Almost half of California’s nursing home residents have filled out a Physician Orders for Life-Sustaining Treatment (POLST) form, setting the tone for other states in a growing acceptance of self-determined end-of-life care.
A person’s race or ethnicity don’t seem to affect the willingness to complete a POLST form, notes a UCLA-led study published in the Journal of General Internal Medicine. However, the study also found that the lowest rates of POLST use were among those with dementia, leading researchers to conclude there’s room for improvement in getting guardians and family caregivers involved in the POLST discussion.
To date, California is the only state that has added fields for POLST completion into the Minimum Data Set.
“POLST is an especially useful tool for nursing home residents because they often experience transitions from the nursing home to the hospital or emergency department and back again,” said Dr. Lee Jennings, assistant professor of medicine in the division of geriatrics at UCLA’s David Geffen School of Medicine and study lead author, in a university news article. “It is an effective tool for reducing unnecessary transfers and communicating a patient’s preferences to a doctor in a new care setting who may not know the patient well, especially if a patient does not want aggressive medical interventions at the end of life.”
In many states, advance directives are insufficient to determine a person’s wishes, since they are not as detailed as a POLST form and are not co-signed by a healthcare professional.