By EUNICE TROTTER
American Senior Communities
Seriously ill people now have a new tool that helps ensure that their treatment preferences are honored.
The tool is a voluntary form that when completed becomes a doctor’s order, allowing the patient to determine what care is or is not provided at the end of life.
Called POST, which stands for Physician Orders for Scope of Treatment, the form is completed by the patient or the patient’s legal representative and a doctor. The form is considered valid whether or not the patient is ill at home, in a nursing facility or a hospital.
American Senior Communities is implementing the POST at its communities statewide. “We believe the POST will be very useful in not only respecting the end-of-life decisions of patients, but also reducing unnecessary medical treatment that could be given,” said Martha Herron, director of Clinical Services for American Senior Communities, which operates 60 Senior Health and Memory care facilities statewide.
POST spells out the course of care a patient wants, which may include avoiding hospital treatment or electing aggressive care. It helps guide treatment decisions, including end of life care preferences. It became legal in Indiana in July.
It differs from a Do Not Resuscitate order in one important way: it is more comprehensive, covering a broader range of health care decisions. It also helps medical providers understand the patient’s wishes at a glance. If you have a completed POST, you do not need a separate DNR form because it is included on the POST. The POST stays with the patient at home in a place where it can be located or in the chart in a hospital or nursing facility. It is usually printed on brightly colored paper so it will easily stand out in medical records. You can change it or cancel it at any time.
What is covered by the POST?
The form provides doctor’s orders for the level of medical intervention a patient wants. The patient decides if the treatment will be comfort measures, limited additional interventions or full intervention. The patient decides the use of antibiotics (comfort only or full treatment) and the use of medically administered nutrition (tube feeding). It states whether or not cardiopulmonary resuscitation (CPR) should be administered in the event of a medical emergency.
Who should complete a POST?
The form is for seriously ill adults with advanced chronic progressive illness, advanced chronic progressive frailty, or terminal conditions.
Is the form required for all seriously ill people?
No. The form is voluntary, but studies have shown that using similar forms increases the likelihood that patients get the care they want. Officials say the POST should be completed when the physician would not be surprised if the patient died within a year. Officials recommend that the form be completed for people in nursing homes or in their own home with hospice or home health care.
Authorities believe it is helpful for a patient to complete all three forms: a living will, power of attorney for health care and a POST form. The completion of these forms maximizes the possibility that the patient will have his/her end-of-life treatment preferences known and respected.
In addition to completing the forms, the patient should discuss preferences for end-of-life treatment with the person who is designated as the legal representative. The POST contains a health care representative appointment section.
The official Indiana POST form can be found on the Indiana State Department of Health website at http://www.in.gov/isdh/25880.htm.
Contact any American Senior Communities location to learn more about Senior Health and Memory Care. To find a location near you, please visit the website at www.ASCSeniorCare.com.