A POLST (physician orders for life sustaining treatment) are a part of the advance care planning process and communicate your wishes as medical orders. POLSTs give seriously ill or frail persons more specific direction over their healthcare treatments compared to advance directives and more options than Do Not Resuscitate (DNR) orders. They will be filled out in consultation with your doctor.
They may also be called a MOLST: medical orders for life sustaining treatment.
What is a POLST?
A POLST communicates your wishes as medical orders, and so is prepared together with your doctor who will sign it. POLST’s have different names in different states, but all have the force of medical orders. POLST’s are specifically for the seriously ill or frail. POLST’s can travel with you and are honored by emergency medical technicians.
How is a POLST different from an advance directive or DNR (do not resuscitate)?
- Advance Directives: POLST’s give more specific directions about your wishes for care than advance directives. You specify exactly what you want and don’t want and for how long. They have the force of medical orders and must be honored by emergency medical technicians (EMT’s). EMT’s cannot honor advance directives or medical powers of attorney. Once emergency personnel have been called, they must do what is necessary to stabilize a person for transfer to a hospital, both from accident sites and from a home or other facility. After a physician fully evaluates the person’s condition and determines the underlying conditions, advance directives can be implemented.
- Do Not Resuscitate (DNR’s): A do-not-resuscitate order, or DNR order, is a medical order written by a doctor. It instructs healthcare providers not to do cardiopulmonary resuscitation (CPR) if a patient’s breathing stops or if the patient’s heart stops beating. If presented, it will be honored by EMT’s. A POLST has the option of specifying DNR but also makes provision for resuscitation and other types of treatment such as feeding tubes and mechanical ventilation.
How do I fill out a POLST form?
POLST’s fit into the entire advance care planning process. By the time most people want or need a POLST they will have learned about their condition, thought about their values and quality of life, and had conversations with those close to them. The actual filling out of the POLST usually takes place in your doctor’s office after a good talk about your medical condition, treatment options, and what you want. Your doctor will fill it out and both of you will sign it. It is good to make several copies for yourself and one will be put in your medical record.
How do I find the POLST for my state?
You may want to review or download your state’s form before you meet with your doctor. The National POLST website has lots of information on POLST’s in general and you will be able to find and download the one from your state.