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You Know about Health Care Directives: Do you know the MOST?

August 2, 2019/in Health Care Planning/by KT Williams

Earlier this year, I wrote an article about health care decision making and many of the health care directives that everyone should consider. If you missed the article, you can find it here. It discusses common health care directives, such as the Living Will and Health Care Power of Attorney. You may be familiar with the Living Will and Health Care Power of Attorney, but do you know the MOST?

What is the MOST?

Those familiar with a Do Not Resuscitate (DNR) Order should think of the MOST (Medical Order for Scope of Treatment) as a new and improved DNR. Rather than simply covering resuscitation like the DNR does, the MOST covers so much more. This means your care will more closely match your wishes. And that is why it is better than a DNR.

Like the DNR, the MOST is a medical record. That means it will be part of our your permanent health care record and easily transferred as you move from facility to facility for care.
Not every state has the MOST. But the majority of states have something similar. For example, Indiana’s version of the MOST is called POST (Physician Order for Scope of Treatment). It’s purpose and benefits are the same as the MOST, and it looks similar, too.

Does the MOST Replace Your Living Will or Health Care Power of Attorney?

The MOST doesn’t replace your advance directives, like your Living Will or your Health Care Power of Attorney. They remain as important as ever. The MOST can serve as an important supplement to them that further explains your wishes and moves with you throughout your health care journey.
Does the MOST Replace a DNR?

The MOST is not a replacement for the DNR. It may reach that status. But, for now, it does not. The MOST is new, and it takes time for hospitals and medical facilities to implement new programs. For example, not long ago, my grandmother was in the hospital. I asked the nurses about the hospital’s use of the MOST because I wanted my grandmother to have one in her medical file. My question was met with blank stares. After I explained what I was asking about, the nurses checked with hospital administrators who said the MOST had not been implemented at that facility. The point is, if you or a loved one have a DNR, don’t consider it obsolete. The MOST may not be available where you receive care. But you should check.

How Do You Get the MOST Into Your Medical Record?

The MOST must be signed by a physician. So you could wait until you are receiving medical care, then ask if one could be placed in your record. But if you wait until you are receiving care before you ask for the MOST, you might not have much time to consider the questions asked or be in the best frame of mind to answer them. Instead, you should review the MOST in advance of any medical need. A good time to consider the MOST is when working on your Living Will and Health Care Power of Attorney.

Where Can You Find the MOST?

Your health care providers should have them. If they don’t, you can also find the MOST under the Kentucky Board of Medical Licensure website. You can print a copy of it and review the questions. Then, you should go over the MOST with your physician so that it will be placed in your medical record. If you want to make sure it agrees with your advance directives, such as your Living Will and Health Care Power of Attorney, consider giving a copy to your estate planning attorney. I want the people and families I serve to receive the care they desire. And if the MOST and the advance directives express different wishes, the result could be devastating. So be proactive in making your wishes known and consistent through your advance directives and medical records. If you have any questions about Estates, Wills, Trusts, Elder Law, Living Wills, Health Care Powers of Attorney, or the MOST, contact us. We’re happy to help.

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