Medical Orders for Life Sustaining Treatment - Patients & Families
Glossary of Terms
Advance Care Planning: Using open communication and Advance Directives to plan future care. Advance directives apply only when you are unable to make decisions about your medical care.Advance Directives/Advance Care Directives: Advance Directives are written instructions on how you want future medical decisions made in case you are unable to communicate or make the decisions yourself. The two most common Advance Directives are the health care proxy form and the living will. Advance Directives are used in Advance Care Planning.
Antibiotics: Medications used to fight infections. Used to treat illnesses or relieve symptoms.
Artificial Nutrition and Hydration: When a person can no longer eat or drink, liquid food or fluids can be given by tube.
Capacity: Capacity is the ability to take in information, understand its meaning and make an informed decision using the information. Capacity varies by task. The capacity to choose a trusted individual as an appropriate Health Care Agent differs from the capacity to agree to a medical procedure or treatment.
Cardiopulmonary Resuscitation (CPR): Attempts to restart breathing and the heartbeat of a person who has no heartbeat or has stopped breathing. CPR involves “mouth-to-mouth” breathing and forceful pressure on the chest to restart the heart. Usually involves electric shock (defibrillation) and a plastic tube down the throat into the windpipe to assist breathing (intubation).
Comfort Measures/Comfort Care: Medical care provided with the primary goal of keeping a person comfortable rather than prolonging life. Comfort measures are used to relieve pain and other symptoms.
Frail Elder: An older person who has trouble performing activities of daily living because of weakness or fatigue. Frail elders are vulnerable to acute illness due to low activity level.
Health Care Proxy Form: The form used to designate an “agent” (also called the Health Care Proxy). Your agent makes health care decisions on your behalf only if you are unable to make decisions yourself. This is the legal advance directive form in New York State.
Intravenous (IV) fluids: A small plastic tube (catheter) is inserted directly into the vein and fluids are given through the tube.
Intubation/Intubate: Placing a tube down an individual’s windpipe to assist in breathing. Intubation is followed by mechanical ventilation.
Living Will: A form permitting you to state your wishes ahead of time in case you develop a terminal, irreversible condition that prevents you from making and communicating your wishes. Although not a legal New York State form, the Living Will provides the “clear and convincing evidence” needed to have your wishes carried out.
Mechanical ventilation: If a person is unable to breathe, a tube is placed down the throat. The tube is connected to a machine that pumps air into and out of the lungs.
Medical Futility/Medically futile: The treatment is ineffective and does not follow commonly accepted community standards for treatment. It is inconsistent with the person’s preferences or goals of care.
MOLST Form: The MOLST form is a medical order form. MOLST tells others your wishes for life-sustaining treatments. The form is on bright pink paper so it can be easily identified in case of an emergency. You use MOLST when you have a serious health condition.
MOLST Program: The Medical Orders for Life-Sustaining Treatment (MOLST) Program improves the quality of medical care people receive at the end of life by turning patient/resident goals and preferences into medical orders. MOLST is based on communication between the patient/resident, Health Care Agent or other designated decision-maker and health care professionals that ensures informed medical decision-making.
POLST: The Physician Orders for Life Sustaining Treatment was started in Oregon in the early 1990’s to improve the quality of medical care provided by turning people’s wishes regarding life-sustaining treatments into medical orders. It is the basis for Medical Orders for Life Sustaining Treatment (MOLST).
Tube-feeding: Providing fluids and/or nutrition by way of a tube placed into the stomach or intestines. On a short-term basis, the tube (Nasogastric tube or “NG-tube”) is placed into the nose, down the throat and into the stomach. For the long-term, the tube is placed directly into the stomach (Gastric, or “G-tube”).
