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POLST and Advanced Healthcare Directives

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Hi, I am Tim Dauwalder, Dr Tim Dauwalder, I work with the VNA Hospice and Palliative Care of Southern California.

Today we met again at a community meeting discussing posted Advanced Heath Care Directives and how they are alike and compare and complement each other. And it was a good turn out and we have done the post before. I would say that in the last six months we have had two talks on this topic and we have a full house every time and great questions.

I think one of the biggest things that the people want to know about the POLST today in particular. POLST again, for those of you that don’t remember from previous talks is a Physicians Orders for Life-Sustaining Treatment. It’s a document, front and back, usually on pink card stock that you can fill out. As I discussed before, you can look on the website for kind of a full web summary of the POLST. But it basically outlines your wishes. Specifically and more commonly for those with advanced disease processes, advanced age or they are very frail when it comes to life sustaining treatments.

The order set is an order set that’s a very specific physician and patient collaboration about what that patient wants, who their decision makers are and there is a lot of the same things that Advanced Health Care Directive does.  The difference is, it is an order set. It must be followed specifically and it is mandated, once filled out, to be followed exactly as written and signed.

And that is a little different to Advanced Health Care Directive, generally, is not as portable. And it is hard to get through pages of the document that can be very broad in their intent.  And even though they may, once interpreted say the same type of things that the POLST says, it’s hard to interpret and we have to make decisions quickly in the hospital setting or in the emergency setting. And the POLST allows you – this is the order set, this is the imperative, this is what we want and it’s allowed to be nuanced. You can add, take a part different types of treatment plans to fit exactly what you want as you discuss it with your family, your physicians, relative to you and your disease process, and what you want both philosophically and medically.

So today, and I am kind of broadening very briefly what we talked about because we went over this before. This was a recap because there was interest and we went over the POLST again and specifically how it augments, goes well with the Advanced Health Care Directive and how they work together and you can go on our website, you can listen to the talks. We are under compassion as a key word on our website search “VNA Hospice and Palliative Care of Southern California” and you will see all our lectures as you reach out to the community at least once a month and a free seminar style with questions and answers.

I enjoy talking about the POLST because I think it empowers the individual to get health care that is relevant to them, that is personal to them and allows their decisions to be honored and for them to be respected as an individual right in the midst of crisis.

So again, even if you have an Advanced Health Care Directive and you feel it is medically perfect and absolutely accurate, it is very hard to translate into action; unlike the POLST which is very specific and works right along with it to help you translate your wishes in a very efficient way to the medical community at large.

So again, we will do these talks periodically. Check the topic, you know, and see if that’s what you want to hear about. Whether it be CHF, COPD, Advanced age, dementia – a lot of good topics we will discuss that affect everyone that we love at some point and some level, whether it be friend or family member or yourself.

So, thanks again for having me today and look on our website and if you want more details or support services you certainly can do that. If you would like to download and print a POLST, you can just type in POLST in your Google search. That’s P-O-L-S-T, and you can select many different options to actually print your own form, take it to your doctor and with your family have discussions about end-of-life planning which certainly will empower you even though it may be a difficult conversation.

So thanks for your time.

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