Considerations for Withdraw of Life Sustaining Treatment (WOLST) in the Home: Psychosocial, Legal and Planning Aspects of Care

Hospice and palliative organizations are increasingly requested to provide a compassionate WOLST (Withdraw of Life Sustaining Treatment) in a setting outside the hospital. For the ventilator dependent patient, 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. The medical team must ensure that it is provided with flawless procession to assure that the family is left with as good a memory as possible. The WOLST team must include a respiratory therapist and physician, as well as nurses, a social worker, and a chaplain.

This session will describe the psychosocial aspects of care, including assessment of the patient and family, understanding the emotions and expectations of a WOLST at home for both the patient and the family, and will review the Ohio laws that govern withdrawal of life sustaining support. The steps in planning for the procedure, including the roles of each member of the WOLST team will be described in detail.

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

Dr. Sarah Doell, Soin/OHI HPM Fellow Ohio’s Hospice, Inc. sdoell@hospiceofdayton.org

Micah Selby, RN, WOLST Team Lead Ohio’s Hospice, Inc. mselby@hospiceofdayton.org

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