Consider a POLST Form for an ailing parent

images-1In 2011 I wrote a post that describes DNR’s (Do Not Resuscitate Orders) http://parentcareplanning.wordpress.com/2011/05/26/do-not-resuscitate/

“A do not resuscitate order is a binding legal document that states resuscitation should not be attempted if a person suffers cardiac or respiratory arrest. A DNR does not affect any treatment other than that which would require intubation or CPR. Patients who are DNR can continue to get chemotherapy, antibiotics, dialysis, or any other appropriate treatment.

If you have an ailing family member who does not wish to be resuscitated they should complete this document and have it signed by their physician. But please be careful to use the form approved in your state.

This summer I attended an excellent seminar presented by Amy Florian, founder of Corgenius, www.corgenius.com. Amy described another tool that can be used to supplement the DNR. It is called the POLST form.

POLST stands for Physician Orders for Life Sustaining Treatment. It is is a form that gives seriously-ill patients more control over their end-of-life care, including medical treatment, extraordinary measures (such as a ventilator or feeding tube) and CPR.

The POLST Paradigm is an approach to end-of-life planning emphasizing: (i) advance care planning conversations between patients, health care professionals and loved ones; (ii) shared decision-making between a patient and his/her health care professional about the care the patient would like to receive at the end of his/her life; and (iii) ensuring patient wishes are honored.

As a result of these conversations, patient wishes may be documented in a POLST form, which translates the shared decisions into actionable medical orders. The POLST form assures patients that health care professionals will provide only the treatments that patients themselves wish to receive, and decreases the frequency of medical errors.

The National POLST Paradigm originated in Oregon in 1991 as leading medical ethicists discovered that patient preferences for end-of-life care were not consistently honored. Recognizing that advance directives were inadequate for the patients with serious illness or frailty– who frequently require emergency medical care – a group of stakeholders developed a new tool for honoring patients’ wishes for end-of-life treatment.

Although the POLST Paradigm began in Oregon, it quickly spread to other states, which tailored the paradigm to fit their unique legal, medical, and cultural contexts. Among the first states to develop POLST Programs were New York, Pennsylvania, Washington, West Virginia, and Wisconsin. These states – and others – have become leaders in improving the POLST Paradigm and demonstrating its importance to achieving patient-centered outcomes.

You can go to the POLST site to determine if there is a POLST program approved in your state http://www.polst.org/programs-in-your-state/

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