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End of Life Conversations and Necessary Documents

End of life conversations are hard to have. As hard as that conversation can be, a plan is needed to prevent confusion on what your loved one's wishes are. There are some different end of life forms and knowing which are appropriate is important and here's why. A verbal request is not enough. You cannot tell the EMTs to not perform or to stop performing CPR nor can a Living Will will not stop the emergency medical team. Once the emergency medical team arrives, they must, by law do everything they can to save your loved one. You must show them a Physician Orders for Life-Sustaining Treatment (POLST) or the Do Not Resuscitate order (DNR) on neon or bright colored paper to prevent them from starting resuscitation measures.

A Living Will is a legal document that addresses end of life preferences such as treatment plans, pain management, other medicines, or nutrition like feeding tubes.

Living wills are more useful in non-emergency situations like when someone is in a hospital or skilled nursing facility. A living will is not a medical order. Because it is not a medical order even if resuscitation or other end-of-life choices are clearly written they will not be honored by EMTs or hospitals.

The DNR is a written and signed medical order provided by a doctor. The DNR order is only for the decision regarding CPR (cardiopulmonary resuscitation). It clearly states that medical staff are not to administer CPR if your loved one's heart stops or if they stop breathing. ​It doesn’t affect any other treatment plans, such as pain management, other medicines, or nutrition like feeding tubes.

A POLST stands for Physician Orders for Life-Sustaining Treatment and is a medical order signed by a doctor. A POLST specifies the end-of-life treatments that someone does or doesn’t want. It can be used in health emergencies because EMTs and hospitals must do what the POLST specifies.​ The following is the link for POLST program in Florida  https://polstfl.org/

A resource to help start the end of life discussion is called the Conversation Project at https://theconversationproject.org/starter-kits/

Once you have the conversation and your loved one knows how they wish to be treated in a medical or health emergency discuss it with their doctor. Their doctor should have access to the necessary forms. Once you have the forms make sure that copies are provided to all health care staff and a copy is easily accessible in an emergency. You do not want to be placed in a situation where their wish is not honored because you did not have the right form at the right time.

 

Written by Jennifer Schwarz