Lasting Wishes Are Foundational

Have you ever made a bucket list? Many versions focus on thrill-seeking tasks like skydiving or climbing a mountain.

But at the end of life, the wishes I hear are simpler and deeper. They are not just events. They reflect the values that shaped a life.

A fisherman asks for one more bass. A grandmother wants one more season of canning tomatoes with her grandchildren. A father wants his children to know he is proud of them but struggles to write the words.

Lasting wishes reveal identity in its clearest form. They point to the values carried across a lifetime.

Families often help make these moments possible, but honoring wishes is not limited to relatives. Communities and foundations can expand what families and care teams are able to do. Together, they can help families honor what matters most.

A lasting wish uncovers what an individual with serious illness values most and offers each of us a chance to extend the same dignity we hope to receive. Legacy interventions in palliative care can support meaning, dignity, and some aspects of well-being, although results vary by intervention and outcome (Boles & Jones, 2021; Chochinov et al., 2011; Vuksanovic et al., 2017).

He had loved the calm of his local ponds his entire life. Diabetes, heart disease, and years of decline had taken his stamina. His fishing poles sat unused in the corner. His world had become small and overly clinical.

When hospice arrived, he did not ask for a cure. He asked for meaning. He asked for one more day on the water.

The IDG care team listened, and his family committed to honoring that request. Through a foundation-supported wish program, the plan came together. A nearby lake. Adaptive equipment donated through community connections. Safety support. Volunteers who understood the importance of the moment. The team made it happen.

The sun was warm. The tackle box felt familiar. When the line tightened and he felt that pull again, he smiled in a way his daughter had not seen in months.

This was more than a fishing trip. This was a restoration of identity. Joy returned for a moment. A memory formed that his family carried long after he died.

This kind of dignity-preserving care shares Dignity Therapy’s focus on meaning, identity, and what a person wants remembered. Trials found high acceptability and some benefits, but effects on distress and broader well-being were mixed (Chochinov et al., 2011; Vuksanovic et al., 2017).

Foundation support can make moments like this possible when needed resources are beyond a family’s reach. It cannot change the illness, but it can honor the life.

Charitable giving can extend meaning beyond a single life and support wishes that may be beyond a family’s reach.

Foundations help create: • A last trip outside • Transportation for a final reunion • Adaptive equipment that restores possibility • A meal that tastes like home • A moment of identity reclaimed with dignity

In ICU studies, the 3 Wishes Project was feasible and low cost. Its use was associated with better family ratings of emotional and spiritual support at end of life (Vanstone et al., 2020; Neville et al., 2023).

The impact can extend further. A fulfilled wish may create: • A memory that becomes a family legacy • A story of joy that may soften grief • A moment that honors the patient

Legacy activities can benefit patients and families, but bereavement evidence remains limited. In one small study, a two-session bereavement life review was followed by better spiritual well-being and fewer depressive symptoms in family members (Boles & Jones, 2021; Ando et al., 2010).

Compassion is a communal responsibility. Donors help transform experiences into legacy.

Most people assume wishes belong to the final weeks, but lasting wishes start earlier. They grow from a single question: What gives your life shape, joy, and purpose?

When asked early, even in good health, lasting wishes reveal: • What anchors us • What brings meaning • What we should make room for each day • What we can help others reclaim during illness or decline

In a trial of patients with metastatic lung cancer, early palliative care improved quality of life and mood. In a separate cancer cohort, end-of-life discussions were associated with less aggressive care near death and better caregiver bereavement adjustment (Temel et al., 2010; Wright et al., 2008).

A lasting wish is not a small request. It is a values inventory. At the end of life, it becomes a compass that helps families and care teams understand what matters when time becomes limited. Used well, it guides families toward clarity.

Take the time to examine your life and priorities. Do they reflect your lasting wishes?

What is on your list, and why wait to live it?

If you are reading this, you may not be in hospice. But you have wishes of your own.

Naming a meaningful wish can clarify purpose and where we want to spend our time.

Ask yourself: • What is one experience I want to have this year? • What is one act of generosity I want to offer someone else? • Who needs my help to experience a wish of their own?

Lasting wishes are not only for the dying. They are for the living. They are for all of us.

When we name them early, we live with clarity. When we pursue them, we uncover purpose. When we help others reach theirs, we live our values.

What we honor, we become.

Sometimes it is the calm of the water. Sometimes it is the joy of giving one more meal from the garden. Sometimes it is a voice on the phone or a hand to hold. Always, it is meaning made visible.

When foundations help fulfill these wishes, they give families the memory of a lasting wish.

When we act on our own wishes or those of others, we give ourselves something just as important: a life aligned with what matters.

May we each discover our own lasting wish. May we honor the dreams of others. May we build a world where no one’s final joys go unheard or unanswered.