Learn about Health Care Proxy & Living Will
(Learn about this via a Presentation)
If you are like most people, you may not have done this yet. Reasons for not preparing health care proxy and living will:
- Belief that Health Care Proxy and Living Will may require a lawyer and could cost hundreds of dollars.
- It is a difficult subject and we are not ready to address it for ourselves and our loved ones. To discuss this with our loved ones could turnout to be a very difficult dialog. We may not even know how to approach this subject.
- Although important, it is not urgent and therefore is being postponed.
- Some avoid because of concerns about legal language and jargon.
- To some of us, even if we know its importance and benefits, but we procrastinate!!
- Indian Circle of Caring USA Inc., (ICC) has undertaken a drive to introduce, educate and encourage for you to take care of this.
To pick up a fully prepared, simple to use, legally acceptable document in Massachusetts, free of charge, called “Five Wishes” please stop by the ICC table at any of the events list on our main page. This document also has Hindi, Gujarati, Bengali or Urdu translation with it, making it easier to get this done.
Since December 2007, ICC has provided over 10,000 copies to our community members FREE of charge. ICC has conducted presentations and workshops in ten (10) states in the USA in our efforts to inform, educate and empower our community about preparation of this important but often neglected document. ICC’s drive to inform, educate and empower our community members to attend to this important matter has been very well received and appreciated. These documents have become part of important services ICC provides and have been proven helpful to a number of clients in their personal lives and decision making.
Five Wishes document provides an easy way to express your decisions about:
1. The person I want to make Care Decisions for me when I can’t – (Health Care Proxy)
2. The kind of Medical Treatment I want or Don’t want (Living Will)
3. How comfortable I want to be
4. How I want People to treat me
5. What I want my loved ones to know
- Fill out a form below to get a free copy for each adult (over the age of 18) in your household
- Review, discuss this simple document with your loved ones
- Decide and document your wishes
- Have it signed by two witnesses
- Get a sense of accomplishment for completing an important task
We are very pleased to provide these documents electronically at no cost as a service to our community.
What we provide:
- A customized, Five Wishes document ready to be completed and signed.
- These documents are available in English bilingual Hindi, Gujarati, Bengali and Urdu languages.
- After providing some basic information, you will be given access to ICC’s account at Aging With Dignity website. Here you will be able to setup an account, option to complete the entire document online and/or to print a document in any of 26 languages, legally valid for ANY of the states you live in the United States.
- You have up to 30 days from initial registration to revisit your account, update and print your copy.
Please note, that each individual should provide demographic information on ICC web page before proceeding to prepare their copy on Aging With Dignity website to receive a free copy using ICC’s account.
What you need to do:
- Provide details about you on the following short form. This data is used for ICC internal use only. Once submitted, you will be provided with a link to a secure site for getting your personal copy on Aging with Dignity website.
- Once on Aging with Dignity website you create your own account and password. Make a note of these items since you will be able to visit the website again to make any changes as well as print out your copy for next 30 days.
- You may select the document in one of the available languages for your copy of Five Wishes.
- Please note, that some states require specific language for first two of these five wishes. If you are resident of these states you will also be provided with appropriate supplemental information. In all cases, the last three wishes are still very relevant and useful. We encourage you to use both of these.
- As you make your choices, video and other information is available for your guidance.
- Please note that all your data as you prepare Five Wishes is confidential and for your personal use only. Neither ICC or Aging with Dignity use or sell or distribute it to anyone.
We at ICC and Aging With Dignity hope that you take advantage of this wonderful resource made available to you. It is a gift to you and your loved ones.
Fill out the form below to download your free copy of Five Wishes.
Note: Required fields are marked with *
ICC is grateful and appreciative of sponsors (individuals and organizations) of Five Wishes. We acknowledge their support and contributions under the Financial Contributions section of the website.
Read only – Sample Five Wishes Document is available for review in five languages below.
In order to download the Five Wishes Document for your use, please review the information on the left column, fill out a form at the bottom of the page. This will lead you to Aging With Dignity website – the publishers of the document. Using ICC subscription you will be able to open an account, fill out the document on line as well as print it out – ready for signature or notary signature for one person at a time.