Podcasts about life sustaining treatment

Send us a textIn my working days, I was a member of my institution's Bioethics committee. I'm now a retired nurse and continue to serve as a community member. Constantly impressed by this committee's work, I wanted you to meet two of these brilliant minds, so I recently sat down with Sandra Shadley, a licensed marriage and family therapist and our committee chair, and Dr. Ryan Howard, our hospice and palliative medicine physician.Sandra holds a unique certification: the HEC-C, or certified healthcare ethics consultant and she explained that Bioethics is guided by four principles: respect for autonomy, beneficence, non-maleficence, and justice. Despite the solidity of these principles, bioethical issues are still quite nuanced.That's all fine and good, but what exactly does a Bioethics team do? They develop and implement policies, educate the hospital community, review research, and, provide consultations with those patients facing end-of-life decisions. The committee consists of various disciplines: social workers, physicians, nurses, critical care leaders, risk management, chaplains, and community members. It's a diverse group with diverse perspectives. Dr. Howard is gifted at having difficult conversations. He approaches patients with curiosity and humility, providing truly patient-centered and individualized end-of-life care.I left this interview feeling joyful. It was inspiring to witness these two individuals, whom I deeply respect, engage in a dialogue about their shared passion for Bioethics. In the five-minute snippet: Excavators, chainsaws, and bonfires, oh my! For my guests' bios, visit my website (link below).The American Society for Bioethics and HumanitiesPhysician Orders for Life-Sustaining Treatment or POLST pdfContact The Conversing Nurse podcastInstagram: https://www.instagram.com/theconversingnursepodcast/Website: https://theconversingnursepodcast.comYour review is so important to this Indie podcaster! You can leave one here! https://theconversingnursepodcast.com/leave-me-a-reviewWould you like to be a guest on my podcast? Pitch me! https://theconversingnursepodcast.com/intake-formCheck out my guests' book recommendations! https://bookshop.org/shop/theconversingnursepodcast Email: theconversingnursepodcast@gmail.comThank you and I'll talk with you soon!

When faced with a terminal illness diagnosis, your emotions can be overwhelming. You still need to navigate the legal aspects, however, to ensure that you and your loved ones are protected. Stacy Francis' guest this week is Alison Arden Besunder, a partner in charge of the Trust and Estates department at Goetz Fitzpatrick. Alison has extensive experience in guardianship and estate litigation. She joins Stacy to discuss end-of-life planning, including steps to take when the timeline is limited. Stacy and Alison delve into navigating the healthcare system, and the importance of having critical documents in place to convey your medical wishes clearly.  Highlights from this episode: Ensure you have a healthcare proxy and living will in place to appoint someone as your medical decision-maker and provide evidence of your end-of-life intentions. Discuss end-of-life decisions openly with your loved ones, promoting a foundation of good communication to handle high-stress situations effectively. Even with your best efforts, you may feel helpless when dealing with a loved one's illness, but remember that your support and care are invaluable during these challenging times. Avoid burnout as a caregiver by setting boundaries and not taking on more than you can handle. Seek support from therapists to manage the emotional burden effectively. Find the right caregivers for your loved one by tapping into resources like personal needs guardians or geriatric care managers who can connect you with experienced aides. When navigating end-of-life care decisions, ask questions and advocate for your loved one to ensure the best possible care and treatment options. Bioethics committees in hospitals can offer support and assistance in decision-making, especially in challenging end-of-life care situations. They can help translate medical jargon and provide guidance to both physicians and families. Even without a living will, there are other forms like MOLT (Medical Options for Life Sustaining Treatment) or PULST (Physician Orders for Life-Sustaining Treatment) that can be used to make end-of-life decisions in a hospital setting. Navigating end-of-life decisions for pets also requires careful consideration, and sometimes there may be disagreements between family members on the best course of action. For anyone facing end-of-life care decisions or other financial challenges related to medical care, seeking guidance from financial advisors can be crucial to manage expenses and make informed choices. Resources Alison Arden Besunder on LinkedIn | Facebook | Twitter Goetz Fitzpatrick | LinkedIn Phone: 212-695-8100 x289 Stacy Francis on LinkedIn | Twitter Email: stacy@francisfinancial.com FrancisFinancial.com Reach out to receive a complimentary consultation! Contact Francis Financial at +212-374-9008 or visit Francis Financial today!

In today's episode Dr. Anders goes deep into questions like: Are Catholics allowed to go into life sustaining treatments? Where are our judgements specified in the Bible? Was God cruel in the Old Testament? and more.

In today's episode Dr. Anders goes deep into questions like: Are Catholics allowed to go into life sustaining treatments? Where are our judgements specified in the Bible? Was God cruel in the Old Testament? and more.

Is there potential for recovery in patients who are withdrawn from life support? Find out about this and more in today's PeerDirect Medical News Podcast.

Bobby Schindler Co-Author “A Life That Matters” Terri Schiavo Life and Hope Network The post 1373. A New Study on the Withdrawal of Life-Sustaining Treatment form Patients with Brain Trauma – Bobby Schindler, 5/16/24 first appeared on Issues, Etc..

Exploring the Complexities and Transformational Power of End-of-Life Care, Tackling the Challenges of End-of-Life Planning and The "Hospice Gap" with Cathy Yuhas.   How do you envision the end of your life? What if you could transform that vision from a fear-filled one to a peaceful and sacred experience? Join us for a heart-to-heart conversation with our guest, Cathy Yuhas, a seasoned nurse specializing in ICU, ER, and hospice care. Cathy shares a powerful, deeply personal story about how a woman's decision to embrace hospice care completely redefined her perception of death, and illuminated the profound importance of planning for the end, free of judgment. We also explore the glaring gaps that exist in our healthcare system, with a specific focus on the realm of hospice care. Cathy recounts her difficulties navigating the system when her father was dying, emphasizing the desperate need for more education and resources in this area. She provides a detailed overview of the history of hospice care in the United States, highlighting the ongoing challenges it faces due to changing reimbursement structures. Cathy's journey maps out the transformative power of end-of-life planning. She emphasizes the critical role played by directives like the Medical Order for Scope of Treatment (MOST) form, and how hospice can be a beacon of care. As we wrap up, Cathy opens up about her role as a grief educator, and the importance of love, forgiveness, and comfort in the dying process. Tune in to this poignant episode that offers profound insights into dying and grief, underscoring the importance of living each day to the fullest.   We dive into: (01:12 - 02:17) Nurse's Journey in Hospice Care (04:47 - 06:09) Exploring Hospice Care Beauty and Gaps (12:38 - 13:46) Medical Orders for Life-Sustaining Treatment (17:12 - 18:09) Improving End-of-Life Care Experience (25:42 - 26:40) The Power of Hospice Care (30:35 - 31:32) Booklet   RATE, REVIEW, & FOLLOW ON APPLE PODCASTS   Links mentioned in this episode: Doulagivers Institute Dying Matters LLC   80-90% of a positive end of life depends on these two things: Knowing the basic skills on how to care for someone at the end of life and planning ahead - and BOTH Doulagivers Institute is giving you for FREE! Access them Below! Making your wishes known is one of the greatest gifts you can give to your loved ones. Download The Doulagivers 9 Choice Advance Directive now! It's FREE! The Doulagivers Level 1 End of Life Family Caregiver Training AVAILABLE NOW ON DEMAND! Listen Now (edited)    Learn more about Cathy - Click here! More about what we do at Doulagivers Institute - Click here!  

