What is a MOLST form? Do I need it? Planning for end-of-life...

MOLST stands for “Medical Orders for Life­Sustaining Treatment”. 

It is a form filled out by a physician and it contains actual orders in regards to important end-of-life issues. Other health care professionals in different settings must follow these orders.

The Department of Health New York really promotes its use. It is recommended for persons with a serious illness or anybody who lives in a long­term care facility or requires long­term care services.

This form covers important topics that are relevant at the end of life. Here are these topics:

Pink Original MOLST form

• Resuscitation

• Framework for Treatment Guidelines: 

1. Comfort care
2. Limited medical interventions
3. No limitations on medical interventions

• Instructions on the use of breathing machines (intubation)

• Future Hospitalizations

• Use of artificial iv hydration and nutrition

• Antibiotic use

• Other instructions

The orders may entirely focus on avoiding any aggressive measures and making sure that the patient’s wishes of comfort care, no resuscitation, no use of antibiotics ne honored.

It is also possible to tailor these orders to an individual’s beliefs and values. Somebody may not want to be on breathing machines but they might still want workup for some of their symptoms (e.g. a CXR) and treatment with antibiotics.

A wonderful aspect of these orders is that they provide the option of “no hospitalization”. There are many people who would very much prefer not to go to the hospital and to stay in the home setting; event if it meant they’d die at home. (Of course, most of those should probably be on hospice – more about that in a future blog post)

By the way, the original MOLST form (in NY it is pink) always stays and travels with the patient from nursing home to hospital to rehab back to nursing home. The doctors and institutions keep copies only.

Not all states are using the MOLST form, some states even call it the POLST form. Talk to your doctor about what options you have. I would strongly encourage you to look into this.

Check out the MOLST form for New York State: Department of Health Website MOLST.

And remember, nothing is written in stone. You will always have the right to change your mind. Your doctor should periodically check in with you about your wishes to make sure that your MOLST is still up to date (there is a section the physician may sign).

This all may seem very scary but it shouldn’t be.

Planning for your future health care today ensures that you are able to voice all your concerns and make your own choices.

I wish you all the best for this endeavor,

Dr. B

PS: Check this article by elder lawyer Nancy Burner for more info on the MOLST form.