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The document outlines the Connecticut Medical Orders for Life Sustaining Treatment (MOLST) pilot program, which provides a structured form for patients to express their treatment preferences in the event of a medical emergency. It includes sections for patient information, eligible diagnoses, goals of treatment, and specific medical interventions such as CPR, hospitalization, ventilation, hydration, nutrition, and dialysis. The form is designed to be kept by the patient and reviewed regularly to ensure it reflects their current wishes regarding life-sustaining treatments.

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Does a MOLST form need to be notarized?

A lawyer is not needed and it does not have to be notarized; you just must have your signature witnessed by two people who are at least 18 years old, neither of whom is the health care agent you appointed.

Who needs a MOLST?

MOLST is generally for patients with serious health conditions. Physicians should consider consulting with the patient about completing a MOLST form if the patient: Wants to avoid or receive life-sustaining treatment. Resides in a long-term care facility or requires long-term care services.

Who should fill out a MOLST form?

Questions About who (health professionals) should sign patients MOLST forms: Who fills out the MOLST form? ➢ A clinician (physician, nurse practitioner, or physician assistant) and the person with advanced illness (or the persons legally authorized representative) if the person lacks capacity.

Who can fill out a most form?

The MOST form is completed by a health care professional in conversation with a patient or authorized health care agent, then signed by the patient/agent and a physician, advanced practice nurse (APN), or physicians assistant (PA). The physician/APN/PA signature translates patient preferences into medical orders.

What is the difference between a DNR and a MOLST?

The CC/DNR form only documents one decision- Not to be resuscitated if your heart or breathing stops. The MOLST form gives you the choice to decide: yes, I do want to be resuscitated or no, I do not want to be resuscitated.

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Who completes a MOLST form?

THE PHYSICIAN OR NURSE PRACTITIONER KEEPS A COPY. This is a medical order form that tells others the patients wishes for life-sustaining treatment. A health care professional must complete or change the MOLST form based on the patients current medical condition, values, wishes, and MOLST Instructions.

What is the purpose of a MOLST form?

Medical Orders for Life-Sustaining Treatment (MOLST) is a program designed to improve the quality of care patients receive at the end of life by translating patient goals for care and preferences into medical orders.

Is a MOLST form the same as a DNR?

For example, DNR (Do Not Resuscitate order) issued on a MOLST form is effective in hospitals, nursing homes and community settings. The MOLST serves as a single document that contains a patients goals and preferences regarding: Resuscitation instructions when the patient has no pulse and/or is not breathing.

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Does a MOLST form need to be notarized?

Who needs a MOLST?

Who should fill out a MOLST form?

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What is the difference between a DNR and a MOLST?

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Who completes a MOLST form?

What is the purpose of a MOLST form?

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