OHA - End of Life Care

End of Life Care and Advance Directives

Ohio Advance Directives Week: October 11-17, 2009
Hospitals, all healthcare providers, and interested parties are invited to promote the use of advance directives such as living wills and healthcare durable powers of attorney during the week of October 11-17. The week celebrates the business of “living today, planning for tomorrow” by encouraging adults to put in writing the care they want to receive should they become unconscious, terminally ill or unable to communicate.

In past years, many Ohio organizations, including hospitals, have recognized the week with educational seminars and informational sessions. The Ohio Hospice and Palliative Care Organization offers an advance directives packet (see below) used to create a living will or health care durable power of attorney, or to designate organ or tissue donation. Large font versions of the living will and durable power of attorney are available as well. Ohioans can fill out these forms without an attorney and it is suggested they make several copies for their personal files as well as to give to trusted family members, physicians, lawyers and others. Hospitals are also encouraged to ask staffers to complete advance directives.

Advance Directives
An advance directives packet, Advance Directives Packet: Choices, Living Well at the End of Life, to help patients and their families make end-of-life decisions is available from the Ohio Hospice and Palliative Care Organization. The packet includes forms used to create a Living Will or Health Care Durable Power of Attorney, or to designate organ or tissue donation. Courtesy of the Ohio Hospice and Palliative Care Organization, large font versions of the Living Will and Durable Power of Attorney are also available.
Download the packet* to distribute at your facility.
Download the forms*
Order additional hard copies*

Old versions of the forms also available in Spanish (EN ESPANOL)
Updated versions will be posted as soon as they are available.
Power of Attorney (PODER DE CUIDADO DE SALUD DE)*
Living Will Declaration (DECLARATION DE TESTAMENTO ED VIDA AVISO AL DECLARANTE)*

MOLST Legislation
HB 241 was introduced in June 2009 and would create a Medical Order for Life Sustaining Treatment (MOLST) form that would help provide standardized documentation of patients’ wishes for treatment toward the end of their lives. The form incorporates do-not-resuscitate (DNR) wishes along with other treatment preferences such as comfort care, limited additional interventions or the use of antibiotics or artificially administered nutrition. The MOLST form would be standardized, brightly-colored and completed by a patient’s physician, physician assistant or nurse practitioner after discussion with the patient or his or her representative. It also would be portable throughout the health care delivery system. Similar legislation has been adopted in other states (see www.polst.org for more information).

Do Not Resuscitate (DNR) Rules
The Ohio Department of Health (ODH) recently revised Ohio’s DNR rules that can be found on the ODH web site. Since 2005, a task force led by the Ohio Hospice and Palliative Care Organization has unsuccessfully sought to revise the DRN rules because they are confusing to many persons including healthcare workers and they do not provide for flexible patient-centered end of life care. In 2008, the task force determined to focus its attention on enactment of MOLST legislation described above.

Resources
Light the Way: Don't Leave Your Loved Ones in the Dark
A campaign of the Ohio State Bar Foundation's Fellows Class of 2002 to tell Ohioans how important it is to plan for health care decisions before a crisis.

Ohio Hospice & Palliative Care Organization
Information and downloadable forms on the several types of advance directives available in Ohio, including the living will, health care power of attorney, Ohio's do-not-resuscitate law and organ and tissue donation.

Put It In Writing

An American Hospital Association Web resource in Spanish and English providing hospitals and consumers information on advance directives.

Education in palliative and End-of-Life Care for Oncology CD-ROM AND DVD

The National Cancer Institute has published a free palliative-care training program for health professionals caring for cancer patients. To order, visit the Web site above or call NCI's Cancer Information Service at 800.4.CANCER.

Contacts
Rick Sites, General Counsel and Senior Director of Health Policy
ricks@ohanet.org

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