A hospice chaplain once commented that people need to say five things before they die: (1) “Please forgive me”; (2) “I forgive you”; (3) “Thank you”; (4) “I love you”; and (5) “Good-bye.”  The Five Wishes provides a way to accomplish this goal.

When using Five Wishes, the individual indicates: (1) the person I want to make medical care decisions for me when I can’t, (2) the kind of medical treatment I want or don’t want, (3) how comfortable I want to be, (4) how I want people to treat me, and (5) what I want my loved ones to know.

In leading the Five Wishes workshop, I go through each wish and talk about the various preferences. And participants have the opportunity to share their experiences and explain their choices. Another topic that always comes up is their desire to plan their own wake and funeral services. Such thoughtful planning helps individuals to apply their own beliefs and values and to experience death as an event of faith lived till the end with dignity and grace.

We promote Five Wishes in our mission workshops as a way to support people in times of serious illness. We also encourage parishioners to invite friends from other faith traditions who want to preserve human dignity and provide peace of mind for themselves and their families. There is even a Five Wishes document for children, so parents know what their seriously ill children would want. 

Typically, our Glenmary missions have some individuals who may be the only Catholics in their families, and retirees whose children are scattered all over the country. By completing their Five Wishes, these mission members help start significant conversations that enable family members to honor their requests. When health care wishes are clearly stated in writing, there is no second-guessing. Guilt feelings and family disagreements can be avoided. Five Wishes is a gift to spouses, families, friends and doctors.

Five Wishes meets legal requirements in 42 states. It is used in the other eight states by attaching the completed Five Wishes document to state forms required in Alabama, Indiana, Kansas, New Hampshire, Ohio, Oregon, Texas and Utah.

The most typical comment from our participants is, “This was wonderful!  Although we don’t want to talk about death and dying, Five Wishes surely makes it easier to start.”

For more information, visit www.agingwithdignity.org.

This article first appeared in the January 2016 Boost-A-Month Club newsletter.