MOLST – Getting Your End-of-Life Wishes into Your Doctor’s Orders

May 28, 2013

Filed under: Medical Care — Tags: — Alexis @ 10:00 AM

Massachusetts has recently enacted the MOLST program – that’s Medical Orders on Life-Sustaining Treatment. This is a solution to a question that a lot of clients ask: “How do I make sure my kids do what I want with end-of-life care?” Or more typically, clients say, “I want a living will.”

MOLST is better than a living will, and it goes further than a health care proxy. Until MOLST, you might share with your children what kind of treatments and care you do and don’t want as you approach the end of your life, and you might get a chance to talk about it with your doctor, and then you hope for the best as you gradually come to rely on others to make decisions for you.

With MOLST, you have a conversation with your doctor while you are able, and then – this is the key – the doctor turns those into “doctor’s orders.” The MOLST form is a pink sheet of paper, and once that is in your medical record, it’s going to carry a lot of weight.

With MOLST, you get to think about and talk to your doctor about the things that are already on your mind – would you want CPR? Ventilation and intubation? Dialysis? Artificial nutrition and hydration? And then you turn them into medical orders. That means that there is a pretty good chance (though no system is foolproof) that as you decline, your medical providers and family will not only know your wishes, but will honor them. Having them in your record as doctor’s orders makes all the difference.

What about changing your mind? Yes, you can. At any time, you can talk to your medical staff about changing a prior decision in the MOLST.

Family members may ask what to do if a parent or loved one is already at the point where they can’t discuss end-of-life care options themselves with their doctor – the MOLST process permits a health care proxy or guardian to review end-of-life choices with the doctor as well.

For more information, and to see a sample form, see the MOLST site. It’s a well written, easy to read site.

Please note that the MOLST process is meant for people with advanced illness or injuries. If you are healthier, then the best vehicle for sharing your end-of-life wishes is something like the Your Way workbook.

Department of Public Health Survey on Health Needs for People with Disabilities

May 20, 2013

This landed in my inbox. It took about 5 minutes to fill it out. Due date is May 31. Here are the details:

Help influence health care in Massachusetts! The Health and Disability Program, part of Office of Health Equity at the MA Department of Public Health (DPH) is conducting a health needs survey for people with disabilities in Massachusetts. The Office of Health Equity promotes the health and well being of minority populations, including people with disabilities throughout the Commonwealth. Results from the survey will be used to determine how best to address the current public health needs of the disability community. To that end, first, please take a few moments to complete the health needs survey yourself here.

DPH would like to get a broad range of respondents representing all the facets of the disability community, please forward the link to your friends and colleagues in the disability community and ask them to complete.

Who should complete this survey?

Residents of Massachusetts, over the age of 18 who have disabilities
Caregivers or guardians of adults or children with disabilities
Disability advocates
Staff at community based organizations or state or local government offices that serve people with disabilities
Academic researchers
Healthcare providers
Public health officials or professionals
Health and wellness promotion specialists
Health administrators
Health policy experts
We also invite participation by anyone else who has an interest in the health of people living with disabilities in Massachusetts. Please forward as soon as possible, as the survey link will only remain active until May 31, 2013. We look forward to hearing from you!

This is a voluntary and anonymous survey. The responses are compiled and we do not have knowledge of individual respondents.