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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!
And now ICU care has flourished, and we can keep people alive in the sense that their heart is beating and we can sustain their ventilation and circulation. 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. ICU care was pretty rudimentary.
I have done a lot of work on POLST and nursinghomes and I’ve seen POLST forms. I saw years ago in Oregon, a POLST form that had been on file in a nursinghome resident’s chart for seven years. I don’t need a checkbox form, I don’t need to know about CPR or mechanical ventilation.
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