What are Medical Orders for Life-Sustaining Treatment (MOLST)?

The MOLST form was created in 2008, but most people are unaware of its existence; even some doctors and eldercare lawyers have never heard of it. The MOLST is intended for patients with serious health conditions who:

• Want to avoid or receive any or all life-sustaining treatment;
• Reside in a long-term care facility or require long-term care services; and/or
• Might die within the next year.

As the form is intended to be used for patients who have been diagnosed with a serious illness, rather than in preparation for the possibility of a serious illness, some argue that the MOLST is not an advance directive. Another reason for this argument is that this form can be completed by a patient’s surrogate or health care agent if the patient has lost capacity to make their own decisions. However, we have chosen to include the MOLST under “advance directives” as the intention is to develop a plan for future care, and a serious illness diagnosis is an important time to reflect on wishes and values to inform care.

The MOLST form is a formal medical order, and documents your wishes regarding CPR, artificial hydration and nutrition, antibiotics, intubation, and comfort care (i.e., care to relieve pain and other symptoms), as well as other options. Back when many hospitals and medical offices used paper records, this was often printed on hot pink paper (which is sometimes still true).