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Life-sustaining treatment orders: A talk with Dillingham Fire Dept.

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An ambulance in front of the Dillingham Fire Dept. and EMS building at the harbor. May 29, 2023.
Izzy Ross

Portable Medical Orders aims to help with planning for emergencies. It's meant for people who have a serious illness or frailty to communicate how they want to be cared for medically. On this episode of Community Corner, KDLG's Izzy Ross talked with Dillingham EMS Prevention Coordinator Laticia Swift about the paperwork for 'life-sustaining treatment' orders.

Izzy Ross: Today we're talking about physician's orders for life sustaining treatment, or POLST. Some people may have heard this called a 'Do Not Resuscitate' order. Laticia, what can you tell me about this?

Laticia Swift: So the POLST is for people who are frail, or critically ill. So usually elders in the community will have one. And it's a two-sided piece of paper that family members and the elderly can fill out with their physician. And it is basically a guide for EMS that, like, if we have to show up to this person's house, and they are passing away or have something else going on, it gives us a layout of what we can and can't do to help them. So really, it's the elder's last wishes.

Ross: I can imagine that these guidelines are really actually important, you know, both legally and ethically for EMS personnel.

Swift: It is. It is. As much as we want to do everything to help someone, we also understand that it is everyone else's right to be able to make those decisions for themselves. So having a POLST is incredibly important, because it tells us what you want us to do.

And it really runs into three categories. So it's: Yes, do everything you can to save my life. And then the next category is: You can do these things, but not these things. And then the next category is: Just make me as comfortable as possible. Don't do anything else.

Another really great reason to have it is that not only do we know what you want, but your family members do as well. We have been in many situations where family members are like, 'No, you have to do everything to save them.' And then, you know, there's some family members at the same place that are like, 'No, that's not what they want.' So this way, it's a legal document for us to be like, 'Listen, this is what your grandmother wanted, this is what we're going to do.' So it makes sure that their wishes are taken care of. But it also lets EMS personnel know what they can and can't do. And if we need to transport them to the hospital, it lets the hospital staff know what can and can't be done as well.

Ross: How prevalent is this in your line of work? How important is this for people?

Swift: I think it's really important. I've been on a handful of end of life calls. And on some of those calls, I have had family members meet me at the door and it's like, here's their paperwork, this is what they want you to do.

Having a POLST is really great, because it has you talked with your physician and your family members beforehand. So everyone's on the same page. It tells the EMS what we can and cannot do. And it makes for a much more comfortable situation for everyone involved.

A big thing that I would like to suggest to people is that if they do decide to get a POLST for family members, call the fire department and let us know. You can send us a copy of it so that we can be better prepared when we get there. We can come out to wherever you are and do a talk with everyone. And if it's something that you're not comfortable talking with the fire department about that's totally fine. But please have that on your refrigerator or someplace it's easily accessible. And then that way if the worst case scenario does happen wnd we have to be out there, you're not in a panic, other family members aren't in panic and somebody can give us the paperwork. Because if you tell us that somebody has one and you cannot provide the paperwork to us, we're doing everything that we can to save that person's life, which may or may not be what that person actually wanted.

Ross: Got it. And where can people get this paperwork?

Swift: So you can get the paperwork from your primary care physician. So if you have family members see people strictly at Kanakanak, they can get it there. ANMC, Providence, anyone's primary care physician can. And then akpolst.org is a really great website that has so much information on a POLST, how to have the conversations with family members, what to do, kind of like a step-by-step with getting the POLST and then where to place it, contacting local providers, everything like that. So [akpolst.org] is amazing.

Ross: Laticia Swift, thanks so much for coming back into the studio to talk about this.

Swift: Yeah, thanks for having me.

Ross: If you're listening to this and you're like, man, there's an event in my community or some resources that I'd like to share with folks listening to KDLG please just give us a call. We'd love to have you on. It can be over the phone, it can be a over Zoom, it can be in person, whatever you prefer. You can give us a call at 907-842-2200 or send me an email. My email is on the KDLG website. You can also send an email to the news team at news@kdlg.org.

Get in touch with the author at izzy@kdlg.org or 907-842-2200.

Izzy Ross is the news director at KDLG, the NPR member station in Dillingham. She reports, edits, and hosts stories from around the Bristol Bay region, and collaborates with other radio stations across the state.