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For a trial to have value, it should not exclude patients over age 80, or those with dementia, or patients residing in nursinghomes. Additional links mentioned in the podcast: Recent JGIM article on POLST in California nursinghomes, hospitalization, and nursinghome care Karl’s GeriPal post on appropriate use of POLST Enjoy!
I once had a patient in the ICU at Moffitt who had had a stroke and was facing, not recovered, going to a nursinghome with a feeding tube. Even if you haven’t completed a healthcareproxy, durable training for healthcare, most states say here’s a list of people who can make that decision in order.
But I do think POLST, which I conceptualize as an advance care planning tool, really sits in between those worlds of decisions that are relevant for the present versus the few future. I have done a lot of work on POLST and nursinghomes and I’ve seen POLST forms. So the first order on all POLST forms is around code status.
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