Advanced Medical Directives Free Forms

End-of-life care innovation spreads from Oregon to other states

Oregon doctors developed the POLST form -- Physician Orders for Life-Sustaining Treatment -- in the 1990s to address shortcomings of other advance directives, such as living wills or notes in medical charts. Very ill or elderly people create those directives to outline treatment they want to have or avoid in a medical crisis. But those forms can be hard to find in an emergency or too vague to be useful. In contrast, POLST forms are brightly colored for visibility and have check-boxes to record specific preferences for several treatments, including the use of antibiotics, oxygen, feeding tubes and intravenous hydration. A study last year compared the form against chart notes or other, more traditional medical directives. Researchers compared what medical treatments people got by what preferences they recorded. POLST proved most effective . POLST users who wanted only "comfort care" measures in a hospital were 59 percent less likely to receive life-sustaining treatments than residents with traditional do-not-resuscitate orders, the researchers wrote in the Journal of the American Geriatrics Society. People whose POLST specified full treatment got just as much care as people who had other requests for full treatment.  The Chicago-based Retirement Research Foundation provided the half-million dollar grant to support development in more states. Oregon Health & Science University's Center for Ethics in Health Care will coordinate the three-year project. The center and others in Caifornia, New York, West Virginia and Wisconsin will help other states build POLST Programs. 

Just read (in Susan Jacoby's new, well-researched new book "Never Say Die") that one-third of all Medicare expenses are incurred in the last year of life, primarily for serious, not-necessarily-life-prolonging interventions for people who've not prepared a Living Will.

If we really want to decrease our Medicare expenditures, the boomers, of which I'm one, will have to give some consideration to how we spend money on our deaths.

There are problems with POLSTs. They're typically prepared for you after you're in the hospital and very sick. The patient doesn't prepare them. Some "specially trained" nurse does. The nurse "interviews" the sick patient, and writes down whatever the nurse decides the patient wants. That document supercedes the patient's Advance Directive, which the patient had prepared with careful thought when s/he was NOT sick.

POLST forms are a wonderful innovation, I've used them with patients and families for years. Oftentimes, people don't know about these until they've reached toward the end part of their terminal or chronic illness. Then, sometimes they have to make a quick decision, whether to or not to fill them out. People should be introduced to these at an earlier point in their illness, so they have more time to speak with their doctor about the choices presented because they are often in denial of nature of the illness. These should be a fixture, especially in oncologists offices. No one here, gets out alive...and people do need to think about what is going to eventually happen and at least mentally prepare themselves.

Do you have an advance medical directive? - Health Notes ...

Saturday was the 6th annual Virginia Healthcare Decisions Day is designed to raise public awareness of the need to plan ahead for healthcare decisions related to end of life care and medical decision-making whenever patients are unable to speak for themselves and to encourage the specific use of Advance Directives to communicate these important healthcare decisions. Appointment of an Agent

You may authorize another person, such as a spouse, child, or friend, to be your “agent” or “proxy” to make decisions for you if you become incapable of making informed healthcare decisions for yourself. You can also specifically tell your agent what kinds of care you do and do not want. This authorization is, in legal terms, often called a “Power of Attorney for Healthcare.”

Written Healthcare Directive

You may also state what kinds of healthcare you want or do not want if you are determined to be unable to express your own wishes. These instructions are often referred to as a “living will.”

FREE FORMS: Pick up an Advance Directive form (with both “Appointment of an Agent” and “Written Healthcare Directive” sections) that you can print and fill out. You should make copies and provide a copy to your doctor, bring one when you come to the hospital, and give copies to your family and friends.They're free and available online and at hospitals.

Frequently Asked Questions Why Create an Advance Directive?

An Advance Directive allows you to state your choices for healthcare or to name someone to make those choices for you, if you become unable to make decisions about your medical treatment. It enables you to say "yes" to treatment you want, or "no" to treatment you do not want.

What Kind of Advance Directive do I Need?

You may execute a power of attorney for healthcare, a written healthcare directive, or both. Of the two kinds of Advance Directives, a power of attorney for healthcare is broader. A written healthcare directive is helpful in stating your wishes, but it may not be possible to anticipate all possible medical situations for which your written healthcare directive might apply. The best way to protect your interests, however, is to execute both.

Are Advanced Directives Only for End-of-Life Issues?

No. Advance directives may address any type of care in situations in which you cannot make decisions for yourself. For example, an advance directive may address psychiatric (mental health) issues, chronic disease issues, and wishes about admissions to certain types of healthcare facilities. Can I Just Say My Wishes Orally?

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