진행자: 김혜연, Naomi Ng 1. 2m Koreans opt out of life-extending treatments 요약: 임종 과정 중 무의미한 연명의료를 받지 않겠다는 사전연명의료의향서 서약자가 내달 200만명을 넘어설 것으로 예상된다. [1] Nearly two million individuals in Korea have formally declined life-extending medical interventions, choosing instead to prioritize their right to die with dignity when suffering from a terminal condition, data showed Sunday. *life-extension 연명, 생명 연장 *dignity 위엄, 존엄 *terminal 말기의, 불치의 [2] Data from the National Agency for Management of Life-Sustaining Treatment reveals that as of the end of August, 1,941,231 people have filed an advance health care directive to abstain from life-saving medical assistance since the system's inception in February 2018. *directive 의향서, 지시, 훈시 *abstain from …을 삼가다[그만두다] [3] Judging from the current monthly growth rate, the number is projected to exceed two million in October. Five and half years have passed since the so-called "Death with Dignity Act" came into effect in Korea in February 2018. The act enabled people to refuse life-prolonging medical treatment. *so-called 소위, 이른바 *enable …을 할 수 있게 하다 [4] Any adult over the age of 19 can register for the advance medical directive detailing treatment plans in the case of terminal illness, which they can also withdraw from at any time. Currently, four types of treatment -- cardiopulmonary resuscitation, use of artificial respiration, hemodialysis and administration of anti-cancer drugs -- are categorized as life-extension care by the government. *respiration 호흡 *anti-cancer drug 항암제 기사 원문: http://www.koreaherald.com/view.php?ud=20230924000091&ACE_SEARCH=1 2. Govt. to survey spending on private education of preschoolers, Suneung retakers 요약: 교육부는 영유아 및 n수생의 사교육비 절감 대책과 공교육 내실화 방안을 마련하기 위해 이들의 사교육 실패 타악에 내년부터 나설 계획이라 발표했다. [1] South Korea's official data on parental spending for their children's education has long faced criticism for overlooking two significant aspects: expenditures prior to the commencement of public education and those occurring after its completion. *overlook 못 보고 넘어가다, 간과하다 *expenditure 지출; 비용, 경비 [2] To address these concerns and better assess the financial burden on parents, the Ministry of Education plans to look into the cost of “private education” of preschool children and high school graduates who are studying to retake the national college entrance exam, known as the Suneung. *address 전달하다, 연설하다 *burden 부담, 짐 *retake 다시 치르다, 재시험 [3] Private education in Korea refers to all forms of learning outside of the formal state curriculum. The ministry said it will survey some 15,000 parents next year on how much they spend for their preschool children's education outside of the regular Korean-language kindergartens that follow the state curriculum. *refer to …에 돌리다, 회부하다, 언급[지칭]하다 *formal 격식을 차린, 정중한 기사 원문: http://www.koreaherald.com/view.php?ud=20230924000138&ACE_SEARCH=1

When faced with a terminal illness diagnosis, your emotions can be overwhelming. You still need to navigate the legal aspects, however, to ensure that you and your loved ones are protected. Stacy Francis' guest this week is Alison Arden Besunder, a partner in charge of the Trust and Estates department at Goetz Fitzpatrick. Alison has extensive experience in guardianship and estate litigation. She joins Stacy to discuss end-of-life planning, including steps to take when the timeline is limited. Stacy and Alison delve into navigating the healthcare system, and the importance of having critical documents in place to convey your medical wishes clearly.  Highlights from this episode: Ensure you have a healthcare proxy and living will in place to appoint someone as your medical decision-maker and provide evidence of your end-of-life intentions. Discuss end-of-life decisions openly with your loved ones, promoting a foundation of good communication to handle high-stress situations effectively. Even with your best efforts, you may feel helpless when dealing with a loved one's illness, but remember that your support and care are invaluable during these challenging times. Avoid burnout as a caregiver by setting boundaries and not taking on more than you can handle. Seek support from therapists to manage the emotional burden effectively. Find the right caregivers for your loved one by tapping into resources like personal needs guardians or geriatric care managers who can connect you with experienced aides. When navigating end-of-life care decisions, ask questions and advocate for your loved one to ensure the best possible care and treatment options. Bioethics committees in hospitals can offer support and assistance in decision-making, especially in challenging end-of-life care situations. They can help translate medical jargon and provide guidance to both physicians and families. Even without a living will, there are other forms like MOLT (Medical Options for Life-Sustaining Treatment) or PULST (Physician Orders for Life-Sustaining Treatment) that can be used to make end-of-life decisions in a hospital setting. Navigating end-of-life decisions for pets also requires careful consideration, and sometimes there may be disagreements between family members on the best course of action. For anyone facing end-of-life care decisions or other financial challenges related to medical care, seeking guidance from financial advisors can be crucial to manage expenses and make informed choices. Resources Alison Arden Besunder on LinkedIn | Facebook | Twitter Goetz Fitzpatrick | LinkedIn Phone: 212-695-8100 x289 Stacy Francis on LinkedIn | Twitter Email: stacy@francisfinancial.com FrancisFinancial.com Reach out to receive a complimentary consultation! Contact Francis Financial at +212-374-9008 or visit Francis Financial today!

Objectives: • Examine what is POLST and its use in Northeast Georgia Health System. • Review patient criteria for POLST qualification. • Understand POLST's role in assisting patients with expressing their medical wishes. • Recognize when POLST is appropriate for patient completion.

