Aging With Dignity - Five Wishes State Information

Five Wishes States

A few states have some requirements that apply to Five Wishes. Most of these special requirements only effect people who are filling out Five Wishes while they are a resident of certain health facilities.

All residents of Wisconsin must attach the notice statement provided below to their completed Five Wishes.

Click on your state to view the details.

California

(Applies only to residents of a "skilled nursing facility")

Connecticut

(Applies only to residents of a "facility operated by the Dept. of M.H. and Addiction Services" or a "facility operated or licensed by the Dept. of M.R.")

Delaware

(Applies only to residents of a "sanatorium, rest home, nursing home, boarding home or related institution.")

District of Columbia

(Applies only to residents of "an intermediate or skilled care facility")

Michigan

(Person designated as health care agent must sign "patient advocate acceptance form" before beginning to make decisions on your behalf.)

New York

(Applies only to residents of a "mental hygiene facility operated or licensed by the office of mental health.")

North Dakota

(Applies only to residents of a "long term care facility or hospital.")

South Carolina

(Applies only to residents of a "hospital, or nursing care facility.")

Vermont

(Applies only to residents of a "nursing or residential care home.")

Wisconsin

(All residents of Wisconsin must attach a notice statement to their completed Five Wishes.)

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	About Five Wishes
	Five Wishes meets legal requirements in these states (and the District of Columbia):
	Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming
	In a state not listed, Five Wishes can still be useful as an attachment to the state's required forms. Many residents in these states find that Five Wishes expresses their preferences in detail and provides a helpful guide to families, caregivers and doctors.