California program helps people record wishes at end of life

A program used in California to help nursing home and terminally ill patients express their wishes regarding treatment at the end of life results in the type of care patients want and expect, according to a new study.

The program is called Physician Orders for Life-Sustaining Treatment and has been adopted in many nursing homes, hospitals and long-term care facilities in California beginning in January, 2009. The program involves an innovative medical form, that is signed by a doctor, allowing patients to specify what kind of care they want at the end of life, such as feeding tubes and other medical interventions. The form was designed 20 years ago in Oregon because of concerns that traditional Do Not Resuscitate orders and advanced directives do not fully communicate patients' wishes for many situations and types of treatments.

The multi-state study, published Friday in the Journal of the American Geriatrics Society, found that patients with the Physician Orders for Life-Sustaining Treatment forms had much less unwanted hospitalization and medical interventions. For example, 98% of people with the forms had orders about medical interventions in addition to resuscitation -- compared to 16% of residents without these forms.

The form "allows patients to tell their health care professionals exactly what they want, so providers know patients' wishes no matter what level of treatment they are seeking," Dr. Susan Tolle, a co-author of the study and director of the Center for Ethics in Health Care at the Oregon Health & Science University, said in a news release.

Efforts to increase awareness about the program are being led in California by the Coalition for Compassionate Care of California and the California HealthCare Foundation. Information and opportunities to learn about the program can also be found on this web site.

-- Shari Roan