Documentation of your medical wishes is more likely to result in correct care, and this is true even for nursing home residents – or perhaps especially for nursing home residents, who may be unable to advocate for themselves or correct mistakes independently. According to a recent study by Indiana University’s School of Nursing and IU’s Center for Aging Research at Regenstrief Institute, nursing home residents who provided a POLST were three times more likely to have their current preferences documented in their medical records than residents who did not have the forms. To quote from the Regenstrief Institute article:
“The study team measured concordance between documentation and current preferences for nursing home residents in 40 Indiana facilities. The researchers compared residents in long-stay facilities who used POLST forms with residents in facilities that did not. They found that preference matched documentation 59 percent of the time for residents with a POLST and 35 percent for residents without.”
That presents a significant difference in the level and quality of care, when just providing correct and updated documentation results in more than half being given correct care.
POLST stands for “physician orders for life-sustaining treatment.” These are a set of forms filled out by you or a guardian (as needed) to state what medical treatments should be given in specific circumstances. This may include whether you elect to have life-sustaining treatment administered, such as CPR, do-not-resuscitate (DNR) orders, artificially administered nutrition, antibiotics, etc. It covers a range of treatments rather than addressing only one specific item, whereas a DNR order, for example, only addresses if you want to be resuscitated or not.
In contrast to an advance directive, a POLST should only be used when a patient reaches end-of-life care. An advance directive is a specific legal document prepared in advance of end-of-life and which establishes many, but not necessarily all, of your medical wishes and names who you wish to act on your behalf.
A similar document, called a MOLST, is common in Maryland. MOLST stands for “medical orders for life-sustaining treatment.” It is almost the exact same as a POLST, but the MOLST is most common in Connecticut, Maryland, Massachusetts, New York, Ohio, and Rhode Island. However, both are likely to be accepted nationwide; if you do not reside in one of the states listed above but you have a MOLST already completed, check that you do not need to update it to a local alternative for yourself or a loved one. The MOLST website is https://marylandmolst.org/
Talk with a qualified estate planning attorney to discuss your options or concerns, and never hesitate to ask questions.