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Medical Orders for Life-Sustaining Treatment

Below is a transcript of the video Medical Orders for Life-Sustaining Treatment (MOLST). This video is part of a five-part series that describes Advance Directives, which document your decisions about your medical care in the event that you cannot speak for yourself in the future.

Click here to view the video.

Narrator:

Let's start with just a bit of history about the MOLST. It has an odd name, but the letters stand for Medical Orders for Life Sustaining Treatment.

In recent years, those in the medical community have determined that there is a need for one comprehensive document that very accurately states what a patient would want as their life sustaining medical treatment.

While other kinds of Advance Directives have been in existence for many years, the MOLST, or Medical Orders for Life Sustaining Treatment, has been recently developed by New York State to ensure your medical wishes are very clear.

Christina Fineberg, Director of Social Work, McAuley Residence:

As a social worker in a nursing home, we see a lot of different personalities. We see a lot of family dynamics. And when a resident doesn't have a health care proxy or their medical wishes known, especially at the end of life, there's a lot of anxiety. There's a lot of emotions at play, and a lot of people want to voice their opinions. And the team, as healthcare providers, want to do what's best for that resident. And we can't, when we don't know specifically what a person wishes are and we have all of these personalities at play; it becomes very difficult to try to do what's best for that resident.

When we know what their wishes are, we can help guide the families or friends through their anxiety and answer their questions, be reassuring that they're following mom's or dad's wishes or their person's wishes, and get pastoral care involved and just provide the support that they need to get through this difficult time.

Narrator:

The MOLST is always on brightly colored pink paper so that it can be found quickly because the information it contains is so very important to your medical care.

The MOLST addresses, in very specific ways, things such as:

  • CPR (cardiopulmonary resuscitation)
  • Intubation and mechanical ventilation
  • Artificial hydration and nutrition
  • Future hospitalization and transfer, or
  • Antibiotics

The MOLST is for people who are expected to be in the last one to two years of life due to a predictable disease. Most people fill out a MOLST form while living in a nursing facility, in assisted living, or in the hospital for an acute problem.

The MOLST has multiple sections that are witnessed by a healthcare professional.

A MOLST is so important that is it strongly recommended that it be filled out with close family members present. A skilled health caregiver will be provided to answer any questions.

Your health care proxy agent may also fill out a MOLST form for you if you lack the ability to make your own decisions.
 

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