This lecture was given at the University of Alabama, Birmingham, on December 2, 2022. For more information, visit thomisticinstitute.org About the speaker: Gina Maria Noia is an Assistant Professor of Theology and Resident Bioethicist at Belmont Abbey College. She received her Ph.D. in Theology and Health Care Ethics from Saint Louis University. She has served as a clinical ethicist for OSF Saint Francis Medical Center in Peoria, IL and St. Alexius Hospital in St. Louis, MO, and she is published in Christian Bioethics and the Journal of Moral Theology. She and her husband, Justin, love spending time with their vivacious one-year-old boy.

Planning documents are for everyone and this is a good place to start the conversation. We should all have these few critical documents in place in the event something happens and we can't make decisions for ourselves. These include: Health Care Proxy Power of attorney Living Will Regardless of age, unfortunate circumstances can happen to anyone and being prepared only serves to lessen the impact should those planning tools be needed. Here are some additional resources to help you through these conversations: Honoring Choices (Massachusetts) https://www.honoringchoicesmass.com/ Five Wishes https://www.fivewishes.org/ What If Workbook https://whatifworkbook.com/ Physicians' Orders for Life Sustaining Treatment https://polst.org/ National Association of Elder Law Attorneys https://www.naela.org/ Suggestions for communicating for a positive outcome: It is not about age. All adults should have a designated emergency plan. Use an example of someone who had an unexpected event that can demonstrate why this planning is important. Although not specifically mentioned in this episode, the Terri Schiavo Case is a commonly good example. https://en.wikipedia.org/wiki/Terri_Schiavo_case. Have the conversation in a comfortable place and have carbs, they help. Reinforce that this is a back-up plan ONLY in the event it is needed (even if you are hoping it will not be the back-up plan). Please click the button to subscribe so you don't miss any episodes and leave a review if your favorite podcast app has that ability. Thank you! More information at https://2sisters-sla.com/ © 2022 Michelle Woodbrey and Alyson Powers

This week, we talk about the POLST form; your Provider Orders for Life-Sustaining Treatment. Join us as we walk you through this important form, step-by-step, giving you the confidence to get it done for yourself or with your aging loved one! Show Notes: Julie's Uplifting Story of the Week: https://www.guideposts.org/caregiving/resource-center/5-ways-to-plan-for-the-final-years Inga's Uplifting Story of the Week: https://wdc.org/ More Information: POLST Directory: https://polst.org/state-programs/ Montana POLST: https://boards.bsd.dli.mt.gov/medical-examiners/provider-orders-life-sustaining-treatment/ Follow Inga & Julie! Connect with Inga on LinkedIn: https://www.linkedin.com/in/inga-lake-4857301b8/ Connect with Julie on LinkedIn: https://www.linkedin.com/in/julie-brubaker-3a89b2114/ Follow Caregiven on Instagram: https://www.instagram.com/thecaregivenpodcast/ Follow Caregiven on TikTok: https://www.tiktok.com/@thecaregivenpodcast?lang=en Subscribe to the Caregiven YouTube Channel: https://www.youtube.com/channel/UChtq-gS4yCWGE5UFnrU8OAA Follow EPAGA Home Care on Facebook: https://www.facebook.com/EPAGAHomeCare Join the Care and Share Facebook Group: https://www.facebook.com/groups/715609402176814 Follow EPAGA Home Care on Instagram: https://www.instagram.com/epagahomecare/ Follow EPAGA Home Care on LinkedIn: https://www.linkedin.com/company/epaga-home-care Visit EPAGA's Website for more articles about home care: https://www.epagahomecare.com/articles Interested in going into business for yourself, but not by yourself? Learn about our home care franchise opportunities at www.epagahomecarefranchise.com!

In the world of healthcare, many times it's presumed that a patient's code status is full code especially in the absence of any medical documentation or family that says otherwise. Is that okay? Or should you seek this definitive information asap, especially when the patient has a high probability of deteriorating? In this episode Nurse Alice shares a recent clinical experience when she discovered a DNR order from an assisted living center for a trauma patient she just received after being told in the handoff from the ER nurse that the patient is full code. If this were you, what would you do? In situations like this Nurse Alice recommends the nurse absolutely find out if the patient has a  POLST (Physician Order for Life-Sustaining Treatment) and if not determine who is the medical decision-maker for the patient if they can't do so. Read more at nurse.org

Medical practices at the end of life differ around the world. In the United States, medicine has moved from a paternalistic model to one that promotes autonomy and self-determination.  In Europe and other regions of the world, patient-physician relationships are still somewhat paternalistic. Different cultures and countries deal in diverse ways with the ethical dilemmas arising as a consequence of the wider availability of life-sustaining therapies. In the past patients died in intensive care units (ICUs) despite ongoing aggressive therapy. Over the years, observational studies documenting physician behavior have noted changes in the modes of patient deaths and an earlier limitations of life-sustaining treatments. This lecture will review the current global practices.

Trisomy 13 & 18 Ethical Considerations with Dr. Paul Mann PARTICIPANTS: Paul Mann, MD Zachary Hodges, MD About Our Guest: Dr. Paul Mann is an Associate Professor of Pediatrics, Chief of the Division of Neonatology and practicing neonatologist at the Medical College of Georgia. He also is the Director of Clinical Ethics for the Augusta University Center for Bioethics and Health Policy. Free CME Credit: https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=7772 Learning Objectives: By the end of listening to this episode, learners should be able to: Recognize aneuploidies as a common cause of genetic abnormalities in pregnancy. Recognize the historically pessimistic counseling given to families of children with trisomy 13 and 18 and how this might continue to influence our counseling today. Recall how most babies are prenatally diagnosed with trisomy 13 and 18. Describe the life-limiting malformations associated with trisomy 13 and 18. Recognize the recent improvement in prognosis of children with trisomy 13 and 18 as they are being selectively offered more intensive and surgical care. Sensitively counsel families about the general prognosis of newborns with trisomy 13 and 18 while avoiding inaccurate and problematic language such as “lethal and incompatible with life.”        Thank you for listening to this episode from the Department of Pediatrics at the Medical College of Georgia. If you have any comments, suggestions, or feedback- you can email us at mcgpediatricpodcast@augusta.edu. Remember that all content during this episode is intended for informational and educational purposes only. It should not be used as medical advice to diagnose or treat any particular patient. Clinical vignette cases presented are based on hypothetical patient scenarios. We look forward to speaking to you on our next episode of the MCG Pediatric Podcast.     Peer Reviewers: Amy Thompson, MD & MCG Pediatric Podcast Committee   References: Kett JC. Who Is the Next "Baby Doe?" From Trisomy 21 to Trisomy 13 and 18 and Beyond. Pediatrics. 2020;146(Suppl 1):S9-S12. doi:10.1542/peds.2020-0818D American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Obstetrics; Committee on Genetics; Society for Maternal–Fetal Medicine. Practice Bulletin No. 162: Prenatal Diagnostic Testing for Genetic Disorders. Obstet Gynecol. 2016;127(5):e108-e122. doi:10.1097/AOG.0000000000001405 Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs. Stamford, Conn: Appleton & Lange, 1999. Print. McCaffrey MJ. Trisomy 13 and 18: Selecting the road previously not taken. Am J Med Genet C Semin Med Genet. 2016;172(3):251-256. doi:10.1002/ajmg.c.31512 Bajinting A, Munoz-Abraham AS, Osei H, Kirby AJ, Greenspon J, Villalona GA. To operate or not to operate? Assessing NSQIP surgical outcomes in trisomy 18 patients [published online ahead of print, 2020 Jun 5]. J Pediatr Surg. 2020;S0022-3468(20)30369-9. doi:10.1016/j.jpedsurg.2020.05.037 Neubauer K, Boss RD. Ethical considerations for cardiac surgical interventions in children with trisomy 13 and trisomy 18. Am J Med Genet C Semin Med Genet. 2020;184(1):187-191. doi:10.1002/ajmg.c.31767 Wightman A, Kett J, Campelia G, Wilfond BS. The Relational Potential Standard: Rethinking the Ethical Justification for Life-Sustaining Treatment for Children with Profound Cognitive Disabilities. Hastings Cent Rep. 2019;49(3):18-25. doi:10.1002/hast.1003 Nelson KE, Rosella LC, Mahant S, Guttmann A. Survival and Surgical Interventions for Children With Trisomy 13 and 18 [published correction appears in JAMA. 2017 May 2;317(17 ):1803]. JAMA. 2016;316(4):420-428. doi:10.1001/jama.2016.9819

