As we get older and cannot care for ourselves, it’s important to think about how we want our life to end. The Five Wishes constitute a living will that sets forth your personal, emotional and spiritual needs, as well as your medical wishes.

A living will lets your loved ones know how to make decisions on your behalf.  They provide critical areas to think about now, when you have the time and mental capability.

Wish One – Who do I want to make healthcare decisions for me when I can’t make them for myself?

This person is your Healthcare Agent.  Choose someone who knows you well, who cares about you and can make tough decisions.  Many times, this will be your spouse.   In some cases it may be another person.  Your Healthcare Agent should stand up for you to make sure your wishes are followed.  Ask someone you can expect to survive you and remain competent when you are at your end of life.

Wish Two – What kind of medical treatment do I want or don’t want?  Do I want life support?

Life support treatment means anything that helps keep you alive.  It includes devices for breathing, tube feeding, CPR, surgery and blood transfusions.  You may wish to avoid all life support treatment or certain procedures.  Your wishes may be dependent on the stage you are at, such as being in a coma and not expected to recover, or having permanent and severe brain damage.

Wish Three – How comfortable do I want to be?

Do I want to be given enough medicine to avoid pain even if that means I will be drowsy, or sleep more than I otherwise would?  What specific things would I like done for me in my final hours?  What music would I liked played for me?  What readings or poems would I like to hear?  What people, animals or things would I want at my side?

Wish Four:  How do I want people to treat me in my final moments?

Do I want lots of people with me, or do I prefer to be alone? Do I wish to have my hand held and be spoken to even if I don’t seem to respond to the voice or touch of others?  Do I want people to care for me with cheerfulness, not sadness? Do I want to die at home, if possible?

Wish Five  – What things do you want your loved ones to know? 

You may wish for family members to make peace with each other before you pass.  You may wish for family and friends to get counseling if they have trouble with your death.  Do you want to be buried or cremated?  Where would you like your body or remains placed?  What things would you like mentioned when people remember you?  What kind of memorial service do you want, and what things should be included (music, songs, readings, other specific requests)?  Will you donate all or parts of your body to science?  Do you have a preferred charity to receive memorial contributions?

The Five Wishes is a plan developed and trademarked by Aging with Dignity.  It seeks to eliminate uncertainty about what should be done in your final days.  It will give your loved ones peace of mind.  It is clear and easy to understand and doesn’t dwell on complicated issues of medical care, but rather the issues of human care.  For more information go to

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About the Author:

Lorenzo Mejia and his wife, Mary Lynn Ryerson, are the owners of Acorn, a caregiver registry located in Chapel Hill.

They founded Acorn based on their experiences caring for his mom, who suffered with Alzheimer’s Disease.  In 2013, he became a Qualified Dementia Care Specialist.  In 2014, the Alzheimer’s Foundation named him the Dementia Care Professional of the Year in the United States.

Lorenzo is the founder of Dementia Friendly Orange County an effort to make local businesses more accommodating to people with dementia.

Lorenzo speaks often on dementia and the challenges associated with caring for loved ones.  He has been interviewed by ABC News and National Public Radio.  He is an advisor to Orange County’s OC-CARES Dementia Capable Community Project.

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Acorn provides screened and vetted in-home caregivers for clients with dementia, Alzheimer’s, ALS and other similar conditions. Options include 24/7, live-in, weekly, weekend or hourly care. Acorn serves Chapel Hill, Durham, Hillsborough, Pittsboro and surrounding areas in Orange, Chatham, Durham and Wake counties.