The POLST program: A retrospective review of the demographics of use and outcomes in one community where advance directives are prevalent

Bernard J. Hammes, Brenda L. Rooney, Jacob D. Gundrum, Susan Hickman, Nickijo Hager

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Abstract

Objectives: Determine the use and utility of the Physician Orders for Life-Sustaining Treatment (POLST) program in a community where powers of attorney for health care (POAHCs) are prevalent. Methods: A retrospective review of medical record and death certificate data of 400 adults who died between September 1, 2007, and March 31, 2008, in the La Crosse County, Wisconsin community. Demographic and cause-of-death data were collected from death certificates. Information about POAHC, POLST forms, and medical treatments provided in the last 30 days of life were abstracted from decedents' medical records. Results: Sixty-seven percent of decedents had a POLST form, whereas 22% had POAHC alone. In comparison with decedents with POAHC alone, decedents with a POLST form were significantly older (83 versus 77 years, p<0.001), more likely to die in a nursing home than in a hospital (p<0.001), and more likely to die from a terminal or chronic illnesses (97%). Decedents with POLST orders for higher levels of medical treatment received more treatment, and in only two cases was there evidence that treatment was discrepant with POLST orders. In 31% of all POLST forms, the person appointed in the POAHC consented to the POLST orders. Conclusions: POLST can be a highly effective program to ensure that patient preferences are known and honored in all settings. POAHCs are valuable because they identify appropriate surrogates when patients are incapacitated.

Original languageEnglish
Pages (from-to)77-85
Number of pages9
JournalJournal of Palliative Medicine
Volume15
Issue number1
DOIs
StatePublished - Jan 1 2012

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Advance Directives
Demography
Physicians
Therapeutics
Death Certificates
Medical Records
Patient Preference
Nursing Homes
Cause of Death

ASJC Scopus subject areas

  • Medicine(all)
  • Anesthesiology and Pain Medicine
  • Nursing(all)

Cite this

The POLST program : A retrospective review of the demographics of use and outcomes in one community where advance directives are prevalent. / Hammes, Bernard J.; Rooney, Brenda L.; Gundrum, Jacob D.; Hickman, Susan; Hager, Nickijo.

In: Journal of Palliative Medicine, Vol. 15, No. 1, 01.01.2012, p. 77-85.

Research output: Contribution to journalArticle

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