Podcasts about life sustaining treatment polst

128 Fall Prevention Strategies for the Elderly: Insights from Hospice Explained Fall Prevention Strategies for the Elderly: Insights from Hospice Explained In episode 128 of Hospice Explained, host Marie Betcher, RN, discusses crucial fall prevention strategies for the elderly. She shares a personal experience with falling and highlights various factors contributing to falls, including age, medication, environmental hazards, and pride. Marie emphasizes the importance of clear walking spaces, proper footwear, reviewing medications with healthcare providers, and the benefits of physical therapy. She also advises on handling falls if they occur, especially for hospice patients, and the importance of using tools like the Physician Order for Life Sustaining Treatment (POLST) form for preventing hospital transport, if needed to get the Fire Dept. for a "Mercy Lift".   00:00 Introduction to Hospice Explained 00:29 Episode Introduction and Host Welcome 00:37 Personal Fall Incident and Initial Thoughts 01:24 Common Causes of Falls 01:41 Environmental and Seasonal Hazards 02:18 Addressing Chronic Conditions and Footwear 03:07 Distractions and Other Fall Risks 04:01 Pride and Mobility Aids 05:33 Practical Tips for Fall Prevention 06:31 Exercise and Physical Therapy 07:28 Concluding Thoughts on Fall Prevention 08:14 Hospice Specific Safety Considerations 09:03 Final Remarks and Podcast Closure     Finding a Hospice Agency 1. You can use Medicare.gov to help find a hospice agency, 2. choose Find provider 3. Choose Hospice 4. then add your zip code This should be a list of Hospice Agencies local to you or your loved one.  Hospice Explained Affiliates & Contact Information Buying from these Affilite links will help support this Podcast.   In addition you can donate to help support Hospice Explained at the Buy me a Coffee link  https://www.buymeacoffee.com/Hospice Kacie Gikonyo's Death Doula School https://hospiceexplained--deathdoulaschool.thrivecart.com/death-doula-school/ Affilitate for the Caregiving Years Training Academy:  https://www.careyearsacademy.com/ref/1096/  Affiliate for DNA is Love listeners also get a 5% discount!! https://dnaislove.com/?coupon=hospiceexplained5  The Death Deck and the E*O*L deck:  https://thedeathdeck.goaffpro.com/  Marie's Contact Marie@HospiceExplained.com www.HospiceExplained.com  

Join special guest, Leonard R. Hock Jr., DO, MACOI, CMD, and our host, Diane Sanders-Cepeda, DO, CMD, for this episode of FMDA's Journal Club, Resident Wishes: DNR, POLST, Advanced Care Planning, and More. Our learning objectives for this session were: Discuss current approaches to advance care planning. Revisit the value and limitations of do-not-resituate (DNR) orders. Describe the opportunities and challenges for Physician Orders for Life-Sustaining Treatment (POLST) in Florida. Discuss the future state of advance care planning, palliative, and hospice care delivery. Recorded: August 31, 2022 Special Guest: Leonard R. Hock Jr., DO, MACOI, CMD Hosted by: Diane Sanders-Cepeda, DO, CMD Available Credit: The American Board of Post-Acute and Long-Term Care Medicine (ABPLM) issues CMD credits for AMDA On-The-Go and affiliate podcast episodes as follows: Claim CMD Credit

Living Will. DNR. Advance Directive. POLST.  You know these forms are important. But are they the same? Do you need all of them? What are they for? And when would you need them?   Forms are location specific. Do an online search for "[where you live] and [name of form]" or ask your lawyer to get the right version for you.   Recap of summary:  Everyone over the age of 18 should specify their wishes and designate a health care proxy, ideally with an Advance Directive or Living Will and Medical Power of Attorney If you're close to the end of life or frail and the risk of complications from resuscitation would not be worth it, that's when you want a Do Not Resuscitate (DNR) order If you're close to the end of life and don't want to artificially extend your life and you want to be sure that your wishes are honored (and it's available in your area), get a Physician Orders for Life Sustaining Treatment (POLST)

