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The Hard Things First: Five Wishes and the Art of Crafting an Advance Directive

Updated: May 29

By Elizabeth Gracen:

It has taken quite a long time to begin this series of articles. I’m talking years! My original intention, long before the global pandemic blurred time as we know it, was to tie in the research and creation of my own personal Advance Directive (legal instructions that outline your health-care wishes, particularly at death) with the stage production that I was involved in at the time at my creative home, the Lineage Performing Arts Center (LPAC).

Waking in the Mourning was one the heavier original plays that we’d endeavored at LPAC, under the direction of artistic director and choreographer Hilary Thomas. The play intertwined three stories that dealt with death and the personal loss of a loved one. As with the majority of the original productions mounted by the company—a 501(c)(3) nonprofit organization—the play was produced with a grant and, as is common with these types of shows, the performance is always followed by a question-and-answer session with professionals who correlate with the play’s subject. 

At the time, I conducted interviews for an article on advance directives with cast members and the professionals in attendance: a hospice worker, a chaplain, and a bioethicist. I also talked to Thomas, who never shies away from tackling topics that most of us simply push to the corners of our lives. It’s always inspiring to ride along with her as she creates important art about these daunting universal subjects that deal with our deepest concerns. 

You’d think that the experience would have been enough to jumpstart my own thoughts and actions about end-of-life planning . . . but it didn’t. Fear-tinged procrastination is my only excuse. However, as fate would have it, Hilary and LPAC never veer off course, reliably dedicated to creating meaningful art with a continued commitment to community outreach. Thus, earlier this year when LPAC offered Staging Your Grand Exit—a workshop designed to assist with creating personal advance directives—I knew the window of opportunity had once again opened for me to deal with the hard things.

What ensued was an inspiring three-hour workshop that incorporated live music, dance/movement, poetry, and writing with the structural framework provided by Five Wishes. 

“Five Wishes was developed as the first advance care plan (ACP) to address personal, emotional, and spiritual wishes, in addition to medical treatment. It’s called the 'living will with heart and soul' because we’ve based our document on what is most important—being able to define a roadmap for how you want to be cared for. It has been embraced by families, community groups, faith communities, medical and legal providers, and businesses who participate in our Five Wishes at Work program.”

Created in 1998 by Jim Towey, an attorney who once served as legal counsel to Mother Theresa as she continued her inspiring work with the sick and dying, Five Wishes was founded as part of a mission to support “human dignity” in the many scenarios that we encounter in this life, especially when it comes to illness and aging. 

The Five Wishes booklet was created after consultation with the American Bar Association and numerous end-of-life experts and provides a thoughtful, easy-to-understand and implement document that, when filled out and signed, becomes a legal advance directive that you can share with your family, your physician, and the most important people in your life.

The booklet is comprised of 10 pages, a combination of short, informative paragraphs along with fill-in-the-blank and multiple-choice selections that assist you in creating your own personal plan should you become seriously ill. The information you provide lets you choose the person you want to make your health-care decisions (your “agent”) and simply and clearly lays out how you wish to be treated should you be unable to make those important health-care decisions for yourself. 

Recognized in 42 states and the District of Columbia, Five Wishes serves as a legal advance directive even if you already have a living will or durable power of attorney for health care. You simply fill out the form (the website offers the choice of ordering a hard copy form [$5] or digital form [$15]), have it witnessed by two people (or notarized in the states of Missouri, North Carolina, South Carolina, and West Virginia), make copies, and share it with your selected agent, family members, and anyone else you care to have it. You keep the original, signed copy in a safe, easy-to-access place in your home. There is even a wallet-sized card that you can carry with you that directs someone to the advance directive should something happen to you. 

The document defines “life-support treatment” in simple terms and elaborates on specific details and circumstances that might occur. However daunting these terms might be at first, Five Wishes makes it easy to choose your personal preference, tailoring your own personal roadmap and undeniable wishes. 

Wish 1

The Person I Want to Make Health Care Decisions for Me

When I Can’t Make Them for Myself.

Wish 2

My Wish for the Kind of Medical Treatment

I Want or Don’t Want

Wish 3

My Wish for How Comfortable I Want to Be

Wish 4

My Wish for How I Want People to Treat Me

Wish 5

My Wish for What I Want My Loved Ones to Know

Personally, I wanted to elaborate on a few fill-in-the-blank answers, so I simply wrote, “See Attached Document.” When I got home after the workshop, I typed and printed even more detail and wishes to include with the advance directive. Let’s just say, if my chosen “agent” chooses not to honor my wishes, that’s on them! 

By the time two friends who attended the workshop with me witnessed my document, and I theirs, it was done!

“I did it! I figured out how I want to die!” 

All I can say was that I was on an almost manic high for the rest of the day. My husband, sister, and chosen relatives all received emails and texts to inform them of my milestone. I know they thought me completely nuts, but it was honestly exciting and almost revelatory to me to have addressed these issues and made a plan for the inevitable. I found it liberating.

Okay, Will & Testament, get ready! I’m headed your way! 

To find out more and to create your own Five Wishes document, visit:


Elizabeth Gracen is the owner of Flapper Press & Flapper Films.

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