A new spin on traditional end-of-life directives has shown promising results among seniors residing in nursing homes in California, according to a new study.
Expanded advance directives show promise, study suggests
Under a program known as Physician Orders for Life-Sustaining Treatments, or POLST, seniors were allowed to record their wishes for end-of-life treatment on an expanded order form rather than rely on more traditional advance directives.
For instance, the POLST form includes preferences for CPR, medical interventions for hospitalizations, antibiotics and more. The orders are recorded on brightly colored, standardized medical order forms that travel across patient settings.
The process resulted in fewer unwanted hospitalizations and medical interventions, according to the study's lead author, Susan Hickman, associate professor in the nursing schools at Indiana University and Oregon Health & Science University.
The study found that patients with POLST forms saying they wanted to receive care focused on pain and suffering relief, for instance, were 59% less likely to receive unwanted treatments than those who had only a do-not-resuscitate form.
“The bottom line is that POLST translates patients' wishes about a range of treatments into medical orders that are easily understood by healthcare professionals and can be acted upon immediately,” Hickman said in a written statement.
The study, funded by the National Institute of Nursing Research, appears in this month's issue of the Journal of the American Geriatrics Society (PDF).
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