Maureen Kures, RN is the CEO of www.RadiantMourning.com. She is on a mission to guide families to decide, document, and discuss their final chapter plans to bring peace for those who live on. Now she facilitates family conversations and leads virtual group workshops to replace drama, trauma, and chaos with calm, ease, and peace. A few highlights from the show: 1. Physician Orders for Life-Sustaining Treatment (POLST) is a form for people with life-limiting illnesses who frequently require emergency medical care. https://polst.org/ 2. DNR or do not resuscitate is an important part of the form. It is only valid in a hospital setting. If you are having surgery, ask your surgeon if a DNR will be reinforced during surgery. 3. Full estate planning is important even if you believe that you don't have much to leave behind. 4. Anyone can get Advance Directive forms off the internet for free and they can be changed at any time. Typically two witnesses or notary public are required in order for it to be valid. 5. Regret is a wasted emotion. Learn from what has happened and grow. Follow and learn more about Maureen at: https://www.facebook.com/radiantmourning https://www.linkedin.com/in/maureen-kures-48377126/ https://www.youtube.com/channel/UCz9b2fdIAVwk_AfveOV2khQ Free Guide: http://startthetalknow.com/ About Me: In 2011, I was diagnosed with Hodgkin's Lymphoma, out of the blue. I did not have any prior health concerns or issues. Fast forward, the dreaded cancer diagnosis opened my eyes, introduced me to my purpose, and lead me to where I am today. As a Cancer Doula, I use my 10-years of experience with cancer to support and guide others diagnosed with cancer. Many people are not familiar with what a cancer doula is. Think of me as a personal health care advocate. Schedule a free 30-minute meet and greet call to learn more. https://bit.ly/OTOSDiscovery Looking for a gift for yourself, a friend, or a loved one who has been diagnosed with cancer or they are a caregiver? Visit my shop. Thanks for joining us on today's episode of the Navigating Cancer TOGETHER podcast! If you enjoyed today's episode, please head over to Apple Podcasts and leave a rate and review to help me reach even more people that are facing cancer. Make sure you visit On the Other Side, follow me on Instagram, or sign up for my bi-weekly newsletter to get information and resources related to cancer. https://www.ontheotherside.life/ --- Send in a voice message: https://anchor.fm/navigatingcancertogether/message Support this podcast: https://anchor.fm/navigatingcancertogether/support

