Here we are on December 18th, squarely in the middle of Phase III of the 2011 “Holiday Season” (well, I start counting at Halloween)!
If you’ve just been dropped-off by the Mother Ship, allow me to point out that you have exactly seven days left until December 25th, but I acknowledge that many of us are probably still suffering from a post-Medicare “open enrollment” hangover, so take two aspirin and call somebody else in the morning.
Now, if “open enrollment” didn’t successfully put you in the holiday spirit, let’s pick up (as threatened) where we left off last week, which was talking about happy little documents called “advance directives.” These are the pieces of paper that tell doctors and other healthcare professionals what you do-or-don’t want done, if you can’t tell them yourself.
There is a specific document called a “POLST” form, which stands for “Physician Orders for Life-Sustaining Treatment,” and this is one of the few times that you really do want to remember what an acronym stands for. Here’s why:
Let’s say that I have an advanced, life-limiting illness (probably induced by “open enrollment”) and I’m at home (it could be “wherever,” but let’s say home) and something medically bad happens. Somebody calls 911 and the EMT’s (the “Good Guys”) come rushing in to save me. That’s their job, which is why they’re the “Good Guys.”
Now, being the totally-on-top-of-it person that I am, I’ve diligently prepared an advance directive that spells out what I do-and-don’t want, and since this “medically bad thing” is preventing me from speaking for myself, everybody in the house is relying on the advance directive to tell the EMT’s what to do or not do, right?
Wrong. EMT’s are required by law to do EVERYTHING THEY CAN to keep me going, and they will, which is why they’re the “Good Guys,” but it’s not what I wanted! How could I have prevented this??
POLST. Remember that the first two letters stand for “Physician Orders?” That’s what allows the EMT’s to respect whatever it is that I did-or-didn’t want; in other words, it lets them off the proverbial legal hook.
You might have seen these POLST forms around – They’re bright, electric green! – One piece of paper, front and back. These things are NOT for everybody and they are NOT a substitute for an advanced directive. Here’s why:
POLST forms are designed for folks who have an “advanced, life-limiting illness;” in other words, you have a condition (or conditions) that could rise up and seriously whack you all of a sudden, potentially sending you on to the Promised Land. If you have some arthritis, maybe a little high blood pressure, maybe a controlled bit of this-and/or-that, POLST is not your thing – But, if you have something seriously serious, it might be.
Also, a POLST form doesn’t necessarily do or say everything you might want (or not want), so it makes perfect sense to have BOTH an advanced directive AND a POLST.
Are you “required” to have a POLST form? Of course not, it’s completely up to you, and if you want the Good Guys to rush in and perform all of their miracles, good for you! – In fact, the various sections of the POLST specifically allow you to say, “I want the full boat!”
The form itself addresses issues like yes-or-no to CPR, extent of medical interventions, antibiotics, medically assisted nutrition, and a field for whatever else. The smart thing would be to get your hands on one of these and read through it, to see if it fits for you. They’re easy to find – Most clinics, facilities and certainly hospitals have them around. You can also go to www.wsma.org/patient_resources/polst which happens to be the Washington State Medical Association’s web site for some great info. More questions? Good! Talk to your doc or healthcare pro.
So, let’s say I did a POLST form, and conscientiously provided copies to my doc and hospital, but I’m mostly at home – What should I do with this electric green eyesore? Well, you want it to be conspicuous, right? Remember the scenario: Something medically bad has happened and the EMT’s come charging in! They’re not likely to stroll casually through the house attempting to detect where I might have hidden the POLST form – They’re going to ACT! So, put it on the refrigerator or the bedroom door, in-or-on the medicine cabinet, on the bedside table – I’ve seen folks tack it to the wall right above the bed! Make it easy, and make it conspicuous!
Now, I know what you’re thinking, because I know what the next question always is because I know what my next question would be: If I do all these forms correctly and give them to everybody who ought to have them and put them in all the right places blah blah, can I count on everything going the way I want everything to go?
Look: I’ve heard and read horror stories, just like you have, about when these things didn’t work or some offspring defied them by screaming, “LIABILITY!” or whatever else. What you haven’t heard are the hundreds and thousands of times that they did work, and people’s wishes were respectfully respected, and I speak from experience – But if you want an iron-clad guarantee that everything will go perfectly no matter what, then I suggest that you signal the Mother Ship, because you are on the wrong planet.
This is about – This whole “Boomer Primer” thing is about – Increasing the odds; Making it more likely that things will go the way you hope they will go. Here’s the only thing I can “guarantee” today: Tomorrow there will be six days until December 25th .
Everything else is a crap-shoot.
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