Your Care Wishes — CareGoals

Section 1 of 5What matters to you

First name What matters most to you, in a sentence or two?

What does a good day look like? What still brings you joy?

Section 2 of 5Who speaks for you

If you couldn't make decisions, who should make them for you? Most states call this person a health care agent or proxy.

Their name, and who they are to you Why them?

Have you told them?

Yes Not yet

Section 3 of 5The care you'd want

If you were seriously ill and not expected to recover, what would matter more?

Try every treatment available Focus on comfort, not prolonging life It depends on the situation I'm still working through this

If your heart stopped, would you want CPR?

Yes, try to restart my heart No, let it stop Only if there's a real chance I haven't decided

What you'd want

What you wouldn't want

These are your wishes, not medical orders. If you're seriously ill, ask your clinician about a POLST, the form that turns wishes like these into orders.

Section 4 of 5Comfort and dignity

Where would you want to be, and what would you want around you? What calms you when you're frightened or in pain? If you couldn't respond, how should people treat you? Is faith or a spiritual practice part of this for you? How?

Section 5 of 5What you want them to know

What do you want the people you love to hear? Is there anything you want to say, mend, or finish?

When you finish, you'll see your Care Wishes as one page you can print, carry, and share. To make it legally official, copy it onto your state's advance directive form and sign it the way your state requires.

If you couldn't speak for yourself, what would you want?

Section 1 of 5What matters to you

Section 2 of 5Who speaks for you

Section 3 of 5The care you'd want

Section 4 of 5Comfort and dignity

Section 5 of 5What you want them to know