Jonathon Feit, co-founder and CEO of Beyond Lucid Technologies & Consulting joins The Dish on Health IT hosts, Ken Kleinberg, Pooja Babbrah and special guest host Ed Daniels to talk about the role of emergency services (EMS) in the healthcare ecosystem now and in the future and how EMS fits into healthcare's interoperability journey. The hosts, Ken Kleinberg and Pooja Babbrah briefly introduced themselves. Guest host, Ed Daniels introduced himself by saying that the majority of his career has been spent on interoperability, data exchange and HIEs. Ed was a volunteer firefighter for 14 years and is currently working on the development of a multi-stakeholder collaborative on eConsent which is why this discussion was of particular interest to him. Jonathon then introduced himself explaining that he is not a field practitioner or first responder. He shared that he joined the military after September 11, 2001 but discovered that his Tourette's syndrome disqualified him from service, which led him to find another way to serve. He decided to leverage his skills as a technologist to solve problems related to data exchange to support EMS and first responders. Beyond Lucid, the company Jonathon co-founded is focused on solving these issues. Right now, Beyond Lucid spends half of their day in the world of Fast Healthcare Interoperability Resources (FHIR), EMS, critical care both ground and air, the other half of the day is in the world of electronic health records (EHRs) focusing on things like patient matching. Beyond Lucid is currently running the Oregon Portable Orders for Life Sustaining Treatment (POLST) registry from a technology standpoint and are branching into pediatrics and medical complexities. What Jonathon finds interesting about this work is identifying what field providers do and what they need. Using end of life medical orders as an example, Jonathon pointed out that there is really a 0% margin of error. If someone has indicated in their records that they don't want to be resuscitated but first responders are unaware of these records, the patient's wishes may not be followed. Another aspect of data exchange from the field to health systems so that data captured in the field can be incorporated into the patient's record fast enough for it to be useful in how the patient is cared for in the emergency room (ER). The future of Beyond Lucid is focused on car crashes, winning a patent on a system to gather crash intelligence about the passengers such as number of passengers, whether children are in the car, or special medical needs of passengers such as hemophilia. There are mission critical pieces of data that need to be exchanged in real-time. What prompted Jonathon to reach out to Point-of-Care Partners initially was the episode of the Dish on Health IT about social determinants of health (SDOH) because it highlighted patient data that helped look at patients as people. SDOH is important to providing holistic care. Host, Ken Kleinberg asked for a little more context of how EMS fits in the overall healthcare ecosystem, asking specifically about how EMS has historically been billed separately from other healthcare services as transport. Mr Feit explained that yes, it's true that EMS is billed as transport is many places but it's a yes with an asterisk because things are changing due to COVID. He explained that you really have to look more broadly to federal laws and how EMS is regarded. For example, up until the last 18 months, CMS regarded EMS as a supplier to healthcare, not a provider. This impacts not only how services are billed but related to interoperability rules as well.  Meaningful use doesn't apply to EMS which is a big problem because EMS uses a different data set that falls under the department of transportation and not Health and Human Services (HHS). He added that EMS is the most expensive taxi ride you'll ever take. With the exception of one value-based care experiment happening now, EMS services are generally billed on a per mile basis and the rate is cost adjusted based on the experience level of the driver and the severity of the patient. EMS is emerging as a central part of safety net care in rural spaces where there aren't enough doctors to serve the population and the fact that it's a service available 24/7. Viewing EMS as a provider is a critical distinction that's starting to change. Ed agreed with how Jonathon characterized the current view of EMS in healthcare generally and in regulation. Ed explained that historically, ambulances were intended to just get the patient into the hospital as soon as possible but it's changed drastically over the years with life-saving services being performed on site and in transit. Ambulances are no longer just transport but definitely a provider situation. It's time for a change in how this type of care is provided and being billed and reimbursed.Ken observed that it would be a real problem if the patient was charged in hospital for how far they were pushed in a wheelchair from their room to get a test. Ken then asked Pooja if there was a parallel between how pharmacists have transitioned to be part of the care team as opposed to an adjunct service. Pooja responded that she does see some parallels and mentioned reading a CMS blog post by Chiquita Brooks-LaSure and other CMS leaders that discussed the Center for Medicare and Medicaid Innovation (Innovation Center) which explored 50 alternative payment models to fee for service. While only a handful were considered successful, the ones that had some success had mandates to back them up. Pooja added that she thinks that just as the payment model in pharmacy is being revisited, the payment and reimbursement model for EMS should be re-examined as well. Ed added that another scenario where the pay for transport model for EMS just doesn't make sense is when a patient maybe just needs to get emergency care at home but doesn't need to be transported to the hospital. The current reimbursement structure doesn't allow for this. Jonathon pointed out that there is currently an “allergy” in the mobile medical arena to good data. He went on to clarify that when you mention CMS, where they have extremely wonky geeks who are truly good at their job, people forget they need fuel for their work, they need data. Jonathon went onto explain that when creating mandates versus voluntary guidance, you really need not just data but good data to back that up and see what is working and what's not. Right now, entering in information about a patient encounter by EMS staff isn't a priority because there isn't an understanding of how good data could transform things for the better. EMS has so much catching-up to do. Jonathon added that this lack of good data problem isn't unique to EMS by any means but it's an issue that needs to be tackled for us to see real change. Jonathon explained that part of the reason he reached out to Point-of-Care Partners was because he felt we provide a breadth of perspective to these issues in healthcare that reflects the bigger picture. He added that when docs talk to other docs or nurses and EMS techs to talk to Fire fighters, they aren't hearing from outside their environment to gain that broader perspective and close the gaps in understanding about their role in the ecosystem. He continued to say that we need to make the case why it's so important to get good data into the system and for that data to be fluid across environments. Ken interjected and said that now that the now we're getting into the interoperability part of the conversation, he wanted to ask about the system that's generally used by EMS called The National Emergency Medical Services Information System (NEMSIS) and asked if it was connected to EHRs.Jonathon responded that NEMSIS is separate and therefore and unequal data set maintained through the National Highway Safety Administration. It has a rich history of tracking data for car crashes and heart attacks while driving which Jonathon admitted was a gross over-simplification. There is a way for NEMSIS to connect to EHRs but there hasn't been education and discussion from the federal level down to the state, county and regional level on why the data and connecting to EHRs matters. Beyond Lucid was awarded a project in California back in 2015 to build the bridge between NEMSIS using HL7 standards like CCD. Beyond Lucid completed a gap analysis to understand what it would take to go from one to the other. What they found was an 85% overlap between what was required in the EMS system and the HL7 CCD. The 15% gap fell largely in 3 buckets including family history, past encounters and mental health which is very similar to SDOH. There are efforts to plug this hole with real-time data. Jonathon added that there are other efforts giving an example the largest fire service in Southern Denver, Colorado which was the first to send real-time data to Sentara health system in 2018 which shows it can be done, however, Jonathon added that health systems and EMS aren't doing a good job of talking with each other about their respective needs. Ken asked Jonathon to talk about Beyond Lucid being one, if not the first EMS IT vendor to join the Commonwell Health Alliance and whether they are now getting some SDOH data from HIEs. Jonathon explained that about 2 years ago at the National Association of State EMS officials, there was an outcry for SDOH and contextual data. Up until then this demand was mostly at the local level. Beyond Lucid volunteered to be the vendor to make this possible and develop a superset of data and has announced this capability to populate SDOH data for 911 calls. This project made a lightbulb go off for those involved on why this data should be a separate data set when it really should be integrated in the overall record. Jonathon explained that strong ID is really important because especially when you're looking at end of life orders, you want to make sure you're looking at the right patient. Unfortunately, a lot of initiatives required affirmative permission from he patient to look them up but the problem is that this doesn't work in the back of an ambulance. Ultimately the trust framework is critical but right now there is so much dirty data. Jonathon went on to say that now that FHIR V4 has been balloted and approved and Carequality/Sequoia was awarded the trust framework project, it seems progress is being made and EMS is finally at the table. Ken asked Pooja to provide her perspective on how EMS might use SDOH and eConsent and advanced care directives. Pooja shared that when you think about the knowledge first responders gain about a patient's living situation and environmental challenges, it makes sense that they could contribute valuable SDOH data that could be used downstream. It's about time the industry start looking at how the data going into EMS systems can be shared along the care continuum. Jonathon interjected that it's also important for police to have access to some of this information and that Beyond Lucid has helped create a database of medically complex children so police know if they are interacting with someone that perhaps is non-verbal so can't explain their situation or who can't follow verbal commands. Without this information Police encounters can end tragically. Encounter data really needs to flow throughout healthcare and also community services. Ken re-focused the conversation on eConsent. Ed shared that he is working on an initiative now on how to get electronic informed consent and advanced directives. It's a very complicated question and there isn't one answer. Ken began to close out the podcast by asking Jonathon if there was any last topic he'd like to cover suggesting perhaps something about COVID and vaccines since Jonathon had mentioned this in conversations prior to the podcast. Jonathon responded that he knows vaccines can be controversial and really he isn't talking about vaccinations per se but it's important to talk about interoperability and data quality and that for many years vaccination registries didn't talk to each other or couldn't be accessed by providers. This is important in the context of when you're planning to hold someone to account on getting vaccinated and proving they've been vaccinated. Jonathon posed the question that shouldn't there be a single source of truth rather than asking people to hold onto a little card? If we get the smart people in the room to solve these problems, we can make so much progress. Pooja added that in her role on the NCPDP board, they've had many conversations about how to use existing standards to create a central source of truth. Pooja explained that she's glad we were able to have this important discussion. 