Assisted living facilities are being hit hard by COVID-19. In Episode 4 of Alz in the Fam, hosts Allan and Poli discuss the shocking news and aftermath of their mom testing positive for COVID-19. In Maryland, where Allan and Poli’s mom lives in a senior living community, a large percentage of coronavirus deaths have been in these senior care facilities and nursing homes. Cases began to appear at their mom’s facility about two weeks ago, so last week every resident and staff was tested for the virus. Turns out, their mom tested positive for the virus too.For the most part, Allan and Poli’s mom is doing well, aside from lack of appetite and no ability to taste food. But this diagnosis led the siblings to having a larger conversation about their mom and her end of life care preferences.The siblings have already taken steps to prepare for their mom’s end of life treatment - they have Advance Care Directive and Orders for Life Sustaining Treatment on file. The Alz In The Fam family urges all caregivers and children to have these conversations with your parents, no matter how difficult they may be. Being prepared is crucial.Currently, some of your parents’ preferences or treatment options may have changed during the COVID-19 pandemic. It is important to have these difficult conversations and be able to understand how different scenarios may unfold for you and your family.Here are the resources that Allan and Poli mentioned during the episode that can help every family navigate difficult end of life care decisions:Maryland Orders for Life Sustaining Treatment: https://marylandmolst.org/pages/molst_form.htm Being Mortal by Atul Gawande: https://www.amazon.com/Being-Mortal-Medicine-What-Matters-ebook/dp/B00JCW0BCY/ref=sr_1_1?dchild=1&keywords=being+mortal&qid=1589922153&sr=8-1 NYTimes OpEd article: https://www.nytimes.com/2020/04/04/opinion/coronavirus-ventilators.htmlIf you enjoy the podcast, would you please consider leaving a short review on Apple/Podcast/iTunes?

Amy Vandenbroucke, JD Executive Dir., National POLST Karl Steinberg, MD, HMDC, CMD,  President-Elect, AMDA   References: Marshall B. Kapp, MPH, JD, "Overcoming Legal Impediments to Physician Orders for Life-Sustaining Treatment", AMA Journal of Ethics, 2015. National POLST Recording Date:  5/5/2020 Available Credit: 0.25 CMD-Clinical    

Join Drs. Valdez and Hoffman to discuss Palliative Care in the era of the COVID pandemic.  Dr. Hoffman lends her expertise and provides great resources linked below, including her podcast series on Surgical Palliative Care.   References and ResourcesSurgical Palliative Care podcast hosted by Dr. Red Hoffman - https://thesurgicalpalliativecarepodcast.buzzsprout.com/ National POLST (Physician Orders for Life Sustaining Treatment) - https://polst.org/programs-in-your-state/?pro=1 Vital Talk - https://www.vitaltalk.org/  Center to Advance Palliative Care (CAPC) - https://www.capc.org/

  If you are stuck at home and without basic legal documents, listen up. In the spirit of offering what I can to help people gain some piece of mind amidst the panic and uncertainty of the pandemic, here are some resources that you can use to get the basics in order, for now. Although none of the documents I’m discussing take the place of a comprehensive estate plan, they are all good things to have. And most of them are documents that you can put in place with minimal or no expense as long as you have access to the internet, a printer, and some cooperative neighbors willing to stay six feet away while you sign them. Once you do sign them, place them in a safe place, let your loved ones know where to find them in case you do get sick, and then, please, go out and take a walk. Advance Health Care Directives An Advance Health Care Directive, also known as a Health Care Proxy or Durable Power of Attorney for Health Care  and Living Will in some states, appoints people to act as your Agents to make medical decisions for you if you are unable to make them for yourself.   Here is a downloadable Advance Health Care Directive form for California that follows the California Probate Code’s statutory form. The AARP offers free, downloadable Advance Directives for all fifty states here: The California Hospital Association offers a free downloadable form for California here. If you are a Kaiser member, Kaiser Permanente offers a downloadable form here. If you would like to learn more about end of life planning and palliative care, please listen to Dr. Jessica Zitter’s interview on my podcast, Life Death Law. She has so much to say about how to be prepared, who to choose as your Agent, and how to negotiate a vist to the ICU. DNR and POLST forms A DNR Order tells emergency medical personnel that you don’t want CPR or other measures, such as intubation, if your heart stops beating. This form, however, needs to be signed by a doctor to be valid, so it’s not exactly a DIY resource. Still, if you are concerned, please do contact your doctor or local Health Department to find out how to get this in place. A POLST form, which is often printed on bright pink paper, is another medical order that is similar to, but broader than, a DNR Order. The name stands for Physician Orders for Life-Sustaining Treatment and it is exactly that — a medically binding order that states what you do, and don’t, want at end of life.  For more information about POLST forms, you can go here. Durable Power of Attorney A Durable Power of Attorney is a legal document that names Agents who can act for you financially, doing things such as writing checks on your behalf, paying your bills, managing your investments, withdrawing assets from your retirement accounts, and paying your taxes.  California offers a simple Durable Power of Attorney as part of its Probate Code.  You can find this many places, but here’s one link. Wills A Will is the last on my list of basic estate documents that everyone should have. If you don’t write one, each state has a set of rules that will determine who will get your property at death (called the laws of intestate succession)  and a judge will have to appoint guardians for your minor children without any input from you.  So, how can you make a Will right now, if you can’t leave the house? I have three suggestions: If you live in California, you can download a simple fill-in-the-blank form offered for free by the State Bar Association here. If you want to do a more customized Will, and you can afford to pay 89.99, you can use WillMaker, software that uses a question and answer format to produce Wills, Durable Powers of Attorney and Health Care Directives for all states, except Louisiana. You can download Quicken WillMaker and Trust 2020. You can create an Online Will for $59.99 at Nolo.com for all states except Louisana.

