Medical Orders for Life-Sustaining Treatment - Patients & Families

Who Should Complete a MOLST Form

People should consider having a completed MOLST form if they:

• Reside in a long term care facility.
• Reside in the community and need long term care services.
• Might die within the next year.
• Want to avoid some or all life-sustaining treatments.
  

Individuals who meet the above criteria should speak with their physicians about whether MOLST is right for them.

Individuals considering MOLST should make decisions after having discussions with their health care professionals about personal wishes and existing medical evidence.

For example:

Cardiopulmonary resuscitation (CPR) is intended to prevent sudden, unexpected death.

CPR is not indicated in cases of:

1. Terminal, irreversible illness where death is expected, or
2. In certain medical situations where CPR is deemed ineffective.
   

For many people resuscitation is unwanted, unneeded and impossible. Depending on the situation and the person’s preferences, CPR may be inappropriate, futile and undignified.

Statistics to keep in mind when having discussions about CPR:

1. Survival rate of CPR on television shows: --> 66%
2. Actual in-hospital survival rates for CPR:
   
   All hospital patients: ------------------------------------->     15%
   Frail elders*: ----------------------------------------------->     <5%
   Individuals with advanced chronic illness**: ----->     <1%
   

* An older person that has troubles performing activities of daily living because of weakness or fatigue. More vulnerable to acute illness due to low activity level.

** Advanced chronic illness such as Alzheimer’s, Parkinson’s or end-stage heart, lung or kidney disease.