In Dealing with End-of-Life, ‘Five Wishes’ can help

Jun 24, 2013 Heather Belli Posted in Articles, NBBJ

Originally published in the North Bay Business Journal

At the end of life, peace of mind and emotional security are as important as financial security. At Willow Creek Wealth Management, we are using new “late life” tools to help our clients think through the complex issues of death and dying. These tools help clients take control and express their preferences before death or a debilitating serious illness prevents them from doing so. We have been helping clients manage their wealth and achieve their “bucket lists” of life goals for many years, and we frequently find ourselves engaged in conversations about “late life” options. To achieve “a good death” it is essential to carefully examine your wishes, articulate them, and entrust them to people who can execute them in the event that you can’t. One of the more useful tools we’ve found is “Five Wishes,” a legal document in everyday language that combines a living will and health care power of attorney while addressing care, comfort, and spirituality. Another powerful tool is a “Physician Orders for Life-Sustaining Treatment,” or “POLST” form. Unlike a health care directive, this document is signed by the patient and their doctor and can reduce unwanted and ineffective care. Finally there is the “ethical will.” Though not a legal document, an ethical will allows us to leave a legacy of our values and can provide a sense of completion to our lives by documenting these values and life’s lessons, for example, from one generation to the next.

‘Five Wishes’ your loved ones should know

Five Wishes is a living will that communicates how you want your medical, emotional and spiritual needs addressed. It comes in the form of a checklist, which instructs your family, friends and medical personnel about your preferences when you are unable to.  It helps them avoid  agonizing over your preferences in critical situations. “Five Wishes” has been featured on CNN, The Today Show and in numerous magazines as the first “living will with a heart and soul”.  It is considered a legal document in California and 41 other states. “Five Wishes” is available in 26 languages and over 15 million people have already used this invaluable form. Look at for more details. The “Five Wishes” should be part of everyone’s estate planning. It asks the following questions:

  • Who do you want to make care decisions for you if you can’t?
  • What kind of medical treatment do you want or not?
  • How comfortable do you want to be?
  • How do you want people to treat you?
  • What do you want your loved ones to know?

If you already have a living will or a durable power of attorney for health care but would like to use “Five Wishes,” be sure to consult your estate planning attorney because a signed “Five Wishes” form revokes previous advance directives you may already have in place.

Does everyone know your preferences for life-sustaining treatment?

“POLST” or Physician Orders for Life-Sustaining Treatment is a form that actually becomes part of the patient’s medical records, making your wishes readily available to medical personnel with access to those records. POLST covers three main life-sustaining issues:

  1. Should CPR be administered?
  2. To what extent should medical personnel intervene (comfort measures only, full treatment, etc)?
  3. Should artificial nutrition be administered or not?

A POLST form must be signed by the patient and physician to be valid, and kept with a patient’s medical records. Check out for additional information.

Preserving your values legacy

The concept of ethical wills has been around for thousands of years and spans many cultures. They provide a way of sharing your life’s lessons, hopes for the future, love and forgiveness with your family and community. The nice thing about these value bequests is that they can be written throughout your life and at moments of transition, travail and great joy.

Making difficult choices now = peace of mind later

None of us wants to think about the end of the game. That’s why some 70 percent of the population does not have a will. But in reality, planning for the future and considering potential contingencies actually helps make the future more secure. As wealth managers, we counsel our clients on broad aspects of life to provide financial security for today and tomorrow. With baby boomers retiring in record numbers, having meaningful discussions about late life issues are an important part of our conversation.