Insurer Aetna began using nurse-care managers to help manage both Medicare and commercially insured patients with terminal illness in 2004, using telephone consultations with patients, doctors and families to, among other things, ensure advancedirectives are in place and complied with.
Regardless of whether people fill out Polst forms or advancedirectives, or both, a coalition of health-care groups says it is important for people to make some decisions about end of life wishes and to choose a surrogate who understands their wishes to step in if necessary.