  If you are stuck at home and without basic legal documents, listen up. In the spirit of offering what I can to help people gain some piece of mind amidst the panic and uncertainty of the pandemic, here are some resources that you can use to get the basics in order, for now. Although none of the documents I’m discussing take the place of a comprehensive estate plan, they are all good things to have. And most of them are documents that you can put in place with minimal or no expense as long as you have access to the internet, a printer, and some cooperative neighbors willing to stay six feet away while you sign them. Once you do sign them, place them in a safe place, let your loved ones know where to find them in case you do get sick, and then, please, go out and take a walk. Advance Health Care Directives An Advance Health Care Directive, also known as a Health Care Proxy or Durable Power of Attorney for Health Care  and Living Will in some states, appoints people to act as your Agents to make medical decisions for you if you are unable to make them for yourself.   Here is a downloadable Advance Health Care Directive form for California that follows the California Probate Code’s statutory form. The AARP offers free, downloadable Advance Directives for all fifty states here: The California Hospital Association offers a free downloadable form for California here. If you are a Kaiser member, Kaiser Permanente offers a downloadable form here. If you would like to learn more about end of life planning and palliative care, please listen to Dr. Jessica Zitter’s interview on my podcast, Life Death Law. She has so much to say about how to be prepared, who to choose as your Agent, and how to negotiate a vist to the ICU. DNR and POLST forms A DNR Order tells emergency medical personnel that you don’t want CPR or other measures, such as intubation, if your heart stops beating. This form, however, needs to be signed by a doctor to be valid, so it’s not exactly a DIY resource. Still, if you are concerned, please do contact your doctor or local Health Department to find out how to get this in place. A POLST form, which is often printed on bright pink paper, is another medical order that is similar to, but broader than, a DNR Order. The name stands for Physician Orders for Life-Sustaining Treatment and it is exactly that — a medically binding order that states what you do, and don’t, want at end of life.  For more information about POLST forms, you can go here. Durable Power of Attorney A Durable Power of Attorney is a legal document that names Agents who can act for you financially, doing things such as writing checks on your behalf, paying your bills, managing your investments, withdrawing assets from your retirement accounts, and paying your taxes.  California offers a simple Durable Power of Attorney as part of its Probate Code.  You can find this many places, but here’s one link. Wills A Will is the last on my list of basic estate documents that everyone should have. If you don’t write one, each state has a set of rules that will determine who will get your property at death (called the laws of intestate succession)  and a judge will have to appoint guardians for your minor children without any input from you.  So, how can you make a Will right now, if you can’t leave the house? I have three suggestions: If you live in California, you can download a simple fill-in-the-blank form offered for free by the State Bar Association here. If you want to do a more customized Will, and you can afford to pay 89.99, you can use WillMaker, software that uses a question and answer format to produce Wills, Durable Powers of Attorney and Health Care Directives for all states, except Louisiana. You can download Quicken WillMaker and Trust 2020. You can create an Online Will for $59.99 at Nolo.com for all states except Louisana.

A Physician Orders for Life-Sustaining Treatment, or “POLST” makes sure that decisions about care at the end of life are written as medical orders that health care providers must follow. The POLST should list the medical care people do or do not want, given their current health condition. Without a POLST, emergency care providers generally must provide such medical treatment to keep people alive. Learn why this is so important to you on this episode of the Bottled Business Sense Show. View show at: http://wfblegalconsulting.com/bbss/ WFB Legal Consulting--LAWYER FOR BUSINESS--A BEST ASSET PROTECTION Services Group

Our guest co-host Ted Carr is back with us for this episode number 2 of our 4 part series. On our previous episode, we discussed why elderly parents fall for scams. This time, we will talk about the common myths of estate planning. Estate planning is one of the pillars of the strategic retirement planning concept. While it may be a task that gets misunderstood or procrastinated over, estate planning can provide a good direction for your loved ones in the future. Furthermore, it gives you a sense of relief as you think about where your household and assets go. Now just a disclaimer here- neither Ted nor myself are experts in the field of Estate Planning. We are just here to talk about our personal experiences. You would definitely want to discuss your own situation with an attorney. What Goes into an Estate Plan? When Les and I met our estate attorney, she talked to us not only about our assets but also about what happens if we get incapacitated. Even our very very naughty pet bird Mr. Grant was part of our estate plan. Nevertheless, you can revise your estate plan numerous times. Here's a list of items every estate plan should include: * Will/trust * A durable power of attorney * Beneficiary designations * Letter of intent * Healthcare power of attorney * Guardianship designations Also, you may add POLST (Provider Orders for Life-Sustaining Treatment) on your estate plan, it's an approach to improving end-of-life care in the United States, encouraging providers to speak with patients and create specific medical orders honored by health care workers during a medical crisis. If I Have An Estate Plan, I Can Avoid Estate Taxes The federal estate tax exemption has increased to $11.2 million per person (or $22.4 million per married couple), so it's unlikely you'll have pay to pay for an estate tax at all. It Is Important to Include Guardianship Designations to Your Estate Plan While many wills or trusts incorporate this clause, some don't. If you have minor children or are considering having kids, picking a guardian is incredibly important and sometimes overlooked. Make sure the individual or couple you choose shares your views, are responsible, financially sound and genuinely willing to raise children. It will give you peace of mind. Probate is an Estate Planning Nightmare Probate is expensive and time-consuming (will take about 2 years) and everything will be open to the public. Property is disposed of according to the laws of the state in which the deceased resided. If they find some personal information from your public records your estate could be vulnerable. The funny thing is that even though you spend all your time to have a private and personal life when you die everything is open to everybody. I Don't Need to Check My Beneficiaries It's one of the common mistake people do. While setting up a plan is a solid first step, keep in mind your salary and family situation can fluctuate over time. Make sure your beneficiaries are current, there are so many 401k plans that haven't had any beneficiaries. If you don't update your estate plan your beneficiary information could go out the window. A Will Can Overview the Distribution of My Assets 60% of people have no wills. A will is also a great first step. It allows you to lay out how your belongings should be distributed. However, it has no controlling power over joint accounts or beneficiaries. The only thing that the will has any control over our assets that are in the person's name alone. You can also start with a holistic will where you write a will on a piece of paper, sign it with the date included,

