Tagged: Mary F. Mulcahy

POLST form presented at Northwestern Memorial, a seminar from LMM co-founder Mary F. Mulcahy, M.D.

Image: Mulcahy speaking to a group of physicians at Northwestern Memorial Hospital
Image: Mulcahy speaking to a group of physicians at Northwestern Memorial Hospital

“The Illinois POLST form is a step in the right direction,” said Mary F. Mulcahy, a co-founder of Life Matters Media and practicing oncologist at Northwestern University, while lecturing physicians about the form Thursday at Northwestern Memorial Hospital.

In March, the Illinois POLST form was released to the public, an effort headed by the POLST Paradigm and the Chicago End-of-Life Care Coalition. This update to the Illinois DNR advance directive aims to improve the quality of life for patients at end of life.

POLSTs, Physicians Orders for Life Sustaining Treatment, are more detailed than conventional living wills and advance directives. These forms give patients the freedom to indicate preferences regarding resuscitation, intubation, intravenous antibiotics and feeding tubes. Such forms are intended for patients in their last year of life, and they can follow patients across state care settings and direct doctors to provide or withhold lifesaving treatments.

Image: POLST form
Image: POLST form

The form should be adjusted over time to fit each patient’s prognosis. “This is not a one-time thing, as patients progress the form can change,” Mulcahy said. “There should be shared decision-making between physicians and patients.” To be valid, the form must be signed by the attending physician.

In the U.S., the average patient visits the hospital more than 30 times and meets nine different physicians during the last six months of life. These patients could benefit from having their medical wishes written down and on hand; the convenience helps cut through the chaos and confusion prevalent in care settings.

POLST was developed in Oregon in the 1990s, and now 14 states have POLST programs. Twenty-eight states are considering the use of such forms.

“Hopefully this form will change the culture and get people talking and preparing for the end of life,” Mulcahy said.

Palliative care expert Andrew Thurston, M.D., agreed. “I think this is great. My hope for the POLST form is that it will clarify patients’ wishes for their end of life care, and that it helps doctors more effectively communicate with their patients,” said Thurston. “We need more open discussion, and with easier language, this form helps.”

More about POLST

Washington POLST form: A new bill aims to close loophole

Illinois POLST form released to public

How POLST forms clarify wishes: Three scenarios

More from Life Matters Media:

Death with Dignity: Vermont House to vote amended end of life bill

Google “Death Manager”: A will for your digital data

Being a friend to someone sick: Advice from author Letty Cottin Pogrebin

An OP-ED for PBS: Inequalities in the health care system

Life Matters Media co-founder Mary F. Mulcahy, M.D., published her research about the racial and economic inequalities in the U.S. health care system for PBS. She continues to spread the message of advance care planning.

Mary F. Mulcahy
Mary F. Mulcahy

She writes:

“Racial disparities and inequities in American healthcare are evident in daily life, but regrettably they are also prominent in death. In these final days of Black History Month, it is imperative to reflect on the final days of all African-Americans and the choices they have within our health care system. These are the choices they aren’t taking, and the phenomenon serves as a means of further disenfranchisement from the medical community at large.

“The National Center for Health Statistics reports that African-Americans in home health care and nursing homes are half as likely as whites to have an advance directive, such as a living will or a do-not-resuscitate (DNR) order. This disparity leaves African-Americans at risk for unwanted medical procedures, unnecessary pain and family strife.”

Read the rest at PBS

Learn more from the Life Matters Media Newswire:

Death Cafe: A movement discusses end-of-life

Some doctors still believe in psychedelic drugs

LMM’s Valentine’s Day message in The Huffington Post

Life Matters Media co-founder Mary F. Mulcahy, M.D., has shared advice about pacemakers and caring for the aged in a new feature for The Huffington Post. She continues to spread the message of advance care planning.

George Hodan
Image: George Hodan

“Our attention turns to the heart this time of year, as signs of Valentine’s Day surround us. It is the organ that works harder than any other muscle in the body, with an electrical system that fires more than 3 billion times within an average lifetime. Starting with the first “whoosh” heard during an obstetrician’s office visit and working until that flat line we see on all-too-many doctor shows, the heart beat is the most recognizable sound known to man.

“More than 400,000 Americans each year take advantage of medical technology to replace a faulty cardiac electrical system or worn out heart muscle. But what happens when the rest of body is ready to die? Is there an appropriate time to flip off that switch? Rapid evolution of medical technology and our own lengthening life spans demand that we consider these questions.

“In the past two decades, pacemaker use in this country has increased by more than 50 percent; globally, such devices have reached even the hearts of the Vatican, as we recently learned that Pope Benedict XVI has had one installed for many years. This technology is currently enhancing the quality of life for more than 3 million of us in the United States.”

Read the rest at The Huffington Post

Learn more from the Life Matters Media Newswire:

Hospice remains a last resort, despite increase in deaths

Vermont Statehouse votes “Death with Dignity”

Life Matters Media featured in the Atlantic

Life Matters Media co-founder Mary F. Mulcahy, M.D., has shared her experiences treating the terminally ill for a new feature in the Atlantic.

Mary F. Mulcahy
Mary F. Mulcahy

When fighting cancer isn’t worth it

The war on cancer is a civil war. It is a battle of two armies, cancer and therapy, fighting it out within a common space. It is an unfair fight.

A recent article in the Washington Post describes a controversial surgery devised by a pioneering and big-thinking surgeon, Paul Sugarbaker. This surgical procedure, known as cytoreduction and heated intraperitoneal chemotherapy (HIPEC), removes metastatic cancer before bathing the abdominal cavity in heated chemotherapy. There are many who celebrate it as life-saving, some who loathe it as toxic, and others who debate its merits and shortcomings endlessly.

Read the rest at the Atlantic.

Learn more from the Life Matters Media Newswire:

Life Matters Media featured in the Good Men Project

Life Matters Media featured in Al Jazeera

Life Matters Media featured in The Huffington Post

Life Matters Media co-founder Mary F. Mulcahy, M.D., has shared her experiences treating the terminally ill for a new feature in The Huffington Post. She continues to spread the message of advance care planning.

“Advance care planning is a dynamic process that evolves over time as a person’s health goes from well, to ill, to ultimately terminal. Less than 10 percent of people will die suddenly; most of us will experience a protracted life-threatening illness. Medical advances have led to few cures of illness, have prolonged the experience of living with chronic illness and have prolonged the process of dying. Add to this the fact that for the next 18 years, baby boomers will be turning 65 at a rate of about 8,000 each day, and it is clear that the role of advance care planning needs to be embraced,” Mulcahy writes.

Learn more from the Life Matters Media Newswire.

Intimacy and end of life: “The Sessions”

Life Matters Media featured in Al Jazeera

Life Matters Media featured in Al Jazeera

Life Matters Media co-founder Mary F. Mulcahy, M.D., is spreading the message of the importance of advance care planning in her op-ed for Al Jazeera. 

“Developing an advance care plan helps us prepare for unexpected events that render so many incapable of making health care decisions. They provide an opportunity to express what functional capacity provides us all with some standard of fulfillment. That standard is individual, but may require the ability to interact with loved ones, to attend to basic personal care, or to live independently. These are personal goals that we can define,” Mulcahy writes.

Learn more from the Life Matters Media Newswire.

End of life care varies across top hospitals

POLSTs work, says Respecting Choices’ Bernard Hammes