End-of-life care documentation program yields care benefits for nursing home residents, study finds

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Nursing home residents who fill out forms through a certain end-of-life care documentation program are more likely to receive the care they request than those with only a Do Not Resuscitate (DNR) order, according to a new study. 

Originally developed in Oregon in 1990, the Physician Orders for Life-Sustaining Treatment (POLST) program is now in nursing home and long-term care facilities in roughly 32 states. Both physicians and patients sign a medical order form detailing the patient's end-of-life treatment preferences, including CPR, hospitalization, feeding tubes and other interventions. The study, which looked at the medical records of 1,711 nursing home residents in three states, found that patients who requested pain management care were 59% less likely to receive unwanted treatments than patients with simple DNR forms.

PLOST patients requesting fewer interventions also received identical treatments for pain and other symptoms compared with other patients. The main point of PLOST is to increase communication between physicians, patients and providers about end-of-life care wishes, according to the Coalition for Compassionate Care of California. The study also found that 98% of PLOST patients had specific end-of-life directions, compared with 16% of DNR patients. The report appears in the July edition of the Journal of the American Geriatrics Association. 


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