Considering your healthcare decisions in advance is an important part of creating an Estate Plan. The three healthcare documents that most people are concerned with are the POLST, Advanced Directive, and Healthcare Power of Attorney. POLST The POLST, or Provider Orders for Life-Sustaining Treatment) is a medical order not a legal documents. Not everyone needs a POLST. This document is prepared with a physician, and sets forth whether you would want extraordinary measures taken to save you life. These measures include CPR. Physicians will often start a POLST dialog with patients that are in declining health...this is not an order for everyone. Advance Directive An Advance Directive gives instructions for care for serious conditions when you are unable to make decisions on your own. Every adult should have an Advance Directive. In Oregon, Advance Directives take a form set forth in the Oregon Statutes. Effective January 1, 2019, Oregon has a new Advance Directive form. If you already have an Advance Directive it will still work, just know that if you fill out a new one it will look a little different. This document appoints your healthcare agents and gives them instructions related to feeding tubes and other artificial life-support measures. It allows you to refuse those artificial measures, state that you want them, or that you only want them on the advice of your physician. Healthcare Power of Attorney Like the Advance Directive, this document also appoints your healthcare agent. However, the Healthcare Power of Attorney gives your agent many more powers related to your healthcare decisions.  Some additional powers are: management of pain medications, coordinating in-home care, and coordinating your general medical treatment. The Healthcare Power of Attorney shines when you are not in an end of life situation, but are unable to make decisions for yourself. The Estate Plans that I prepare include an Advance Directive and Healthcare Power of Attorney (I call it an Advance Directive Addendum). These are important choices that every adult needs to make. If you'd like to learn more about Healthcare & Estate Planning or have any other Estate Planning questions, please schedule a complimentary Estate Planning Strategy Session.

Jennifer Henry, LSW, is a Research Project Manager with the VA HSR&D Center for Clinical Management Research at the VA Ann Arbor Healthcare System. In this podcast, she discusses her poster, “Integrating the Life-Sustaining Treatment Template into Current Processes in Community Living Centers.”

POLST: Physician Orders for Life-Sustaining Treatment. Why and when should you complete this form? Dr. Susan Tolle answers these important questions. She founded and has directed the Oregon Health & Science University Center for Ethics in Health Care since 1989. She has shepherded its growth into an internationally recognized ethics center with programs such as the Physician Orders for Life-Sustaining Treatment (POLST) program and the Oregon POLST registry. She is a practicing internist of general medicine and geriatrics at OHSU. #Portland

POLST: Physician Orders for Life-Sustaining Treatment. Why and when should you complete this form? Dr. Susan Tolle answers these important questions. She founded and has directed the Oregon Health & Science University Center for Ethics in Health Care since 1989. She has shepherded its growth into an internationally recognized ethics center with programs such as the Physician Orders for Life-Sustaining Treatment (POLST) program and the Oregon POLST registry. She is a practicing internist of general medicine and geriatrics at OHSU. #Portland

Most states have passed legislation to honor a type of advanced directive, commonly known as a POLST, for Physician Orders for Life Sustaining Treatment. It is basically a more detailed and specific DNR (do not resuscitate). Patients consistently report preferences to die peacefully at home but all too often end up dying in hospitals, with advanced medical interventions and an uncomfortable end. Most clinicians are not adequately prepared to address this issue. End-oflife care is about listening to patients and their families and engaging them in honest dialogue about options and outcomes--easy to say, but excruciatingly hard to do. This presentation will explore the economic and societal issues of end-of-life care for an aging society and encourage the use of an enduring set of medical orders guided by clinicians but chosen by patients and their families. This session will discuss POLST and ongoing research in the state of Oregon, which has proven that the POLST program more accurately conveys end-of-life preferences that are more likely followed by medical professionals. The POLST program has been a key vehicle in Oregon's successful efforts to increase the effectiveness of advance care planning and decrease unwanted hospitalizations at the end-of-life.

POLST: Physician Orders for Life-Sustaining Treatment. When and why should you complete this form? Dr. Susan Tolle answers these questions. She founded the Oregon Health & Science University Center for Ethics in Health Care and has directed it since 1989. Tolle has shepherded its growth into a now internationally recognized ethics center with programs such as the Physicians Orders for Life-Sustaining Treatment (POLST) Program and, more recently, the Oregon POLST Registry. She is a practicing internist of General Medicine and Geriatrics at OHSU.

POLST: Physician Orders for Life-Sustaining Treatment. When and why should you complete this form? Dr. Susan Tolle answers these questions. She founded the Oregon Health & Science University Center for Ethics in Health Care and has directed it since 1989. Tolle has shepherded its growth into a now internationally recognized ethics center with programs such as the Physicians Orders for Life-Sustaining Treatment (POLST) Program and, more recently, the Oregon POLST Registry. She is a practicing internist of General Medicine and Geriatrics at OHSU.

In this episode, the coach welcomes the Director of Family Services at Hospice of Central PA, Susan Resavy. They discuss the differences between Advanced Directives and a POLST (Physician Order for Life-Sustaining Treatment), and why they are becoming more commonplace across the country . Information on Hospice of Central PA on the web: http://hospiceofcentralpa.org/ on Facebook: http://www.facebook.com/HospiceOfCPA/ on Twitter: @Hospiceofcpa

