MOLSTfor Caregivers

MOLSTstands for Medical Orders forLife-SustainingTreatmentsWhat:

The Maryland MOLST form is a two-page directive about cardiopulmonary resuscitation (CPR) and other life-sustaining medical treatment.

Why:MOLST tells doctors and other people what medical treatments a patient wants or does not want to receive in the event of a medical crisis.

Where:Where should you keep MOLST in the patient’s home? In a labeled container:• At the bedside• Behind the bedroom door• On the refrigerator

Who:Who do you give the MOLST form to?• Always give the MOLST form to medics and the

ambulance crew.• Every time the patient goes to a hospital or any

health care facility, the MOLST form goes with the patient.

When:Completion of the MOLST begins with a conversation or a series of conversations between the patient, the patient’s health care agent or surrogate, and a qualified, trained health care professional that defines the patient’s goals for care, reviews possible treatment options on the entire MOLST form, and ensures shared, informed medical decision-making.

Find the MOLST form at www.Dhmh.maryland.gov/marylandmolst

www.PeninsulaHomeCare .com Wicomico & Somerset Counties 410-543-7550Worcester County 410-208-4828Sussex County 302-629-4914Maryland

A MOLST form

must be signed

by a physician.

revised 08/18