POLST

I continue to be amazed about what I don’t know. 

I recently read about a man who had an advanced directive on file at his hospital; however, no one noticed it in his file when he was admitted.  The patient was unable to speak for himself, the son wanted life-saving measures for his father (father and son never discussed scenarios) and for two weeks none of the medical personal saw the form.  The father had medical procedures and other unwanted treatment and was sent back to the nursing home from whence he came.

What I didn’t know is that the Advanced Directive is not a physician’s order.  I should have known this because a physician hasn’t signed it. Of all the many surgeries we have had in my family, the only question asked is – Do you have a Living Will?  No one asks to look at it, to review it with the patient, to ascertain if the patient understands the form.  And from some of the comments in the article I noted above, the Advanced Directive is placed in the person’s chart or scanned in and then gets lost among the myriad of test results and physician notes.   

The second piece of information I learned is people with serious illness need an Advanced Directive or Living Will and a POLST.  The latter is a form signed by a physician with very specific directions.  First responders are required to give assistance unless the patient has a POLST, Physician Orders for Life-sustaining Treatment.  About half the states in the US has a POLST Program and the other half is developing one.  Visit www.polst.org for specific information about your state.

The bottom line, and my mantra, is talk with your family so that the younger generation knows what you want regarding end of life decisions and you know what they want in the event of their own unexpected crisis.

Nothing beats talking to another human being about these difficult topics.