Have you ever thought if you were seriously ill what kind of medical treatment you would want toward the end of your life? How would you communicate your wishes to your loved ones and your physician? End-of-life planning begins with talking about what you want for your medical treatment.
See also: End of Life Care
The Louisiana Physician Order for Scope of Treatment (LaPOST) translates a patient’s end-of-life wishes and goals of care into a physician order that travels with the patient wherever he or she goes in the health care system. This allows communication among health care professionals in real time.
LaPOST was created as a best practice model through the efforts of the LaPOST Coalition, a statewide network of health care professionals. Led by Susan Nelson, MD, FACP, FAAHPM, Senior Services Medical Director for the Franciscan Missionaries of Our Lady Health System, the coalition views the LaPOST document as a starting point to help improve Louisiana’s health care system and to honor a person’s wishes as the end of life nears.
“Medical advancements allow doctors in some cases to significantly prolong patients’ lives. While some patients might benefit from that, it may not be the ideal treatment for everyone,” explains Dr. Nelson. “Although LaPOST itself is completely voluntary and neither for nor against life-sustaining treatment, the document gives patients who face a life-limiting and irreversible condition more control in deciding the point where active curative treatment is no longer attempted, and the focus shifts to comfort and symptom management.”
LaPOST is distinguished from two other end-of-life documents – a living will and health care power of attorney.
LaPOST is recommended for a patient who has a life-limiting and irreversible condition and a life expectancy of less than a year. It takes effect when the patient is unable to communicate his or her own wishes. The patient can choose to change or revoke the document at any time.
Because it is a physician order, health care professionals must comply with the specified treatment. LaPOST was designed to eliminate some of the confusion and stress experienced by the patient, family members and caregivers during a loved one’s last moments of life.
“It’s important for everyone to know that LaPOST is here, and the change that it represents,” said Dr. Nelson. “Most of all, we want to encourage physicians and patients to talk about end-of-life choices and medical decisions.”
LaPOST is an initiative of the Louisiana Health Care Quality Forum, a private, not-for-profit organization. The Forum’s other areas of focus include quality measurement and analytics, the patient-centered medical home, health information technology and outreach/education.