One of the most heartbreaking things about this emergency is the prohibition of in person visitation of loved ones who were already declining in facilities. Communication with facilities is less than ideal. Now, more than ever, healthcare workers need to know where legal decision-makers stand on treatments and possible interventions, because one never knows when COVID-19 will take hold.
The Practitioner Order for Life Sustaining Treatment (POLST) is a universal doctor’s order that lays out what treatments and interventions are permitted for a person in the last years of his or her life. It is signed by the individual or his or her legal representative, and the physician, nurse practitioner or physician’s assistant. It can be filled out and signed over the phone. It can be updated. The most recent POLST always controls. POLST is designed to follow the resident to any subsequent setting, such as a hospital, or hospice.
Of course, the first step of all of this is to determine the resident’s competence to sign a POLST, and subsequently, if the resident is not competent, to determine who the legal medical decision-maker is. The social service department should conduct a telephone conference with the decision-maker to make, reconfirm or update the POLST.
These issues are upsetting and difficult but we’re here to help. Call 732-382-6070 and ask for a telephone consult.