Instructions for patients and caregivers after signing MOLST

Patient and Caregiver Information

ALL patients will be made as comfortable as possible at the end of life.

PATIENTS

·         Put your MOLST form where it can be seen (on the refrigerator or on the back of a door).

·         Carry your MOLST form (or a copy) when you travel outside of your home.

·         Inform your family and caregivers about your MOLST instructions and form.

·         Talk with your clinician and caregivers about whether or when to call 9-1-1.

·         To void your MOLST form, write “VOID” across it in large letters on both sides.  

·         Tell your clinician (and others who have copies) to void their copies of your MOLST.

·         Ask your clinician to fill out a new MOLST form with you if you want one.

·         Fill out a health care proxy form to appoint your “health care agent” because family members are not always authorized to make medical decisions for you in all situations or settings.

·         Discuss your values, wishes and decisions about medical care with your health care agent.

FAMILY MEMBERS AND CAREGIVERS

·         The MOLST form is used voluntarily by patients to express their treatment wishes.

·         The patient made their treatment decisions after discussions with a clinician about the medical situation, the patient’s values and goals for care, and thebenefits and burdens of treatment. 

·         The MOLST form must travel with the patient at all times.

·         MOLST instructions are honored by health providers in any setting (e.g. home, nursing home or hospital).

·         The MOLST is valid when Sections D and E are complete.  

·         Patients can void the MOLST form or request and receive medically-indicated treatment at any time.