Wellington Cares hosted its inaugural luncheon at the Wanderers Club in Wellington on Thursday, Oct. 22.
Executive Director Kathy Foster thanked sponsors and welcomed attendees.
“Wellington Cares started five years ago as a dream, with eight friends who went to lunch and said, ‘I think we can do this.’ Five years later, we provide supportive services and programs for all persons over 65 living in the Wellington community,” Foster said.
On a regular basis, Wellington Cares provides services to more than 70 local residents. Transportation, social outings, basic home maintenance and help attending doctor visits are some of the many free services that Wellington Cares offers seniors in the community.
Foster noted that the group’s volunteers underwrite their own expenses, which helps Wellington Cares provide its services free of charge. This year alone, she said, volunteers have donated more than 900 hours of service to the community
Foster introduced keynote speaker Dr. Stuart Bagatell, associate program director for the internal medicine residency program at the University of Miami Miller School of Medicine’s Palm Beach campus and medical director of the JFK Internal Medicine Faculty Practice. He is an expert in end-of-life planning.
Bagatell related one particular case, that of his own grandmother, as she aged in Florida.
“That’s my Grandma Rose. I have an emotional disclosure here, and I think we all do. I think this is a topic that whether you’re a doctor, a lawyer, a nurse, a caregiver, whatever you call yourself, this is going to affect us all one day,” he said. “I feel that, as a physician, I have to make it my priority to make sure a conversation is started and continued throughout my patients.”
Bagatell practiced in Louisiana before moving to Florida and worked within the POLST Paradigm, which stands for Physician Orders for Life Sustaining Treatment. It is an approach to planning the end of life, with patients’ wishes being upheld.
“At the end of the day, what I’m going to talk to you about is not a political issue; it’s about patients’ rights, plain and simple. It’s not about death panels, it’s not about saving money, it’s about patients’ rights,” he said.
Patients have the right, within reason, to dictate the care that they receive, Bagatell said. POLST is a medical order, which translates what is written in a living will, and gives doctors instructions on how to take care of a patient. POLST orders are voluntary advanced directives. In Oregon, he said, almost all assisted living facility patients have one. “It’s written so doctors and nurses can actually follow along,” he said.
POLST lets doctors know how a patient wants to be treated, whether they want CPR, and what kind of help the patient wants if they do or do not have a pulse. Patients without a pulse needing CPR survive only approximately 10 to 15 percent of the time, Bagatell said.
“That’s not taking into account folks who have serious life-threatening illnesses,” he said.
Most patients that Bagatell treats are doing relatively well — they have a pulse and they’re breathing.
“Do they want to focus on just pain control, comfort and being kept clean, and being kept out of the hospital? Would they rather have limited additional interventions?” he said. “Or someone who says they want full treatment… These are the conversations that you may have.”
Feeding tubes for artificial nutrition are also something that patients must decide on, he explained. Do they want a feeding tube? After a stroke, do they want a feeding tube? A living will and a DNR (do not resuscitate) order do not inform the doctors about that, he said.
POLST started in 1995 in Oregon, and since then, almost every state has POLST regulations or is developing them. At Florida State University, Bagatell is working with lawyers and doctors to create something for patients that is expected to go to the Florida Legislature in February. “Everyone knows that this is good medicine; they’re just a little bit afraid,” he said.
A great resource to start planning for medical procedures is a starter kit available at www.theconversationproject.org. To learn more about the POLST Paradigm, visit www.polst.org.
For more information about Wellington Cares and the services that the nonprofit provides, visit www.wellingtoncaresorg.com.
