Author: Jeffrey A. Gudin
Most states have passed legislation to honor a type of advanced directive, commonly known as a POLST, for Physician Orders for Life Sustaining Treatment. It is basically a more detailed and specific DNR (do not resuscitate). Patients consistently report preferences to die peacefully at home but all too often end up dying in hospitals, with advanced medical interventions and an uncomfortable end. Most clinicians are not adequately prepared to address this issue. End-oflife care is about listening to patients and their families and engaging them in honest dialogue about options and outcomes--easy to say, but excruciatingly hard to do. This presentation will explore the economic and societal issues of end-of-life care for an aging society and encourage the use of an enduring set of medical orders guided by clinicians but chosen by patients and their families. This session will discuss POLST and ongoing research in the state of Oregon, which has proven that the POLST program more accurately conveys end-of-life preferences that are more likely followed by medical professionals. The POLST program has been a key vehicle in Oregon's successful efforts to increase the effectiveness of advance care planning and decrease unwanted hospitalizations at the end-of-life.