Dr. Steven Baumrucker and Amy Vandenbrouke, JD, Director of National POLST, discuss Physician Orders for Life Sustaining Treatment (POLST) and the push for a national standard.

Thousands upon thousands of pro-lifers are preparing for the March for Life 2020 to make their presence known and voices heard in defense of the unborn and their mothers. The 47th annual March for Life in Washington, DC takes place on January 24th. This year’s theme, “Life Empowers: Pro-Life is Pro-Woman” carries a special historic moment with it. 2020 marks the 100th anniversary of the 19th Amendment of the Constitution which guarantees women the right to vote. The movement to pass the 19th Amendment was led by women suffragists, considered the early pioneers of the feminist movement, who understood that abortion ends a life and harms women. To delve into the details of this year’s March and today’s pro-life movement we speak with Jeanne Mancini, President of the March for Life. Then in our mailbag segment, we answer questions regarding end-of-life care decisions and POLST forms that many doctors ask patients to fill out. We wrap up the show with our bricklayer segment, giving you practical tips on how to begin building bridges between faith and politics one brick at a time. This week we discuss how to get involved with a local March for Life. Useful Links: Minnesota's March for Life: https://www.mccl.org/march Archdiocese of St. Paul & Minneapolis March for Life registration: https://www.archspm.org/marchforlife/ Catholic Healthcare Directives & End-of-Life Care Decisions Guide: www.MNCatholic.org/healthcaredirective Response to MMA revisions of the Provider Orders for Life-Sustaining Treatment (POLST) form: https://www.mncatholic.org/response-mma-revisions-provider-orders-life-sustaining-treatment-polst-form/ A Pastoral Statement on Physician Orders for Life-Sustaining Treatment (POLST): https://www.mncatholic.org/stewards-of-the-gift-of-life/ Guidance for completing the POLST form: https://www.mncatholic.org/guidance-completing-polst-form/

