A Physician’s Order for Life-Sustaining Treatment (POLST) is an advanced medical directive. Specifically, it communicates your wishes as medical orders. It helps you avoid unwanted treatment and improve the quality of your last days. A POLST form consists of a set of medical orders that applies to a limited population of patients, such as seriously ill or frail persons. It addresses a limited number of critical medical decisions. Moreover, it has the option of specifying Do Not Resuscitate. In addition to that, it also specifies details for other types of treatment such as feeding tubes and mechanical ventilation.
What is a POLST?
A POLST is a document that medical personnel have available to help patients in crisis. It lets EMS workers know what your wishes are regarding CPR and other life-saving procedures. POLSTs have different names in different states, but all have the force of medical orders. POLSTs can easily travel with you and are honored by EMS workers.
How is a POLST different from an Advance Directive?
If you are seriously ill, have advanced frailty, or are nearing the end of life, advanced planning is strongly advised. Both Advance Directives and POLST forms are parts of advance care planning but are not the same.
When you need a prescription, you go to your provider who writes or types an order for your prescription and signs it. POLST is just like a medical order. You need to go to your health care provider who will write out the POLST and sign it. The difference with a POLST is that you should have a good talk with your provider about what you want considering your current medical condition: What is likely to happen in the future? Treatment options? You’ll also be asked to sign your POLST form.
POLST forms tell other providers what your wishes are in case you cannot communicate. They are used if you need medical help, but cannot tell others what you want. If that happens, the form tells providers to give you the treatments you chose.
The POLST form is a document that people with serious illnesses or advanced frailty fill out to help their providers know their goals in medical care. It’s also voluntary, and you can choose whether you would like one. If you are healthy, your provider may decide not to sign a POLST form for you because it was designed for people who are seriously ill or have advanced frailty (depending on the laws of your state or country).
POLST and EMT
POLST forms give specific instructions about what to do in an emergency if you are unable to speak for yourself. While these forms do not appoint someone to speak on your behalf (surrogate or health care agent), they can be used in conjunction with Advance Directives. In a POLST, you specify exactly what you want and don’t want and for how long.
These aforementioned choices are then written in medical orders that must be followed by Emergency Medical Technicians (EMTs). EMTs cannot honor Advance Directives or health care power of attorney forms. If emergency personnel have been called, they must do what is necessary to stabilize you—including both those who have suffered accidents and those who have been taken from their homes or other facilities—for transfer to a hospital. After a physician fully evaluates your condition, they can implement the Advanced Directive.
How is a POLST different from a DNR?
A do-not-resuscitate order, or DNR order, is a medical order written by a doctor. It instructs healthcare providers not to perform cardiopulmonary resuscitation if a patient’s breathing stops or if the patient’s heart stops beating. If presented, it will be honored by emergency medical technicians. A medical order for life-sustaining treatment, or POLST, includes the option of a DNR but also makes provisions for resuscitation and other types of medical treatments such as feeding tubes and mechanical ventilation.
What do you have to do to fill out a POLST form?
In order to fill out a POLST, there are several steps:
- Learning about a condition,
- Thinking about one’s values and quality of life, and
- Conversing with those close to you.
Once this is done, the actual filling out can happen. It usually takes place in the doctor’s office after a good talk about the medical condition, treatment options, and what you want. The doctor will fill it out, and both of you will sign. You should make several copies for yourself and one will be put in your medical record.
Where can you find the correct form for your state?
POLST regulations may greatly vary. For instance, if you live in the United States you may want to review your state’s form before you meet with your doctor. The National POLST website has a lot of information on POLSTs in general, and you can find and review the one from your state.
While creating a POLST is completely optional, it could provide you the treatment you want, and potentially enhance your last moments. A POLST is also compatible with Myend’s Advanced Care Plan. This is a great way of providing detailed information to your loved ones. Sign up now and see how our online services can help you plan ahead!