Image of Susan E. Hickman, Ph.D.

The COVID-19 pandemic has amplified the importance of advanced care planning and Physician Orders for Life-Sustaining Treatment (POLST) after a new study found that less than half of the orders match the current treatment preferences. 

“Our finding that nursing home residents or their surrogate decision-makers often no longer agreed with their POLST form highlights the critical need to work with nursing homes, residents and their families to ensure these documents are reviewed regularly and updated to reflect current situations and preferences,” said lead researcher Susan Hickman, Ph.D., director of the Indiana University Center for Aging at the Regenstrief Institute.

Findings were recently published online  in the Journal of the American Geriatrics Society. Researchers found that less than 50% of POLST forms for the 275 study participants matched their current treatment preferences for resuscitation, medical interventions and artificial nursing. Findings also revealed that “a notable number of individuals” whose current treatment preferences didn’t match their POLST did not want to update the document either. 

“Obviously, nursing homes and clinicians need to work on educating people about the importance of these decisions,” Hickman warned. “We are working to help them with these efforts.”

She added, “COVID has elevated the importance of making advance care planning decisions and periodically reviewing these choices, because, as we have seen very clearly over the past year, major care decisions may need to be made quickly and needs may change.” 

POLST forms in previous studies have been found to triple the odds of a resident’s treatment preferences being known. AMDA — The Society for Post-Acute and Long-Term Care Medicine last year became the first national organization to endorse the adoption of a national POLST form for documenting nursing home residents’ end-of-life wishes.