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

Join Dr. Lael Duncan and TNS host Steve Heilig for a wide-ranging discussion of innovations and controversies in end-of-life care. Lael is the medical director of consulting services for the Coalition for Compassionate Care of California, a Sacramento-based non-profit organization and interdisciplinary partnership of thought-leaders dedicated to promoting high-quality, compassionate care for everyone who is seriously ill or nearing the end of life. She is an expert educator on Physician Orders for Life-Sustaining Treatment (POLST), end-of-life communication between patients and providers, advance care planning, and legislation that impacts end-of-life care in California. Dr. Duncan consults with health care organizations, medical providers, and communities to improve access to care that honors patient values.

Randi Belisomo, DBe, is the President and Co-Founder of Life Matters Media. She serves as a reporter at WGN-TV in Chicago and is a frequent contributor to Chicago Public Radio, Relevant Radio and WGN 720 AM. She writes about issues related to end of life healthcare and policy for Reuters Health.Belisomo holds a doctorate from Loyola University-Chicago in bioethics and health policy, as well as an M.S.J. from Northwestern University’s Medill School of Journalism. She is a Phi Beta Kappa graduate of the University of Notre Dame. She is a multiple Emmy Nominee and a Peter Lisagor Award winner for best in-depth series, best feature and best sports story.She currently serves on the boards of Living Water International and Mental Health America- Illinois. She is a chair person of the Carlos Hernandez Award in Meritorious Journalism at DePaul University and a member of the Illinois Task Force for the Physician Orders for Life Sustaining Treatment (POLST). She is a Respecting Choices certified advance care planning facilitator and instructor.Having served as a caregiver and widowed at a young age, Belisomo knows that end of life issues impact everyone at some point. She hopes that through the work of Life Matters Media, the inevitable challenges with which life presents and often surprises us will be made easier for the organization’s audiences. See acast.com/privacy for privacy and opt-out information.

We have a great podcast this week exploring the advance care planning needs for hospitalized adults and what palliative care teams are doing (and not doing) to meet these needs. We've invited Kara Bischoff, a palliative care doctor and Assistant Professor at UCSF in the Department of Hospital Medicine, who published a paper in JAMA Internal Medicine on this very topic. Why was this JAMA IM paper so important for those who work in our field? This was a real world study, looking at over 73,000 consultations from the Palliative Care Quality Network (PCQN). They found palliative care teams consistently identified surrogates for patients, often addressed their preferences regarding life sustaining treatments, including code status, and frequently found a preference regarding life sustaining treatments that was different than what was previously documented before the consult. But rarely completed advance directives (only 3.2% of patients seen by palliative care teams) or Physicians Orders for Life-Sustaining Treatment (POLST) forms (12.3% of patients seen by palliative care teams).

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.

Guest: Karl Steinberg, MD, CMD Host: Eric Tangalos, MD "Advance directive" is an umbrella term that encompasses end-of-life documents, including a living will and durable power of attorney for healthcare. Such documents can be scary for many patients, and as such, advance directives are not very common among the general US population. Yet these documents can be powerful tools in ensuring patients receive the type of care they desire. What do physicians need to know about advance directives in caring for patients at the end of life? Dr. Karl Steinberg, associate medical director for skilled nursing care at Scripps Coastal Medical Center in Vista, California, discusses variations, misconceptions and confusion surrounding advance directives, and says there is room for improvement. Many states have enacted Physician Orders for Life Sustaining Treatment (POLST) programs to address end-of-life care issues. What do these programs involve, and how effective are such programs in alleviating confusion with end-of-life care? Dr. Eric Tangalos hosts.