Models & Research

Physician Orders for Life-Sustaining Treatment (POLST) is a document to help ensure that a patient’s wishes are known and honored toward the end of life. It uses a standardized medical order used to indicate which types of life-sustaining treatment a seriously ill patient wants or doesn’t want if his or her condition worsens.

POLST assists health care providers and patients or their surrogate to develop a transferable care plan of desired interventions when dealing with serious, life-limiting illness. Through focused conversations about preferences for nature and intensity of care, people are able to establish a customized standard of care across care settings. The bright pink card stock form travels with the patient and is legally binding in California when properly dated and signed.

Promises to Keep: Changing the Way We Provide Care at the End of Life published by the National Coalition on Health Care and The Institute for Healthcare Improvement. in October, 2000. This report presents the stories of institutions and organizations that made a commitment to change and innovation to improve care at the end of life. The profiles presented in this report reflect some of the most promising pioneering efforts underway in the field of palliative care. RAND’s Center to Improve Care of the Dying (CICD) staff worked closely with the National Advisory Panel of Americans for Better Care of the Dying to develop selection criteria for groups profiled.

Reluctant Realism
by Margaret R. McLean and Margaret A. Graham published in Issues in Ethics, Winter, 2003 Volume 14, Number 1, Markkula Center for Applied Ethics, Santa Clara University pp. 7-9.

To assist in the goal of improving the Latino health care experience in the San Jose community, 66 adults agreed to participate in a series of three focus group sessions that explored their attitudes and concerns regarding end-of-life care. This article presents their views of death and dying, their interactions with the health care system, and their concerns about discussing these issues with their families.

Sonoma County is in the middle of re-engineering the county’s health care system for service to MediCal and uninsured populations with the Department of Health Services in the lead. A DHS Planning and Implementation Committee is now working with Partnership Health Plan to design and fund the care delivery system that will become operational in Sonoma County later in 2008.

Sonoma County is also in the process of assessing the impacts and potential for Sutter Health Center intent to transition out of its Health Access Agreement to provide care for the county’s indigent and uninsured. Important meetings and documents related to the Proposed Sutter/Memorial transaction may be accessed at Healthcare Impact Assessment

TAKING CARE: ETHICAL CAREGIVINGIn OUR AGING SOCIETY published by The President’s Council on Bioethics
Washington, D.C., September 2005
Preface
The President’s Council on Bioethics was created by President George W. Bush on November 28, 2001 to advise the President on bioethical issues related to advances in biomedical science and technology. Taking Care addresses the ethical challenges of caregiving in our rapidly aging society, with special attention to the care of people with dementia. The report purpose is to provide a humanly rich account of the caregiving dilemmas social, familial, and personal, and to offer some important ethical guidelines for the care of persons who can no longer care for themselves.