End of Life Decisions

by Kathy Lupfer Nielsen, Family and Consumer Sciences Agent
 

I recently attended the Positive Aging Day sponsored by the Sedgwick County Extension Service along with several other agencies. A session provided by TROOP Wichita, was of special interest to me. I had not heard of Transportable Physician Orders for Patient Preferences.

While this is currently available in Kansas City area as well as Wichita/Sedgwick County, it is something to know about and to ask your physician about when making these decisions. TROOP Wichita is based on the belief that all individuals have the right and responsibility to make their own health care decisions. It is designed to improve the quality of care people receive at the end of life by translating their treatment goals and preferences into their medical orders. It can clarify a patient’s intentions for treatment and minimize confusion regarding a person’s care preferences.

TROOP is modeled on the Physician Orders for Life Sustaining Treatment (POLST) paradigm which was developed in the 1990s and is one of 30 such efforts underway nationally.

This form complements the Advanced Directive and isn’t intended to replace it. An advanced directive is necessary to appoint a legal health care representative and provide instructions for future life-sustaining treatments. An Advanced Directive is recommended for all adults, regardless of their health status.

Difference between the Advanced Direction and the TROOP or POLST (as it is called in other states)

Advanced directive:

• For anyone 18 and older
• Provide instructions for future treatment
• Appoints a Health Care Representative
• Does not guide Emergency Medical Personnel
• Guides inpatient treatment decisions when make available.

TROOP/POLST (Physicians Orders for Life Sustaining Treatment Paradigm):

• For persons with serious illness-at any age
• Provides medical orders for current treatment
• Guides actions by Emergency Medical Personnel when made available
• Guides inpatient treatment decisions when made available.

This form is recommended for individuals with advanced, chronic, progressive or terminal illness or for any individuals who wish to further define their treatment preferences for end of life care beyond the advance directive. It is to accompany the patient when transferred to home or new care facilities.

Carolyn suggested that we all Google end of life videos to learn more about these issues. One statement she made that really stuck with me was “just because lots can be done medically for you, should it?” That is for you, the patient, your health care agent and physician to discuss. Not an easy conversation to have with your family or maybe even your doctor. A book she recommended was “Talking about Death Won’t Kill You” by Virginia Morrison. For more information on this contact the Wichita Medical Research and Education Foundation at 316-686-7172 or www.wichitamedicalresearch.org.