Considerations for Withdraw of Life Sustaining Treatment (WOLST) in the Home: Medications, The Role of the Respiratory Therapist, and WOLST for Left Ventricular Assist Device (LVAD) Patients

Hospice and palliative organizations are increasingly requested to provide a compassionate WOLST in a setting outside the hospital. For a patient dependent on a life sustaining device such as a ventilator or a left ventricular assist device (LVAD) a WOLST at home may be the only remaining hope of returning home, and the only alternative to death in the hospital.

A WOLST is a deeply emotional process, for both the family and the team.  The medical team must assure flawless performance to ensure the family is left with as good a memory as possible. The presentation will describe the medications and dosing utilized for patient comfort, the importance of the respiratory therapist as the guide for the team.  New challenges facing hospice and palliative medicine teams that care for patients with left ventricular assist devices (LVAD)and the procedure for withdrawal of those devices in the home will also be discussed.

Presented by: Dr. Colleen Pema, D.O., F.A.C.O.I. Ohio’s Hospice, Inc. (OHI) cpema@purehealthcare.org

Dr. Thomas Flynn, Soin OHI HPM Fellow Ohio’s Hospice, Inc. tflynn@hospiceofdayton.org

Robert Westendorf, CRT Extraordinaire Ohio’s Hospice, Inc. bwestendorf@hospiceofdayton.org

Dr. Cleanne Cass, FAAHPM, FAAHP, HMDC Physician Director of Community Care and Education Ohio's Hospice of Dayton ccass@ohioshospice.org