This post is from the National POLST website and truly gets a conversation started!

Physician Orders for Life-sustaining Treatment 

“The National POLST Paradigm is an approach to end-of-life planning based on conversations between patients, loved ones, and health care professionals designed to ensure that seriously ill or frail patients can choose the treatments they want or do not want and that their wishes are documented and honored.”




Allow Natural Death

There is a shift in the terminology used when discussing the decision not to attempt to resuscitate with CPR. The shift is to use the verbage of Allow Natural Death.  I am thrilled, personally and professionally to use these words and direct the conversation toward the natural, the non-clinical and bring a more gentle tone to a consistently difficult conversation.




I was thinking about all the “work” people do before they die, the kind of work that attempts to finally express the desires of their hearts while they are still alive.  My how hard that must be!  Knowing you will not be “working” any more soon and will not be able to take part in the things of life that are so special to each individual person.

Wonder what kind of “work” I will be able to do when it is my time…

W = writing notes, special memories, obituary, family history/legacy, thank yous and “I am sorry for…”

O = organizing personal items, belongings and papers that hand off responsibilities

R = reminising and remembering life with loved ones and friends…recapping what has brought joy

K = kicking hard!  Fighting for life as long as possible before there is a need to truly rest




This is an acronym for a Power of Attorney Health Care.  A person has a right to choose another person to represent them in health care decisions.

Choosing this person is an important decision for you or your people, especially as they lose clarity in thought and or decline in their health condition.

Now is the time to ask the person (parent/sibling/children/friend/etc) what their wishes are in health care.  Do they want to have CPR, mechanical ventilation, artificial feedings or aggressive treatments for a terminal condition.

Asking a Social Worker, Nurse, Physician or a lawyer how to begin this process will be a good place to start the process.

Pending ideas:  Five Wishes, Advanced Directive, Living Will



What’s that?!  The initials of DNR abbreviate the form that indicates Do Not resuscitate.  A DNR status allows a person to not require cardiopulmonary resuscitation when their heart or respirations cease.

Signing the form comes after a process of facing your physical mortality.  Accepting that you will not be recovering from your condition.

How hard is this decision?  VERY!  When I watch people sign their own DNR, it usually is an “of-course” I don’t want CPR.  When legal representatives sign, there comes a paradox of grief and conflict…people express they feel they are “giving up” on their loved one.

I tried to sign a DNR form as a trial run.  When the pen actually was at the paper’s edge, I became tense and hesitated big time.  It’s just not that easy.




Whew…one moment you are here and the next moment you are gone. Just like mist!

T.O.D. stands for Time of Death.

We all will have a documented time, when someone will look at the clock just after you took your last breath. Then, there will be another person who will write that time on the formal Death Certificate. And thennnnnn…some dear sole will carry copies of that document all over town to wrap up finances, will and bills, prooving you are dead!

I hope if you think about this moment in time for yourself, you get to have the anticipation that it will be THE greatest trip of your life and that you are finishing without regrets (or at-least not too many).


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