Making Your End-of-Life Preferences Known

A survey of Californians done in late 2011 for the California Healthcare Foundation shows a huge disconnect between what we want and what we do — or, more accurately, don’t do — when it comes to end-of-life choices.

For instance:

  • Sixty percent said it was “extremely important” they not burden their families with tough choices about their care; yet almost as many (fifty-six percent) have not communicated their end-of-life wishes and of the minority to actually discuss the topic, only twenty-three percent have put their wishes in writing.
  • Almost eight percent say they want to discuss end-of-life care with their physician, yet only seven percent have done so.
  • Most of us prefer to die a natural death at home. But the reality is most deaths in California, at least as of 2009, occur in a hospital (forty-two percent) and nursing home (eighteen percent).

To help with both the decision-making and getting those final wishes in formal order is a relatively new concept offered by state called the Physician Orders for Life-Sustaining Treatment, which documents a patient’s preferences. Called POLST for short, the program is designed to improve the quality of care people receive at the end of life. “It is based on effective communication of patient wishes, documentation of medical orders on a brightly colored form and a promise by health care professionals to honor these wishes,” according to the web site

The time to have a conversation and complete the form is when you or a loved one has the cognitive abilities to understand and fully contribute to the conversation. To learn more about California’s POLST program, go to