Instructions for patients and caregivers after signing MOLST

Patient and Caregiver Information for after signing MOLST

 

IN A MEDICAL EMERGENCY

 

  • If the person has been receiving hospice care, call the hospice program first.
  • If 9-1-1 is called or EMTs/fire/police arrive, tell them about the MOLST.
  • If the person is taken anywhere for care, send the MOLST form with the person. 
  • Tell any health professional who may medically treat the person about the MOLST.
  • Remember that all patients are made as comfortable as possible at the end of life.

 

INFORMATION FOR PATIENTS WITH MOLST FORMS

  • Keep your MOLST form in a place where it is easy for others to locate.
  • Carry your MOLST form (or a copy) when you travel outside of your home.
  • Inform your family, health care agent and caregivers about your MOLST form.
  • Discuss your treatment decisions and goals with your loved ones.
  • Keep a list of anyone who has a copy of your MOLST. 
  • To void the MOLST form, write “VOID” across both sides.  
  • If the MOLST is voided, tell everyone who has a copy to destroy their copy.
  • Ask your clinician to fill out a new MOLST form with you if you want one.

 

INFORMATION FOR FAMILY MEMBERS AND CAREGIVERS 

  • The MOLST form is filled out and signed by a clinician after discussions with the patient.* 
  • The MOLST form is used voluntarily by patients* to communicate treatment decisions.
  • The MOLST form reflects the decisions the patient* expressed to the signing clinician.
  • The MOLST form should travel with the patient at all times.
  • The MOLST form is to be honored by licensed health professionals in any setting.
  • Patients* can change their mind and choose to receive medically-indicated treatment, no matter what the MOLST says.

 

* (Or the patient's health care agent, if the patient lacks capacity)