Synonyms
Medical orders for life-sustaining treatment (MOLST); Medical orders for scope of treatment (MOST); Physician orders for life-sustaining treatment (POLST); Physician orders for scope of treatment (POST); POLST paradigm program (PPP); Portable medical orders for life-sustaining treatment (POLST); Provider orders for life-sustaining treatment (POLST)
Definition
Advance Care Planning
Advance care planning (ACP) is a communication process that aims to help an individual plan for future medical care if the person is unable to make his or her own medical decisions. An estimated 45–70% of older adults facing end-of-life (EOL) treatment decisions are incapable of making those decisions themselves (Institute of Medicine [IOM] 2014). ACP helps an individual prepare for a sudden unexpected illness or injury, from which the person may recover, as well as the dying process and ultimately death. The goal of ACP is to ensure that individuals receive care consistent with their expressed...
This is a preview of subscription content, log in via an institution to check access.
References
Bernacki RE, Block SD, American College of Physicians High Value Care Task Force (2014) Communication about serious illness care goals: a review and synthesis of best practices. JAMA 174(12):1994–2003. https://doi.org/10.1001/jamainternmed.2014.5271
Block SD, Billings JA (2014) A need for scalable outpatient palliative care interventions. Lancet 383:1699–1700. https://doi.org/10.1016/S0140-6736(13)62676-8
Bomba (2005, Revised 2011) New York 8-Step MOLST Protocol https://molst.org/how-to-complete-a-molst/ on New York MOLST website https://MOLST.org
Bomba PA (2017) Supporting the patient voice: building the foundation of shared decision-making. Generations 41(1):21–30
Bomba PA, Orem KG (2015) Lessons learned from New York’s community approach to advance care planning and MOLST. Ann Palliat Med 4(1):10–21. https://doi.org/10.3978/j.issn.2224-5820.2015.01.05
Bomba PA, Vermilyea D (2006) Integrating POLST into palliative care guidelines: a paradigm shift in advance care planning in oncology. J Natl Compr Cancer Netw 4(8):819–829. https://doi.org/10.6004/jnccn.2006.0069
Bomba PA, Morrissey MB, Leven DC (2011) Key role of social work in effective communication and conflict resolution process: medical orders for life-sustaining treatment (MOLST) program in New York and shared medical decision making at the end of life. J Soc Work End Life Palliat Care 7(1):56–82. https://doi.org/10.1080/15524256.2011.548047
Bomba PA, Kemp M, Black JS (2012) POLST: an improvement over traditional advance directives. Cleve Clin J Med 79:457–464. https://doi.org/10.3949/ccjm.79a.11098
Casarett DJ, Quill TE (2007) “I’m not ready for hospice”: strategies for timely and effective hospice discussions. Ann Intern Med 146:443–449
Coleman EA (2003) Falling through the cracks: challenges and opportunities for improving transitional care for persons with continuous complex care needs. J Am Geriatr Soc 51:549–555. https://doi.org/10.1046/j.1532-5415.2003.51185.x
Coleman EA, Boult CE (2003) Improving the quality of transitional care for persons with complex care needs: positions statement of the American Geriatrics Society health care systems committee. J Am Geriatr Soc 51:556–557. https://doi.org/10.1046/j.1532-5415.2003.51186.x
Davis MN, Toombs Smith S, Tyler S (2005) Improving transition and communication between acute care and long-term care: a system for better continuity of care. Ann Long-Term Care 13:25–32
Detering KM, Hancock AD, Reade MC et al (2010) The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. BMJ 340:c1345. https://doi.org/10.1136/bmj.c1345
Elwyn G, Frosch D, Thomson R et al (2012) Shared decision-making: a model for clinical practice. J Gen Intern Med 27(10):1361–1367. https://doi.org/10.1007/s11606-012-2077-6
Fagerlin A, Schneider CE (2004) Enough. The failure of the living will. Hast Cent Rep 34:30–42. https://doi.org/10.2307/3527683
Fallowfield L, Jenkins V, Farewell V et al (2002) Efficacy of a cancer research UK communication skills training model for oncologists: a randomised controlled trial. Lancet 359:650–656. https://doi.org/10.1016/S0140-6736(02)07810-8
Fromme EK, Zive D, Schmidt TA et al (2012) POLST Registry do-not-resuscitate orders and other patient treatment preferences. JAMA 307:34–35. https://doi.org/10.1001/jama.2011.1956
Hammes BJ, Rooney BL, Gundrum JD et al (2012) The POLST program: a retrospective review of the demographics of use and outcomes in one community where advanced directives are prevalent. J Palliat Med 15(1):77–85. https://doi.org/10.1089/jpm.2011.0178
Happ MB, Capezuti E, Strumpf NE et al (2002) Advance care planning and end-of-life care for hospitalized nursing home residents. J Am Geriatr Soc 50:829–835. https://doi.org/10.1046/j.1532-5415.2002.50207.x
