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FIVE
WISHES

MY WISH FOR:

1.The Person I Want to Make 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

5. What I Want My Loved Ones to Know

In law enforcement there is always the possibility that you won't make it home from the job in one piece.  We all think that it won't happen to us but sometimes it does.  The Five Wishes document was designed by the Commission on Aging with Dignity, which is a private, non-profit organization founded in 1996 to affirm and safeguard human dignity, and to promote better care of the dying.  Part A is a good tool for thinking through Durable Power of Attorney for Health Care issues. It is valid in Virginia.  Part B is perhaps one of the strongest features of Five Wishes because it goes into comfort and remembrance issues. 

Feel free to use this form and pass it on to your family, friends and co-workers.

 Five Wishes
in .pdf format