Five Wishes vs a Living Will: Which One Do You Need?

Five Wishes is a branded advance directive that costs $5. It includes a living will, plus a health care power of attorney and three sections about physical comfort, spiritual comfort and what you want your family to know. A living will on your state's own form covers only the medical treatment part, and most states give it away free. Five Wishes says it meets the legal rules in 46 states and Washington DC. In Kansas, New Hampshire, Ohio and Texas, you may need an extra step, such as also using the state form.

So which do you need? If you want to write about your feelings, faith and comfort as well as treatment, choose Five Wishes, unless you live in one of those four states. If you want the simplest legal form for your state, use the free state form. Either way, what matters most is that you fill one in, sign it properly and give copies to the right people.

This page compares the two, side by side. It is general information, not legal or medical advice.

Where did Five Wishes come from?

Five Wishes was created by Jim Towey, a lawyer. For 12 years, he served as legal counsel to Mother Teresa of Calcutta, until her death. He also lived and volunteered full-time at her home for AIDS patients in Washington, DC (Five Wishes FAQ).

There, he saw what mattered most to people near the end of life. It was not only machines and treatments. It was "maintaining their comfort and dignity." He founded the nonprofit Aging with Dignity and wrote Five Wishes with doctors, nurses, lawyers and end-of-life experts. That is why it asks about your personal, emotional and spiritual needs, not just the medical and legal ones.

Today, Aging with Dignity says more than 44 million copies have been given out, in 33 languages (Five Wishes).

What is the difference between Five Wishes and a living will?

	Five Wishes	State living will form
What it is	A branded advance directive from the nonprofit Aging with Dignity	Your state's official form, often called an advance directive
Cost	$5 for one paper copy (checked 2 November 2026); digital version also sold	Usually free from your state or CaringInfo
Names a health care agent	Yes (Wish 1)	Often, in the same form or a separate proxy form
Medical treatment wishes	Yes (Wish 2), with three choices for each treatment	Yes, usually yes or no choices
Comfort, dignity, spiritual and family wishes	Yes (Wishes 3, 4 and 5)	Usually not
Where it is valid	Meets legal rules in 46 states and DC, says the publisher; extra step may be needed in KS, NH, OH and TX	Written for your state's law
Notary	Required only in NC, SC, WV and MO, says the publisher	Depends on the state
Languages	33, most bilingual with English	Usually English, sometimes Spanish
Covers money decisions	No	No

The biggest difference is tone. A state form reads like a legal document. Five Wishes reads more like a letter. Many people find it easier to start.

What are the five wishes?

Here is what each section covers, according to the publisher (Five Wishes).

1. Wish 1: Health care power of attorney. The person who makes care decisions for you when you can't.
2. Wish 2: Living will. The kind of medical treatment you want or don't want. For each common life-support treatment, you have three choices. You can say you want it, or you do not want it. Or you can say you want it only if your doctor thinks it will help, and stopped if it does not. Five Wishes says it is the only advance directive with that third option (Five Wishes FAQ).
3. Wish 3: Physical comfort. How you want to be cared for and treated. Five Wishes says this includes being treated with kindness, in whatever way that means to you.
4. Wish 4: Spiritual comfort. Your faith, beliefs and what brings you peace.
5. Wish 5: What I want my loved ones to know. Messages for your family, and your memorial wishes.

One thing to read carefully. Wish 2 includes a statement that you do not want anything done or omitted "with the intention of taking my life." Five Wishes explains that this is about intent: comfort care is fine, even if it may shorten life. Make sure each line matches your own views before you sign.

Which states have extra rules for Five Wishes?

The publisher says Five Wishes meets the legal requirements in Washington DC and most states. It names four where you can still use it but "may need to take an extra step": Kansas, New Hampshire, Ohio and Texas (Five Wishes FAQ). Page 3 of the document explains this. In those states, the safest choice is to complete the state form too.

Four states need a notary for Five Wishes: North Carolina, South Carolina, West Virginia and Missouri. Everywhere else, you need witnesses, following the instructions on page 10. Witnesses usually cannot be a relative or someone who inherits from you.

What if you move or travel? Five Wishes says a directive that meets the rules of the state where you signed it is valid elsewhere too. It "will be honored in all 50 states under reciprocity," it says. But CaringInfo, run by a national hospice group, says states treat out-of-state forms differently (CaringInfo). If you live part of the year in another state, fill in that state's form as well.

When is a state living will the better choice?

Choose your state's own form if:

• you live in Kansas, New Hampshire, Ohio or Texas, and want one simple form that clearly meets local rules;
• you want it free, today, with nothing to order;
• your doctor or hospital prefers the state form;
• you have clear yes or no wishes and do not need the extra sections.

Our guide on how to write a living will walks through the state form, step by step, with signing rules for several states.

When is Five Wishes the better choice?

Choose Five Wishes if:

• you want to say more than yes or no to treatments;
• comfort, faith or family messages matter to you;
• English is not your first language, and you want a bilingual version;
• you find legal forms hard to start, and want something that reads like plain speech;
• you want to start a family talk. Five Wishes suggests reviewing the document with your family.

You can also do both. Some people sign their state form for legal certainty and fill in Five Wishes for the personal sections. If you do, make sure they do not disagree. If two papers say different things, doctors and families may not know which to follow.

Five Wishes vs power of attorney: what is not covered?

Five Wishes names a health care agent. It does not cover money.

If you become unable to manage your affairs, someone still needs to pay bills and run your bank account. That needs a separate paper: a durable power of attorney for finances (NIA).

Five Wishes also says the funeral wishes in Wish 5 are not legally binding. They show your preferences. For a binding plan, it suggests a pre-need contract with a funeral provider or your will (Five Wishes FAQ).

And neither Five Wishes nor a living will is a medical order. If you are seriously ill or frail, emergency teams follow medical orders signed by a doctor. Read POLST vs DNR to see how those work. For the bigger picture, see the difference between an advance directive and a living will.

How do you fill in either form well?

1. Think before you write. What makes life worth living for you? What would you fear most? Where would you want to be? Draft your answers on plain paper first.
2. Choose your agent, and a backup. Ask them. Our guide on how to choose a health care proxy helps.
3. Fill in the form in ink, as Five Wishes advises.
4. Sign with the right witnesses or notary for your state.
5. Give copies to your agent, your doctor and your family. Ask your doctor to put one in your medical file.
6. Keep the original somewhere easy to find. Five Wishes suggests a desk or even the fridge door, and a wallet card.
7. Review it once a year, and after a big change in health or family.

Step 1 is where most people get stuck. They sit down with the form and freeze. The Complete Planning Library includes a My Wishes Worksheet built for this step. You draft your values, care wishes and comfort wishes in plain words first. Then you copy your decisions onto the legal form. It is not a legal form itself. It is for people who are ready to work through their wishes, not just read about them.

Our free end-of-life readiness check shows which papers you still need, in a few minutes.

The honest lesson

The best advance directive is the one you actually sign. A $5 booklet in a drawer, filled in and witnessed, is worth more than the perfect form you meant to get to.

Death is part of every life. Writing down how you want to be cared for at the end is one of the kindest things you can do for the people who will be beside you.