Health beat: The power of preparing for end-of-life treatment

Grief and confusion could have been avoided if a common form had been at the scene of a nursing home where a 71-year-old woman died last month.

That's the view of Dr. Victor Sandler, director of Home Care and Hospice for Fairview Health Services, who advocates broader use of so-called POLST forms to clarify when medics and doctors should pursue lifesaving measures for dying patients.

And when they shouldn't.

POLST (short for Physician Order for Life-Sustaining Treatment) is a one-page document doctors sign after consulting with seriously ill patients on the types of lifesaving care they want.

In the case of Linda Sandhei, medics reportedly started to resuscitate her on Aug. 7 and prepare her for transport from a Maplewood nursing home to a hospital when her husband intervened and told them it was against her wishes and to stop. They agreed and she died that day.

EMS policies for medics in Maplewood, and the Twin Cities in general, urge them to continue with lifesaving efforts unless they are futile or a written doctor's order tells them not to do so.

"If there had been a POLST form," Sandler said, "I think it would have been a nonissue."

Instead, six firefighters were placed on administrative leave amid a complaint investigation, reportedly about the decision to halt lifesaving efforts. At least two have resumed active duty.

POLST forms haven't eliminated all confusion at hectic life-or-death scenes. For example, medics have ignored them when patient signatures were missing, even though only doctors' signatures are required, Sandler said. But a POLST is more comprehensive than a standard DNR — do not resuscitate — order, and should be considered for anyone at greater risk of dying within a year due to age or illness, he said. "This is a doctor's order."