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West Virginians who are chronically ill or in a nursing home are more likely to receive the end-of-life-care they want if they have made their wishes known through a certified document filled out with their physicians, according to a recent study.

The document, called the Physician Orders for Scope of Treatment, "advances over the advance directives," said Dr. Alvin Moss, a professor of medicine at West Virginia University and director of the state's Center for End-of-Life Care.

Moss co-authored a recent study that looks at the effectiveness of POST forms. The study was published in the July issue of the Journal of the American Geriatrics Society.

"Advance directives are something a patient completes and gets notarized, and a doctor is not involved," Moss said. "It is not a physician's order, and that is the weakness with a living will and a medical power of attorney. The doctors review and then examine the patient, and then they can make a decision whether or not the advanced directive is appropriate."

POST forms address the shortcomings of other legal documents that can be too vague or hard to find during a medical emergency, Moss said.

POST forms travel with the patient, are brightly colored and are very specific to what the patient wants -- being hospitalized, receiving CPR, feeding tubes or being put on a breathing machine, he said.

In the study, Moss and other scientists tracked the treatment of more than 1,700 long-term nursing home residents with an average age of 84 in West Virginia, Wisconsin and Oregon. About half of them had POST forms.

Of those who said they wanted to be treated mostly to relieve pain, those with the form were 59 percent less likely to receive unwanted treatment than those with a standard "do not resuscitate" order, according to the study.

"It's important because in West Virginia, three-quarters of state residents said at the end of life, they want to be free of pain and suffering and do not want to be put on a machine," Moss said.

West Virginians who are chronically ill or in a nursing home are more likely to receive the end-of-life-care they want if they have made their wishes known through a certified document filled out with their physicians, according to a recent study.

The document, called the Physician Orders for Scope of Treatment, "advances over the advance directives," said Dr. Alvin Moss, a professor of medicine at West Virginia University and director of the state's Center for End-of-Life Care.

Moss co-authored a recent study that looks at the effectiveness of POST forms. The study was published in the July issue of the Journal of the American Geriatrics Society.

"Advance directives are something a patient completes and gets notarized, and a doctor is not involved," Moss said. "It is not a physician's order, and that is the weakness with a living will and a medical power of attorney. The doctors review and then examine the patient, and then they can make a decision whether or not the advanced directive is appropriate."

POST forms address the shortcomings of other legal documents that can be too vague or hard to find during a medical emergency, Moss said.

POST forms travel with the patient, are brightly colored and are very specific to what the patient wants -- being hospitalized, receiving CPR, feeding tubes or being put on a breathing machine, he said.

In the study, Moss and other scientists tracked the treatment of more than 1,700 long-term nursing home residents with an average age of 84 in West Virginia, Wisconsin and Oregon. About half of them had POST forms.

Of those who said they wanted to be treated mostly to relieve pain, those with the form were 59 percent less likely to receive unwanted treatment than those with a standard "do not resuscitate" order, according to the study.

"It's important because in West Virginia, three-quarters of state residents said at the end of life, they want to be free of pain and suffering and do not want to be put on a machine," Moss said.

In 2002, West Virginia became the third state in the nation to offer POST forms, after Oregon and Washington. Today, 11 states offer the documents.

Unlike other end-of-life documents, patients fill out the POST form with their physician, so they become better informed of their treatment options, Moss said.

"The POST form does a much better job of communicating what the patient wants, and 95 percent of the time those wishes are honored," Moss said.

The documents also reduce the number of in-hospital deaths, and in turn reduce health-care costs, Moss said. About 30 percent of Medicare dollars are spent on patients in the last year of life, he said.

Of patients with POST forms with orders to forgo resuscitation and requesting comfort measures only, the rate of in-hospital death was 5 percent compared to a national average of 32 percent, he said.

"This program was not developed to save money, but it's figured out that when we honor patients' wishes we do save money," Moss said.