End of life medical care initative going state wide; modeled after La Crosse

By: Alyssa Fenske Email
By: Alyssa Fenske Email

LA CROSSE, Wis (WEAU)- An end-of-life medical care initiative is being piloted across the state and it’s being modeled after a successful western Wisconsin program that’s been said to be a national example.

Greg Thompson, a physician at Gundersen Lutheran is constantly reminding his patients about advance directives.

“The advance directive is a framework for decisions that need to be made. For example if the patients heart stops and stops breathing would they want CPR?” explained Thompson.

All around the state the Wisconsin State Medical Society is becoming a leader in making sure advance directives will be part of the health system.

“What makes this program tick is the redesigning of health systems so that it becomes part of routine care. We need to make sure it’s not an afterthought, and not something the patient does on their own,” said Head of Making Choices Program at Gundersen Lutheran, Bud Hammes.

Without it Thompson says unnecessary stress can be put on him and those involved with the patient.

“It’s every day in the Intensive Care Unit that advanced directives come into play in helping the family and us as physicians provide treatment in a matter he or she would request,” said Thompson.

One key part of the La Crosse model that will be left out of the state version, is the use of POLST’s. POLST’s are the physician’s orders, not the patients about their end of life care. It has been a large controversy as of late in the medical field.

“POLST is a physician order does not need the patients own writing. POLST is four questions where the physician where the physician identifies with their patient what area’s of care would you want depending on what your illness is,” said Advance Directives Coordinator at Mayo Health System in La Crosse, Katherine Karage.

Both Mayo Health System and Gundersen Lutheran physicians use the POLST. But some doctors will only use some of the questions, and change the form to better fit the needs of the patient.

“We would only do this with patients who only have a very limited life expectancy,” said Hammes.

Without the POLST the advance directive can still work effectively on its own.

“It can make it simple or make people think more carefully about what it is that I might be confronted with,” said Karage.

It’s suggested that anyone over the age of 18 should consider an Advance Directive/ Power of Attorney for Health Care. Physicians in La Crosse start suggesting it to those who are in their 30’s and up. Talk to your doctor if you haven’t already spoken with them about your end-of-life care.


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