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Notes on POLST October 2020

Notes on POLST October 2020

October 2020


POLST Use in Pennsylvania

While no recent survey can confirm the exact use of POLST in the state, we do know that POLST is in use in about 95% of counties.


New Users

A significant number of requests for information are being received from new users asking where to obtain POLST forms. Education materials and the POLST form are available through either of the two POLST websites found here and here. Users are asked to download and print the form on pulsar pink 65# stock.


Advice for Patients

 

POLST forms are medical orders and must be completed and signed by a doctor, nurse practitioner or physician assistant. At times a patient or family member will obtain a form and attempt to complete it. It may be necessary for health care professionals to advise the family of the correct approach. The following statement is a recommendation for use as an explanation for patients.

 

The form is completed by your health care provider after discussing what is important to you, your current diagnosis, what is likely to happen in the future and what your treatment options are. Since the POLST form is how your provider tells another provider what you want, the words and phrases on the form use medical terminology. The POLST form was not created for patients to fill out and complete: your provider should be the person filling it out after talking with you.


POLST for Spanish Language Patients

The Pennsylvania POLST website provides a link to a Spanish language POLST brochure. This tri-fold document contains an overview of POLST and answers questions that Spanish language patients and families may have about the purpose of POLST. Health care providers who care for Spanish speaking populations may want to make this available to patients who have a serious health condition or their families. It discusses for whom POLST is appropriate and how someone may make their health care treatment preferences known.

 

Additionally, to assist limited or non-English speakers we have a link to a Spanish language POLST form. These non-English forms are intended to be used to help patients, caregivers and loved ones understand the POLST form but they are not intended to be used as the final form and should not be signed. The translated form is for educational purposes only to be used when discussing a patient’s wishes. The signed POLST form must be in English so that emergency personnel can read and follow the orders. 

 


COVID-19

According to the Pennsylvania Department of Health and other medical professionals the coronavirus pandemic will last through the end of the year and likely into 2021. We continue to provide resources on our website for health care professionals and the public. One example that may be useful for your seriously ill patients is a video, “If you get sick, will your POLST orders match your treatment wishes”.  


The site includes videos for professionals, tools to facilitate communication with patients with COVID-19, and a link to national organizations. 

 

 


National POLST

The National POLST office regularly distributes a newsletter that address POLST from a coast-to-coast perspective. Readers can subscribe here


Oregon POLST

Oregon is one of a few states not requiring a patient or surrogate signature on its POLST form. The subject is discussed in this month’s American Journal of Hospice and Palliative Medicine® “POLST Signature Requirements: Responding With Compassion While Ensuring Informed Consent”, written by Doctors Robert Macauley and Susan Tolle. 


The authors state that in some cases, attempting to ensure informed consent may lead the surrogate to feel that they are signing their loved one’s “death warrant,” creating additional emotional and spiritual distress. They note this may be especially true in pediatrics as anecdotal reports indicate that parents often find this act a source of profound anguish. 


The entire paper is fully available via Open Access and can be found at:  https://journals.sagepub.com/doi/epub/10.1177/1049909120953084.


Thank you for your continuing support of POLST.

 

Judith Black, MD, MHA

National POLST Leadership Council

Jewish Healthcare Foundation Medical Advisor

blackjs352@gmail.com

 

Marian Kemp

POLST Coordinator

Coalition for Quality at the End of Life (CQEL)

PAPOLST@verizon.net


Coalition for Quality at the End of Life (CQEL)

 

Jewish Healthcare Foundation

EQT Plaza

625 Libery Ave, Ste. 2500

Pittsburgh, PA 15222

 

412-594-2550

 

 

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