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Form allows patients to take control of end-of-life decisions

By Katie Demeria

Over the past several years, Lynn Gray, vice president of patient and family support services with Blue Ridge Hospice, has been trying to give people more control over their lives.

With National Healthcare Decision Day approaching on April 16, Gray said now is the opportune time to encourage local residents to talk about their preferences in regard to end of life treatments.

Gray and her team are trained to certify health care providers such as general practice physicians, nursing homes and assisted living facilities to fill out physician orders for scope of treatment forms with their patients and residents.

These POST forms are medical orders that allow patients to decide how they would like their providers to react should their condition quickly deteriorate.

The forms are meant for patients with chronic or life-limiting diseases.

"Having control over your life is such an important thing," Gray said. "At that point you've often lost so much control over your world, so to give people the ability to participate in their care is so important. The last thing we want to do is intervene where we're not wanted."

Gray sits on Virginia's POST Project executive committee. The project is designed to encourage as many health care facilities to become POST certified as possible.

The forms differ from advanced directives in that they are medical orders and do not impact care from a legal standpoint.

"It's a physician signed order endorsed by a physician with whom you have a relationship," she said. "And it will accompany you if, for example, you live in a nursing home and are transported to the hospital."

Patients filling out POST forms have the opportunity to decide what comfort measures and interventions they would like if their conditions should decline rapidly. It also gives them the opportunity to decide if they would like a feeding tube at any point.

Gray pointed out that many patients do not want to be transported back and forth from assisted living homes to hospitals for aggressive care at the end of their lives.

Nor do family members necessarily want to see their loved ones transported in order to receive that aggressive care.

"It can be very disturbing, especially for someone with dementia. Taking that person out of a safe environment they're used to and putting them in a hospital room often causes them great stress," she said.

The next step for Gray is getting the word out so facilities take advantage of the training she and her team can provide.

National Healthcare Decisions Day is useful in that it encourages people not to ignore the choices they will inevitably have to make, making them instead when they are healthy enough to understand all their options.

"The important message about National Healthcare Decisions Day is for people to think about their health care in terms of their treatment preferences, especially if you're dealing with chronic diseases," she said.

If she gets enough interest, Gray said, her team will also provide local training sometime in June. Training includes attending an eight-hour course and taking a four-hour online training module, which can cost $100 to $125 per person. Gray said she is working on gaining grants to help smaller facilities shoulder the costs.

"It gives a kind of simplistic template for guiding families through these conversations, which are not easy to start," she said. "But they are so important to have, and is such a personal choice."

Those interested in learning more about POST forms can go to www.virginiapost.org or www.blueridgehospice.org.

Contact staff writer Katie Demeria at 540-465-5137 ext. 155, or kdemeria@nvdaily.com

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