Let us not forsake the dying, says Pa. report

  1. philadelphia inquirer, posted on mon, feb. 05, 2007

    let us not forsake the dying, says pa. report

    death can linger as we live longer. ideas: help the caregivers, raise standards, redirect benefits, and honor last wishes.
    by michael vitez

    inquirer staff writer

    pennsylvania must do a much better job of caring for people with chronic illnesses in the last stages of life, according to a new state report.
    the report, to be released today, urges more support to family caregivers, better education and higher standards for health professionals in end-of-life care. it also called for restructuring how health care is paid and provided to allow more attention on keeping people comfortable at the end of life and not just trying to cure them.

    the current method of financing end-of-life care simply "fails to direct resources where they are needed," the report said.

    overall, the report - produced by the task force for quality at the end of life empaneled by the governor in 2005 - noted that the process of growing old and dying has changed in america, and the health-care system has not changed with it. as a result, too many people are suffering, and it is the responsibility of the public, health-care professionals, and elected officials to push for improvements.

    "providing quality end-of-life experiences for all pennsylvanians is a challenge of increasing urgency, and one that must be tackled by all of us," concluded the report, called "improving end of life experiences for pennsylvanians" and chaired by secretary of aging nora dowd eisenhower....

    ...the report also called for "a continuity of care and respect for patient preferences across care settings." too often when people are transported from home to a nursing home, or from a nursing home to a hospital, their stated wishes are lost or left behind or ignored. the report suggested one remedy as a statewide adoption of a system of binding medical orders that was created in oregon and now being used in 13 states, including parts of western pennsylvania.

    the system is known as polst, which stands for physician orders for life sustaining treatment (www.polst.org).

    "the centerpiece of polst is a document, a brightly colored medical order form, that converts patient treatment preferences into written medical orders based on conversations between patient and physicians," the report noted. the form goes everywhere with a chronically ill person and should prevent paramedics, for instance, from reviving someone against his or her wishes. it is a binding doctor's order....
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    About NRSKarenRN, BSN, RN Moderator

    Joined: Oct '00; Posts: 27,592; Likes: 13,831
    Utilization Review, prior Intake Mgr Home Care; from PA , US
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  3. by   oramar
    Does anyone else have a problem with people coming in and saying "Yes I do have a living will but I haven't a clue where it is." Or they know where it is but it is at home and getting someone to there house to get it is real problem. I guess there needs to be an education program that says, "you know those living wills you have, well when you go to hospital you must take them along" I am mystified as to why people go to hospital without their living will". I guess In emergency situation they are too upset to remember them. In the case of preschedule surgeries they seem suprised that anyone would want to see them. Perhaps these new forms will help with that. My own dear Mom's living will has been attached to her frig. for three years now with a sign that says, "PLEASE TAKE THIS ALONG IF YOU TAKE MOM TO HOSPITAL!" OF course I was the one that took care of that situation. My own will be on my frig here shortly with same sign.
  4. by   NRSKarenRN
    I carry my mom's living will in my wallet. plasetered to homecare chart and doctors chart. Sure do hope the lving will taped next to oxygen tank, sign pinned to lampshade "No Code, Do not resusitate" will help if my Dad panics and calls 911. However, can't talk Dad into signing living will, "you know what I want" is his standard reply.

    Will have to get one of these forms. Shocking pink should help.
  5. by   aimeee
    What a great idea!
  6. by   carolCCRN
    Family members frequently disregard the patient's wishes as written in the living will. Few MDs that I have worked with will honor a living will or DNR directive if the family wants everything done. As I'm sure you've heard before, dead people don't sue, but their families do. Not sure what the answer to this problem is.