POLST The Form and the Implementation

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POLST - The Form andthe Implementation

• Gwendolyn Kaltoft
• RN, EdD

March 30, 2009
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Yolo Hospice

• The Yolo Hospice team of professionals helps
  people fully live the final days of their lives
  by focusing on the whole person
  body-mind-spirit.
• We provide clinically expert care, delivered in a
  spirit of loving service that emphasizes comfort
  through pain control and sophisticated symptom
  relief.
• We offer no-cost adult and childrens grief
  support services and end-of-life education to
  help meet community needs.
• As the first hospice in our area, we have been
  providing not-for-profit hospice care in our
  communities since 1979.

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Yolo Hospice

• LIFE - Hospice is about how you live. We
  encourage people to live, really live, until they
  die. Hospice is not about death, its about
  celebrating life
• COMFORT - Hospice is medically directed and
  assists people who are dying and their loved ones
  with care that emphasizes pain control,
  sophisticated symptom relief, and comfort
• WHOLE PERSON - Honoring every moment of life,
  hospice is designed to treat the whole person
  (body-mind-spirit) and not the disease
• TEAM - The key to Yolo Hospice is our
  well-rounded team of expert professionals
  providing uncompromising care and devoted to
  their work. Our interdisciplinary team includes
  nurses, home health aides, spiritual counselors,
  bereavement counselors, social workers, and
  trained volunteers

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Objectives

• Honoring the form
• Procedures to complete the form
• Barriers and limitations
• POLST as a community care tool
• Working with other institutions communication
  through the POLST

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Using POLST in Multiple Settings

• Patients Home
• Residential Care Facilities for the Elderly
  (RCFE)
• Board and Care Homes
• Skilled Nursing Facilities
• Hospitals

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Process of Completing the POLST

• Initiated Spring 2008 - Form is completed on
  every admission visit
• MSW Social Worker or Registered Nurse reviews
  form with patient and or DPOA/HC
• 100 of Yolo Hospice patients have a POLST
  completed

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Implementing POLST as a Plan of Care

• Moves with patient from home to any other health
  care setting
• Rare communication problems with other
  institutional providers
• Seen as active plan of care

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Implementing POLST as a Plan of Care

• Changes may occur to form and
• Subsequently to the plan of care
• Patient may change his/her choices about
  directives, i.e., patient may have been admitted
  to hospice care with selection of Attempt CPR
  and Full Treatment.
• As he/she moves through the hospice care
  continuum may select DNR and Comfort Only

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POLST as Support for Patient and Caregiver

• Tool for communication
• With patient and
• With caregiver
• Throughout the dying process

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Summary

• 100 use at Yolo Hospice
• POLST is central to individual and community plan
  of care
• Promotes ease of communication with other health
  care providers and with patient and caregivers

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Thank you