CMSA Today - Issue 5, 2016 - 18

focus of shared decision making, and patient wishes are honored. A key factor in the use of the form is in understanding what is a "rich" conversation. Rich conversations are ones where the primary focus is to hear from patients and/ or their surrogate the thoughts, feelings, concerns, and goals for treatment in light of the fact they have now been identified as having a serious medical condition that could be life-threatening. These "rich" conversations are then documented using the POLST form-which translates this conversation into actionable medical orders signed by the physician. In some states, physician extenders like nurse practitioners or physician assistants may also sign these orders. This document, with actionable medical orders, is then kept by the patient and family and will follow them from care setting to care setting. Each setting should take a copy and ensure that the original is returned to the patient or his or her representative on discharge or transfer. They remain in force until and unless the patient or his or her surrogate rescinds them by completing a new POLST. There are a number of significant differences between traditional Advance HealthCare Directives and the POLST paradigm form that will improve access and availability of the right information provided at the right time. POLST is for the seriously ill at any age; the classic way to tell if a person should complete a POLST form or a traditional advance directive is to ask yourself, "Would you be surprised if this person died within the next 18 months?" If the answer is no, then the POLST form should be completed. If yes, then a durable power of attorney for healthcare or other similar advance directive should be considered. The most important aspect for someone with a longer timeline is that they identify and appoint a surrogate decision maker. For physicians, a properly completed POLST will guide treatment recommendations and patient care plan. This includes: choices about CPR, intensity of medical treatment as well as artificially administered nutrition (and hydration). If you already have answers to these three areas, you will know a great deal more than with an advance directive alone and, more importantly, be in a position to have treatment align with the patient goals for care. The POLST paradigm form is designed to guide the completion by having what is referred to as a "rich conversation." This "rich" conversation will assist you to gain insight and understanding of what your patients already know, what they understand about the treatment choices available and their goals. In the relatively new field of palliative care, this form is essential in the initial palliative care consult. The POLST paradigm form is separated into four sections: Section A addresses CPR preference, Section B, their desired intensity of Medical intervention, Section C, their wishes regarding artificially administered nutrition and finally Section D, which is for signatures and contact information. Each section spells out in clear language what the options are, gives the person assisting the patient an opportunity to explore with him or her any specific education needs that might help in understanding. Once this has been done, the patient or his or her surrogate decision maker signs the form, the physician or in some states a nurse practitioner or physician assistance signs the form. Any healthcare worker who assisted the patient in completing the form signs on Brain & Spinal Cord Injury Rehabilitation Programs for People of all Ages When a life-altering injury requires quality care Residential Programs * Outpatient Services * Day Treatment Home & Community-Based Rehabilitation * Home Care Vocational Programs * Comprehensive Rehabilitation Medical Care * NeuroBehavioral Programs To schedule a tour or to speak with an admissions team member, call 800.968.6644 rainbowrehab.com 18 787573_Rainbow.indd CMSA TODAY1 Issue 5 * 2016 * DIGITAL 1/9/16 2:02 AM http://www.rainbowrehab.com

Table of Contents for the Digital Edition of CMSA Today - Issue 5, 2016

President's Letter: Leading Through Change
Immediate Past President's Letter: Risks, Challenges and Progress
Association News
CMSA Corporate Partners
Normalizing End-of-Life Care with Rich Conversations
Personal Feelings/Professional Face: The Hidden Grief of the Helping Professional
INDEX OF ADVERTISERS
CMSA Today - Issue 5, 2016 - cover1
CMSA Today - Issue 5, 2016 - cover2
CMSA Today - Issue 5, 2016 - 3
CMSA Today - Issue 5, 2016 - 4
CMSA Today - Issue 5, 2016 - 5
CMSA Today - Issue 5, 2016 - President's Letter: Leading Through Change
CMSA Today - Issue 5, 2016 - 7
CMSA Today - Issue 5, 2016 - 8
CMSA Today - Issue 5, 2016 - Immediate Past President's Letter: Risks, Challenges and Progress
CMSA Today - Issue 5, 2016 - 10
CMSA Today - Issue 5, 2016 - 11
CMSA Today - Issue 5, 2016 - Association News
CMSA Today - Issue 5, 2016 - 13
CMSA Today - Issue 5, 2016 - CMSA Corporate Partners
CMSA Today - Issue 5, 2016 - 15
CMSA Today - Issue 5, 2016 - Normalizing End-of-Life Care with Rich Conversations
CMSA Today - Issue 5, 2016 - 17
CMSA Today - Issue 5, 2016 - 18
CMSA Today - Issue 5, 2016 - 19
CMSA Today - Issue 5, 2016 - 20
CMSA Today - Issue 5, 2016 - 21
CMSA Today - Issue 5, 2016 - Personal Feelings/Professional Face: The Hidden Grief of the Helping Professional
CMSA Today - Issue 5, 2016 - 23
CMSA Today - Issue 5, 2016 - 24
CMSA Today - Issue 5, 2016 - 25
CMSA Today - Issue 5, 2016 - 26
CMSA Today - Issue 5, 2016 - INDEX OF ADVERTISERS
CMSA Today - Issue 5, 2016 - 28
CMSA Today - Issue 5, 2016 - cover3
CMSA Today - Issue 5, 2016 - cover4
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