Welcome, Medicare Nation! I’m excited about our guest and our important topic today. We’re discussing the confusion surrounding advanced directives. Have you ever thought about what would happen if you can’t speak for yourself and are in an emergency health situation? Who will express your wishes, and will the health care professionals understand? Dr. Ferdinando (Fred) Mirarchi is the ER Director of University of Pittsburgh Medical Center-Hamot. He has a solution!  Tell us about health care directives and the issues that commonly arise when people come to the ER. There are three types of directives: living will, DNR (Do Not Resuscitate order), and POLST (Physicians’ Order for Life Sustaining Treatment). All three of these have safety issues surrounding them, and all three bring questions. When are they to be followed? None of us know when an emergency situation may arise, so when do we carry these documents with us? Even medical professionals don’t understand these orders, but no one really wants to raise the safety concerns. What happens when someone comes to the ER with no accompanying family and no papers? It’s not just an ER situation, but anywhere in the hospital, for any medical procedure. “You, the patient, are asked if you have a Living Will, then you are subjected to whatever their understanding is as to what that means.” About 78% of the time, physicians assume that a Living Will equals a DNR, but in 64% of cases, a DNR is strictly an end of life order and does not apply to critical care emergencies. Medical professionals assume if you have any advanced directive that you’re an end of life care patient and don’t want care. Many don’t understand the difference between being critically ill and being in an “end of life” situation. If you have advanced directive documents, should you bring them with you to any scheduled procedure, like a colonoscopy? Most physicians would say YES, but I say NO. Keep your document in a safe place so that it doesn’t compromise your care and treatment. Pull it out when you need it, but then you face a retrieval issue. Will the proper medical professional have access to your papers when they need it? We have a process that can insure that those documents are retrieved when needed. Most ER doctors are forced to look at a paper and make an interpretation, based on THEIR understanding, which might not be right for you. Can you explain the difference in a Living Will and a DNR? A Living Will is a legal document, not a medical document. It is for use in situations when someone can’t speak for themselves, develops a terminal condition, or is in a persistent vegetative state. A DNR is specifically for when someone is found with no pulse or breathing, and no CPR is desired. There is a common misunderstanding that a DNR means no medical treatment at all, when it most often applies to end of life care. When someone has a Living Will and the medical professional assumes it’s a DNR, then it can affect care and treatment of any medical emergency. “It’s a coin toss with a 50% chance of being treated or not being treated.” You’ve developed a solution to help people explain their wishes about receiving treatment. Can you explain? At the Institute of Health Care Directives, we have created ID cards containing detailed information to be understood by any medical professional in any hospital. It gives patients a voice to guide their care and treatment. Your ID card has info and directives linked with a QR code that accesses a video recording of your wishes. The recorded video is in a database and can be pulled up on any smart phone for any medical situation you may encounter. Will this ID card work in any medical office, hospital, or ER? Yes, and it’s in clear and understandable medical language so that any professional will know what to do. Can you explain how to find out more and what the service includes? Visit our website: www.institutehcd.com or email us: info@institutehcd.com. You can even call us at 814-490-6584. Dr. Mirarchi is offering a 10% discount to the first 100 MN callers on either of the available packages. The Basic package is for healthy, young people, and the VIP package is for those with multiple medical problems. The VIP package gives you access to an on-call doctor 24/7/365. You can ask any question or any medical professional treating you can call for information about your condition. Our solution is a much clearer and simpler process and has received great response from physicians. The goal is to plan for when you are critically ill and (separately) for when you’re at the end of life. There is a study coming out in 3-6 months on a 15 state trial, and the preliminary results are amazing. This is truly a game-changer in the health care industry. Here is the news story video of the 57y.o. man who was mistakenly noted as "DNR" in his hospital file           whistle blower 9 Investigative news http://www.wsoctv.com/news/9-investigates/whistleblower-9/whistleblower-9-do-not-resuscitate-bracelet-mistakenly-put-on-hospitalized-mans-wrist/446014450    Here is a Parody Video on "Advanced Directives" https://youtu.be/S6XKv7MOuts Good Practice (A parody of Green Day's " Good Riddance") By Michael Barton Do you have questions or feedback? I’d love to hear it! I may answer one of your questions on the air! email me: support@themedicarenation.com Thank you for listening! If you enjoyed this podcast, please subscribe and leave a 5 star rating and review in iTunes! (Click here)     Find out more information about Medicare on Diane Daniel’s website! www.CallSamm.com            

PC Sanderson, A Massachusetts Medical Orders For Life - Sustaining Treatment (MOLST) Podcast 081916 by OPENPediatrics

Welcome, Medicare Nation! I’m excited about our guest and our important topic today. We’re discussing the confusion surrounding advanced directives. Have you ever thought about what would happen if you can’t speak for yourself and are in an emergency health situation? Who will express your wishes, and will the health care professionals understand? Dr. Ferdinando (Fred) Mirarchi is the ER Director of University of Pittsburgh Medical Center-Hamot. He has a solution! Join us to learn more! Tell us about health care directives and the issues that commonly arise when people come to the ER. There are three types of directives: living will, DNR (Do Not Resuscitate order), and POLST (Physicians’ Order for Life Sustaining Treatment). All three of these have safety issues surrounding them, and all three bring questions. When are they to be followed? None of us know when an emergency situation may arise, so when do we carry these documents with us? Even medical professionals don’t understand these orders, but no one really wants to raise the safety concerns. What happens when someone comes to the ER with no accompanying family and no papers? It’s not just an ER situation, but anywhere in the hospital, for any medical procedure. “You, the patient, are asked if you have a Living Will, then you are subjected to whatever their understanding is as to what that means.” About 78% of the time, physicians assume that a Living Will equals a DNR, but in 64% of cases, a DNR is strictly an end of life order and does not apply to critical care emergencies. Medical professionals assume if you have any advanced directive that you’re an end of life care patient and don’t want care. Many don’t understand the difference between being critically ill and being in an “end of life” situation. If you have advanced directive documents, should you bring them with you to any scheduled procedure, like a colonoscopy? Most physicians would say YES, but I say NO. Keep your document in a safe place so that it doesn’t compromise your care and treatment. Pull it out when you need it, but then you face a retrieval issue. Will the proper medical professional have access to your papers when they need it? We have a process that can insure that those documents are retrieved when needed. Most ER doctors are forced to look at a paper and make an interpretation, based on THEIR understanding, which might not be right for you. Can you explain the difference in a Living Will and a DNR? A Living Will is a legal document, not a medical document. It is for use in situations when someone can’t speak for themselves, develops a terminal condition, or is in a persistent vegetative state. A DNR is specifically for when someone is found with no pulse or breathing, and no CPR is desired. There is a common misunderstanding that a DNR means no medical treatment at all, when it most often applies to end of life care. When someone has a Living Will and the medical professional assumes it’s a DNR, then it can affect care and treatment of any medical emergency. “It’s a coin toss with a 50% chance of being treated or not being treated.” You’ve developed a solution to help people explain their wishes about receiving treatment. Can you explain? At the Institute of Health Care Directives, we have created ID cards containing detailed information to be understood by any medical professional in any hospital. It gives patients a voice to guide their care and treatment. Your ID card has info and directives linked with a QR code that accesses a video recording of your wishes. The recorded video is in a database and can be pulled up on any smart phone for any medical situation you may encounter. Will this ID card work in any medical office, hospital, or ER? Yes, and it’s in clear and understandable medical language so that any professional will know what to do. Can you explain how to find out more and what the service includes? Visit our website: www.institutehcd.com or email us: info@institutehcd.com. You can even call us at 814-490-6584. Dr. Mirarchi is offering a 10% discount to the first 100 MN callers on either of the available packages. The Basic package is for healthy, young people, and the VIP package is for those with multiple medical problems. The VIP package gives you access to an on-call doctor 24/7/365. You can ask any question or any medical professional treating you can call for information about your condition. Our solution is a much clearer and simpler process and has received great response from physicians. The goal is to plan for when you are critically ill and (separately) for when you’re at the end of life. There is a study coming out in 3-6 months on a 15 state trial, and the preliminary results are amazing. This is truly a game-changer in the health care industry. Do you have questions or feedback? I’d love to hear it! I may answer one of your questions on the air! email me: support@themedicarenation.com Thank you for listening! If you enjoyed this podcast, please subscribe and leave a 5 star rating and review in iTunes! (Click here)     Find out more information about Medicare on Diane Daniel’s website! www.CallSamm.com    

