MOLST – Medical Orders for Life Sustaining Treatment
In addition to an advance directive, your loved one should talk with his or her health care provider about a Medical Orders for Life Sustaining Treatment (MOLST). This is literally an order from a doctor detailing the life support treatments your relative wishes to receive or not receive. Think of it like a prescription.
Across all settings In the chain of command of the medical system, a MOLST provides the instructions for all the other people on the health care team. No matter where your loved one is—at the hospital, in a skilled nursing facility, or at home with EMTs (emergency medical techs) from a 911 call—the MOLST makes it clear what the staff is supposed to do, or not do, to be true to your loved one’s wishes.
Shared decision-making tool Although the order is from the doctor, the MOLST is designed to be a tool to assist in a conversation with your relative. The doctor can describe the different life support measures, their pros and cons. It is your loved one who makes the decision about which ones feel right for his or her values and desired quality of life.
Your loved one stays in control With a MOLST, your relative’s choices are what matters. He or she has set the course ahead of time so care unfolds according to his or her wishes, even if your loved one is unconscious or unable to speak when the time comes.
Get help with the conversation If you would like to have someone to talk to about the MOLST, give us a call at 508-888-2898. We are well-versed in this document and have people dedicated to answering your questions!
The doctor will keep it in his or her medical records. If the doctor’s office is linked up with the local hospital’s electronic record system, they will have it also. You should ask for a copy. Keep it on the refrigerator at your loved one’s home. Emergency medical techs (the people who respond to 911 calls) are trained to look there for important documents and instructions like the MOLST. If you are driving to the hospital yourselves, without an ambulance, try to remember to bring the MOLST with you. It simply helps to keep it with your relative at all times.
• How is a MOLST different from an advance directive?
Many people wonder whether they need to complete a MOLST AND an advance directive. The answer is YES. An advance directive names your loved one’s preferred decision maker. It also gives a general sense of preferred life support measures. Advance directives can come in several formats and they are not always the same. They often include room for more descriptions, like a conversation. In an emergency, medical staff need short, easy to find, quick instructions. A MOLST provides that and makes sure that each of the possible life support measures has been addressed.
• Can a MOLST be changed?
Yes. As long as your loved one is conscious and can talk to the doctor about his or her wishes, a new MOLST can be created. It will be put in the medical records and your relative will be given a new form to replace the old one.
• Where can we learn more about life support measures?
Check out our article about Health Care Planning. There is a section about life support measures. For each intervention, it will give you some facts about success rates, long-term consequences, risks and benefits. Reading this before meeting with the doctor can help your loved one prepare questions for the conversation.
• Should everyone have a MOLST?
No. Unlike an advance directive, a MOLST is just for people who are seriously ill. If your loved one does not want to have this discussion, a MOLST is not required. Having a MOLST simply adds greater certainty that all desired medical treatments, and only the desired medical treatments, will be employed.
Want to talk?
If you or your loved one have questions about the MOLST, or about advance directives, give us a call at 508-888-2898. Our knowledgeable team can give you and your loved one the time that is needed to fully understand and work through the options.
What can you do to help your loved one make an appointment to create a MOLST with his or her health care provider?
I am beyond grateful for the comprehensive, compassionate care provided by Grace Life Care, sensitively delivered by founder Kerry Davis and her colleague Maureen Costa. As an out of state caregiver, I was overwhelmed by the challenge of securing care for my mother. Kerry and Maureen combine their medical expertise and expansive network of resources to offer all-encompassing care management services. They are coordinating my mom’s overall medical care. They were instrumental in helping my mom successfully settle into assisted living, ensuring a smooth transition via frequent visits to, and communication with, the assisted living community and providing opportunities for thoughtful engagement in the broader community, where my mom spends time with Maureen one-on-one. I am indebted to them for the support they continue to empathetically provide to my mom (and to me).
Grace Life Care has been such a blessing in my moms and my life. There is absolutely no way I could have navigated the past couple of years without Kerry. Caring for my mom with dementia while living out of state along with being the only family member after my dad and sister passed, has been the most challenging time of my life. She is currently in a Memory Care Facility. Kerry and now Maureen visit weekly and help coordinate care for my mom.I am so thankful for Grace Life Care. Truly angels on earth.
As an attorney I need someone I can trust to assist me in helping elderly clients manage their medical needs when family is not an option. Grace Life Care has handles several clients for me all with positive outcomes.
I have had the pleasure of working professionally with Kerry for quite a few years. Moving to an assisted living community can be overwhelming for a senior navigating the process on their own and also for family members who don't live locally (or do!). Our families who have worked with Kerry are grateful for her knowledge as an RN during medication changes, hospitalizations or other medical concerns. She is an advocate for her clients. If you need help managing the care of an senior relative or yourself, I would recommend calling Kerry to see if she can help!