Kentuckians Deserve the MOST Medical Orders for Scope of Treatment

KY Advance Directives have helped ease some of the burden of acute decision making in very specific emergencies, such as cardiopulmonary arrest. The difficulty is in defining patient preferences where cardiopulmonary arrest is NOT the issue.

We still have work to do in promoting individualized Advance Care Planning around end-of-life care.

Hospice of the Bluegrass, taking the lead in advocating for the best care for people at the end-of life, is piloting the use of a new kind of advance care directive called the MOST (Medical Orders for Scope of Treatment) document with our patients and their families. Our goal in the short term is to determine whether or not use of this new document will promote concordance of treatment received by patients with their informed preferences.

What is MOST?

It is a new kind of advance directive. The MOST form is a brief, simple, highly visible, portable medical order that quickly translates end of life care goals into preferred treatments. It is an additional tool to ensure that your preferences are known and honored.

Why Now?

States have been struggling to find the most effective ways for health care providers to open and sustain end-of-life care conversations with patients and families. The consensus appears to be for a portable physician/clinician order to address specifics of care commonly faced including resuscitation, feeding, fluids, antibiotics, comfort and surrogate decision making.

Forty-three states have some connection to the POLST (Physician Orders for Life Sustaining Treatment) Paradigm national network. Kentucky is one of 7 that does not.

Click hereto give us your contact information if you would like to help us help Kentuckians get the MOST.

Does This Replace other Advance Directives?

Currently MOST is only used as an adjunct to Kentucky’s legal advance directives, such as the Living Will, or EMS-DNR.

What do I do with the most?

You use it to discuss and document with your health care provider your preferences if you should find yourself facing end-of-life care decisions.

What if I change my mind?

The MOST form can and should be updated at any time that your preferences change and/or your medical situation changes. If you no longer wish to have a MOST, it can simply be destroyed and discarded.

A short video Explaining M.O.S.T.

Our patients and families speak about the MOST form

“The social worker and nurse went through the form with us step-by-step. They explained our options and answered our questions. It made it much easier and we felt confident that our wishes would be followed.” P.P.