James Hynds, PhD, discusses the ethics of futile life-sustaining treatments in pediatrics. Series: "UCLA Pediatric Grand Rounds" [Health and Medicine] [Education] [Professional Medical Education] [Show ID: 29422]

James Hynds, PhD, discusses the ethics of futile life-sustaining treatments in pediatrics. Series: "UCLA Pediatric Grand Rounds" [Health and Medicine] [Education] [Professional Medical Education] [Show ID: 29422]

From BCB... http://bestofbcb.org/wu-128-end-of-life-conference-april-4/ Following last month's popular and sold out Aging-in-Place & The Villages Concept workshop, Sue Barrington invites the community to discuss and discover the options available, legal requirements, and benefits of planning for the end of our own lives at an End of Life Conference. To be held from 9 to 3 on Saturday April 4 at the Community Center, the conference offers an opportunity to join with others and learn how end-of-life planning can be the greatest gift we can give both ourselves and our loved ones.   During the course of the day doctors, lawyers, educators, and many others will offer insights in their areas of expertise. Among these will be Luke Carpenter of the BI Fire Department  (explaining the rules and regulations that make up the protocols that emergency responders must follow when 911 is called); Dr. Dick Baker, a retired teacher of family medicine at UW & UNC who currently volunteers as Medical Director for Compassion & Choices;  and Dr. Jeannette Franks, a passionate gerontologist who has taught ethics, grief and loss, and courses on geriatrics and gerontology for over 20 years at UW. Everyone attending will learn about and receive an official POLST form (Physicians Orders for Life-Sustaining Treatment) and by day's end, can leave with a legal document ready for use. This form can provide security for patient and physician that patient's wishes will be carried out. The $40.00 conference fee includes a binder of information, official documents, & lunch.  For more information, visit www.biparks.org or call 206-842-1616. Credits:  BCB host, writer, and audio tech Joanna Pyle; BCB audio editor Lyssa Danehy de Hart; BCB publishers Chris and Diane Walker.

In this episode of Living Care Radio, host and elder law attorney, Darol Tuttle, discusses the five levels of estate planning. Analogizing in a fun way to a video game, Darol discusses the entry level of estate planning which is simply putting into place powers of attorney and so called "Living Will." More about Living Wills in a moment. Next, Darol introduces the idea of "Level 2" which is simply adding to Level 1 with a Last Will and Testament. It is imperative, if married, to include a trust created at death for the benefit of the surviving spouse that holds funds for his or her long term care. The reason that this is important is to finance skilled nursing costs with jeopardizing important Medicaid benefits. This is often overlooked in planning and can cause the assets of the surviving spouse to be depleted unnecessarily. Level three involves the use of a Revocable Living Trust or other devices to avoid probate. The rest of the show was dedicated to higher levels of planning to finance care. Darol again interviewed Lisa Doyle, owner of CayCare and a registered nurse, and discussed an incident in California in which a 87 year old woman suffered a heart attack in a common area of an Independent Living Community and a staff member of the community refused to perform CPR, citing company policy. The incident was discussed from the perspective of Washington law, which provides for a Physician's Order on Life Sustaining Treatment and Advanced Directives. Advanced Directives are also known as Living Wills and Darol discusses the two documents and there differences.

The first report reviews medical statistics commonly used in "risk" shared by physicians when patients are making an informed decision. The second report reviews a new program (Physician Orders for Life-Sustaining Treatment or POLST) aimed at refining end of life decisions.

Background: Advance Care Planning (ACP) is an emerging strategy to ensure that well-reflected, meaningful and clearly documented treatment preferences are available and respected when critical decisions about life-sustaining treatment need to be made for patients unable to consent. In Germany, recent legislation confirms that advance directives (AD) have to be followed if they apply to the medical situation, but implementation of ACP has not yet been described. Methods/Design: In a longitudinal controlled study, we compare 1 intervention region (4 nursing homes [n/hs], altogether 421 residents) with 2 control regions (10 n/hs, altogether 985 residents). Inclusion went from 01.02.09 to 30.06.09, observation lasted until 30.06.10. Primary endpoint is the prevalence of ADs at follow-up, 17 (12) months after the first (last) possible inclusion. Secondary endpoints compare relevance and validity of ADs, process quality, the rate of life-sustaining interventions and, in deceased residents, location of death and intensity of treatment before death. The regional multifaceted intervention on the basis of the US program Respecting Choices (R) comprises training of n/h staff as facilitators, training of General Practitioners, education of hospital and ambulance staff, and development of eligible tools, including Physician Orders for Life-Sustaining Treatment in case of Emergency (POLST-E). Participation data: Of 1406 residents reported to live in the 14 n/hs plus an estimated turnover of 176 residents until the last possible inclusion date, 645 (41%) were willing to participate. Response rates were 38% in the intervention region and 42% in the control region. Non-responder analysis shows an equal distribution of sex and age but a bias towards dependency on nursing care in the responder group. Outcome analysis of this study will become available in the course of 2011. Discussion: Implementing an ACP program for the n/hs and related health care providers of a region requires a complex community intervention with the effect of nothing less than a cultural shift in this health care sector. This study is to our knowledge the first to develop a strategy for regional implementation of ACP, and to evaluate its feasibility in a controlled design.