Returning home late one night after a concert, Desiree Thomas received a phone call. The voice on the other end relayed something urgent, and Desiree slipped out of her cowboy boots, into sweats and hit the road.

Arriving at Long Beach Medical Center, she was met with the realization that her fears had become a reality — her mother was dying.

Twelve months before this moment, Desiree’s mother was diagnosed with stage 4 colon cancer at the MemorialCare Todd Cancer Institute (TCI) at Long Beach Medical Center. That same year, Desiree’s dad was diagnosed with stage 4 neck cancer.

To say that the weight of both diagnosis was heavy on Desiree, the oldest of five children, is an understatement. She spent that year caring for both her parents, and her mom eventually became an inpatient at TCI as her condition worsened. Before the concert, Desiree had returned from Georgia, where she was helping her dad through his cancer treatment.

But in February 2016, as Desiree stood at her mother’s side, she knew exactly what her mother wanted in her final moments of life.

Days before leaving to Georgia, Desiree and her mom took time to fill out Five Wishes® — a legal document that acts as an advance directive, protecting an individual’s end-of-life wishes. “Talking about her Five Wishes® was the last significant conversation I had with my mom before she died,” says Desiree, who on a whim thought it was a good moment for them to have the conversation. “We sat down together and went through the whole book.”

Desiree compares the document to a map that guides you through your end-of-life journey. It includes questions on personal, emotional, spiritual and medical wishes, providing support to seriously-ill individuals and their families at a time that can be emotionally confusing or draining. “What I love is that it’s written in such plain language — anybody can understand it,” says Desiree. “It triggers important conversations about things you might not think about in regards to end-of-life care.”

Desiree serves as director for Long Beach Medical Center’s Trauma Service, and learned of Five Wishes® through the Palliative Care Program at Long Beach Medical Center. “Starting the conversation is awkward,” says Desiree. “But the way it’s written is not cold and clinical — they’re very real questions. My mom and I were actually joking and laughing as we were writing it.”

When time came for Desiree to decide how to move forward with care for her mother, who had been transferred to the intensive care unit and was having difficulty breathing on her own, she found herself referring to her mom’s completed Five Wishes®.

“It was the exact scenario we discussed while going through the booklet,” says Desiree. “We decided together that in this situation, she’d have 48-hours of maximum therapy. If that didn’t work, I knew that’s when she wanted to go. I wouldn’t have known had we not had that conversation.”

In her experience in trauma care, Desiree often sees families conflicted over making decisions in unfortunate situations — especially for those with complex family dynamics, which she admits is an issue with her own family. “Her husband and my brothers felt very comfortable knowing that my mom and I had this conversation,” says Desiree. “We were all very much on the same page about what she wanted, and in a time of extreme stress, it was nice to have one thing taken off my plate — she made those decisions herself.”

Desiree found help in the advance directive even after her mother’s death. “Wish five helps plan your memorial services,” explains Desiree. “We’re Italian; my mom didn’t care about anything but was really specific about the food — lasagna, zucchini, garlic bread — and I wrote it down. At her service, that’s exactly what we had.”

“Completing Five Wishes® is really helpful, especially in unexpected situations,” says Desiree, who actively encourages patients and families she meets in her role to have the conversation about end-of-life care. ”I strongly believe everyone should be having this conversation — it helps clear up so many questions, and releases the burden of responsibility or guilt that people may feel.”

Three months after her mom’s passing, Desiree completed her own Five Wishes®, “I have my map for life.”