Hickman SE, Tolle SW, Brummel-Smith K et al (2004) Use of the physician orders for life-sustaining treatment program in Oregon nursing facilities: beyond resuscitation status. J Am Geriatr Soc 52:1424–1429. https://doi.org/10.1111/j.1532-5415.2004.52402.x
Hickman SE, Nelson CA, Moss AH et al (2009) Use of the physician orders for life-sustaining treatment (POLST) paradigm program in the hospice setting. J Palliat Med 12(2):133–141. https://doi.org/10.1089/jpm.2008.0196
Hickman SE, Nelson CA, Smith-Howell E, Hammes BJ (2014) Use of the physician orders for life-sustaining treatment program for patients being discharged from the hospital to the nursing facility. J Palliat Med 17(1):43–49. https://doi.org/10.1089/jpm.2013.0097
Hickman SE, Keevern E, Hammes BJ (2015) Use of the physician orders for life-sustaining treatment program in the clinical setting: a systematic review of the literature. J Am Geriatr Soc 63:341–350. https://doi.org/10.1111/jgs.13248
Hickman SE, Sudore RL, Sachs GA et al (2018) Use of the physician orders for scope of treatment program in Indiana nursing homes. J Am Geriatr Soc 66:6. https://doi.org/10.1111/jgs.15338
Hickman SE, Unroe KT, Ersek M et al (2019) Systematic advance care planning and potentially avoidable hospitalizations of nursing facility residents. J Am Geriatr Soc. https://doi.org/10.1111/jgs.15927
Institute of Medicine (2014) Dying in America: improving quality and honoring individual preferences near the end of life. The National Academies Press, Washington, DC
Jennings LA, Zingmon D, Louie R et al (2016) Use of the physician orders for life-sustaining treatment among California nursing home residents. J Gen Intern Med 31(10):1119–1126. https://doi.org/10.1007/s11606-016-3728-9
Lakin JR, Block SD, Billings JA et al (2016) Improving communication about serious illness in primary care. JAMA Intern Med 176:1380–1387. https://doi.org/10.1001/jamainternmed.2016.3212
MacKenzie MA, Smith-Howell E, Bomba PA, Meghani SH (2017) Respecting choices and related models of advance care planning: a systematic review of published evidence. Am J Hosp Palliat Care 20(10):1–11. https://doi.org/10.1177/1049909117745789
Monroe County Medical Society (2004; revised 2017) Community-wide guidelines tube feeding/PEG placement. Benefits and Burdens of PEG Placement. https://molst.org/wp-content/uploads/2018/07/PEG-placement-for-adults-1.pdf. Accessed 9 July 2019
National POLST Paradigm (2019) Guidance for health care professionals to identify appropriate patients for POLST. https://polst.org/wp-content/uploads/2019/01/2019.01.14-POLST-Intended-Population.pdf on National POLST Paradigm website POLST.org. Accessed 9 July 2019
Periyakoil VS, Neri E, Kraemer H (2018) Common items on a bucket list. J Palliat Med 21(5):652–658. https://doi.org/10.1089/jpm.2017.0512
Rahman AN, Bressette M, Enguidanos S (2017) Quality of physician orders for life-sustaining treatment forms completed in nursing homes. J Palliat Med 20(5):538–541. https://doi.org/10.1089/jpm.2016.0280
Schmidt TA, Zive D, Fromme EK et al (2014) Physician orders for life-sustaining treatment (POLST): lessons learned from analysis of the Oregon POLST registry. Resuscitation 85:480–485. https://doi.org/10.1016/j.resuscitation.2013.11.027
Sudore RL, Lum HD, You JJ et al (2017) Defining advance care planning for adults: a consensus definition from a multidisciplinary Delphi panel. J Pain Symptom Manag 53(5):821–832. https://doi.org/10.1016/j.jpainsymman.2016.12.331
Sulmasy LS, Bledsoe TA (2019) American College of Physicians Ethics Manual: Seventh Edition. Ann Intern Med 170(2_Supplement):S1–S32. https://doi.org/10.7326/M18-2160
Temel JS, Greer JA, Muzikansky A et al (2010) Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 363:733–742. https://doi.org/10.1056/NEJMoa1000678
Teno JM, Licks S, Lynn J et al (1997) Do advance directives provide instructions that direct care? SUPPORT Investigators Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. J Am Geriatr Soc 45:508–512. https://doi.org/10.1111/j.1532-5415.1997.tb05179.x
Teno JM, Gruneir A, Schwartz Z et al (2007) Association between advance directives and quality of end-of-life care: a national study. J Am Geriatr Soc 55:189–194. https://doi.org/10.1111/j.1532-5415.2007.01045.x
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Section Editor information
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this entry
Cite this entry
Bomba, P.A. (2020). Advance Care Planning: Medical Orders at the End of Life (MOLST, POLST). In: Gu, D., Dupre, M. (eds) Encyclopedia of Gerontology and Population Aging. Springer, Cham. https://doi.org/10.1007/978-3-319-69892-2_1029-1
Download citation
DOI: https://doi.org/10.1007/978-3-319-69892-2_1029-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-69892-2
Online ISBN: 978-3-319-69892-2
eBook Packages: Springer Reference Biomedicine and Life SciencesReference Module Biomedical and Life Sciences