Palliative Care
Tools for Advance Care Planning
Advance Directives
An Advance Directive form allows patients to make end-of-life choices about their future care if they lose the ability to make decisions for themselves. The Rochester community has created a common Advance Directive form that addresses two kinds of advance directives:
- The Health Care Proxy allows an individual to designate a person to make decisions on his or her behalf if the individual becomes unable to do so. The Health Care Proxy should be knowledgeable about the patient's wishes and values, and should make decisions as he/she believes the patient would make under the circumstances.
- The Living Will allows an individual to set out his or her philosophy about medical decision-making if the individual loses the ability to speak for himself or herself in the future.
Medical Orders for Life-Sustaining Treatment
Medical Orders for Life-Sustaining Treatment (MOLST) is a document designed to help health care providers honor the treatment wishes of their patients. This document:
- Summarizes a patient’s current treatment preferences with regard to:
- Do-Not-Resuscitate (DNR)
- Do-Not-Intubate (DNI)
- Future hospitalization
- Feeding tube
- Other treatment preferences
- Centralizes information on these issues
- Facilitates record keeping
- Ensures transfer of appropriate information between health care providers and between health care settings
The MOLST form does not replace advance directive documents (see below). The MOLST characterizes a patient's current treatment preferences, whereas an advance directive helps guide medical decision-making if patients lose the ability to speak for themselves in the future.
All of the acute care hospitals in Rochester and many of the hospitals and nursing facilities in Western New York State are now using the MOLST, which has been formally recognized by the New York State Department of Health. In addition to its widespread use, on a trial basis in Monroe and Onondaga Counties, the MOLST can now serve as a substitute for the non-hospital DNR form. This allows the orders and limitations to be completed once and reviewed/updated as necessary to remain in effect when a person changes medical facilities or if his or her preferences change in the future.
To learn more, see MOLST Frequently Asked Questions (FAQs).
Still have questions about the use of the MOLST at Strong Memorial Hospital? See Facts and Misconceptions about the new MOLST forms.
Clinical Tools for Medical Professionals
Pain Management Pocket Card
Most health care providers throughout the hospital
and Rochester community have been trained in the World Health Organization
(WHO) pain
standards. We are committed to comprehensive pain assessment and
treatment for patients experiencing moderate to severe pain. As
part of that commitment, we have worked with experts in palliative
care and pain management to create convenient and age-specific pocket cards—one for children and one for adults—with prescribing
principles and guidance about medication dosage.
The End of Life/Palliative Education Research Center (EPERC) seeks to advance End of Life Care through an online community of educational scholars and clinicians, providing easy access to many resources. Fast Facts & Concepts are peer reviewed, one-page outlines of key information on important end-of-life topics.
Commonly Used Forms
Consultations:
- New Monday afternoon outpatient Palliative Care Clinic: In addition to the usual Thursday morning palliative care consultations provided by Tim Quill, MD and Kathy Kennel, NP, we will now be adding a second half day (Monday afternoon) staffed by Drs. David Korones and Jeffrey Allen. Both of these sessions will be held on AC3 in the oncology outpatient area. The service is not limited to oncology patients, as we are prepared to see adults with a wide range of medical and palliative care problems. In addition, outpatient pediatric consults can be arranged with David Korones on a case-by-case basis. We look forward to helping your patients maximize the quality of their lives while they are simultaneously receiving the best possible treatment of their diseases.
To obtain an inpatient or outpatient consultation or to inquire about other available palliative care services, please call (585) 273-1154.
|
