Using the POLST form at end-of-life
One of the greatest gifts ever received from my parents are their living wills, appointment of a healthcare power of attorney and their willingness to share that information with my brother and me. (Jump to Lessons Learned)
Dad and mom completed their Five Wishes advance directives together, and committed to honoring one another’s choices. Fortunately, those last days in the hospital my father was able to choose his end-of-life care with his doctors. My mother takes great comfort in knowing dad died the way he wished, and I believe this was his final gift to our family.
Given the limitations of advance directives: vague or outmoded language; stories that abound of them lost amongst hospital paperwork; family members unaware of its’ existence; I was interested to learn of another form designed for serious illness and end-of-life care. (Source: nytimes.com: The trouble with advance directives).
The POLST (Physician Orders for Life-Sustaining Treatment) is a national program that specifically addresses end-of-life medical treatments. Meant for people with severe illnesses, the form is completed by a doctor based on discussions with the patient or legal surrogate. This legal document translates the shared decisions into actionable medical orders and is portable across healthcare settings. (Sources: polst.org: About the national POLST Paradigm/ and Silvercentury.org: Developments in End-of-Life care: The POLST paradigm).
- Although the program is nationwide, states use varying names to describe the document: NJ – Practitioner Orders for Life-Sustaining Treatment (POLST); NY – Medical Orders for Life-Sustaining Treatment (MOLST); CO – Medical Orders for Scope of Treatment (MOST); LA – Louisiana Physicians Orders for Scope of Treatment (LaPOST).
- Currently, there is no national POLST electronic registry, and many states do not have a statewide electronic registry.
- Don’t rely on an advance directive or POLST form alone. If at all possible, have ongoing conversations with your parents about the care they want. Two websites: The Conversation Project (theconversationproject.org) and Prepare (prepareforyourcare.org) can help start the conversation.
- Goals of Care is a New Jersey based 501(c)(3) nonprofit founded by David Barile, MD. Dr. Barile serves as its medical director and is a board-certified physician in Internal Medicine, Geriatric Medicine, and Hospice and Palliative Medicine. He has pioneered the Four-Step Model©, a unique tool that structures end-of-life conversations between the medical team and a patient or the patient’s decision makers.
- For more information on Dr. Barile and the Four-Step Model© go to: goalsofcare.org
Disclaimer: The material in this blog is for educational purposes only. It is not intended to replace, nor does it replace, consulting with a physician, lawyer, accountant, financial planner or other qualified professional.
