Medical Orders for Life Sustaining Treatment - Patients & Families

Core Elements of the MOLST Program

The MOLST Program is based on communication between the patient/resident or surrogate (the Health Care Agent or proxy or legally designated decision-maker) and health care professionals that ensures informed medical decision-making. This communication is recorded as medical orders on the MOLST form.

Medical orders derived from these conversations should be recorded on the MOLST form.

The MOLST form

1. Contains actionable medical orders regarding life-sustaining treatments.
   
2. Is recommended for individuals with an advanced chronic progressive illness or terminal illness or for anyone interested in further defining their end-of-life care wishes.
   
3. May be used to limit medical interventions or clarify a request for all medically indicated treatments including cardiopulmonary resuscitation (CPR).
   
4. Provides explicit direction about resuscitation status (“code status”) if the patient is pulseless and/or apneic (not breathing).
   
5. Includes directions about other types of intervention that the patient may or may not want.
   For example: Decisions about future hospitalizations, ICU care, antibiotics, artificial nutrition and hydration, intubation and mechanical ventilation.
   
6. Is a bright pink color that is easily identified in case of emergency.
   
7. Accompanies the patient as he or she is transferred home or to a new care settings (e.g., long-term care facility or hospital).
   
8. Should be reviewed and renewed periodically, as required by New York State and Federal law and regulations, and/or if:
   
   
   • Periodically  
   • As required by New York State and Federal law or regulations
   • If the individual’s preferences change
   • If the individual’s health status changes
   • If the patient is transferred to another care setting
     
   
   Additionally, the MOLST Program:
   
   
   • Includes training of health care professionals about the goals of the program and use of the MOLST form.
   • Features a plan for ongoing monitoring of the program and its implementation.