POLST Overview
If you have a serious health condition, you need to make decisions about life-sustaining treatment. Your physician can use the Physician Orders for Life-Sustaining Treatment (POLST) to represent your wishes as clear and specific medical orders, indicating what types of life-sustaining treatment you want or do not want at the end of life.
What is the POLST form?
POLST is a physician order that helps give seriously ill patients more control over their end-of-life care. Produced on distinctive bright green paper and signed by both the clinician and patient, POLST specifies the types of medical treatment that a patient wishes to receive toward the end of life. As a result, POLST can prevent unwanted or medically ineffective treatment, reduce patient and family suffering, and help ensure that patients’ wishes are honored.
POLST is not for everyone. POLST is designed for seriously ill individuals, or those who are in very poor health, regardless of their age. POLST complements an advance directive and is not intended to replace that document. An advance directive is still necessary to appoint a legal health care decision-maker, and is recommended for all adults, regardless of their health status. And unlike an advance directive, POLST must be signed by both the patient and a health care professional, usually a doctor, nurse practitioner or physician assistant after having a conversation with the patient to understand his/her wishes and goals of care. Completing a POLST is voluntary.
What information is included on the POLST form?
You have the power to determine the kind of treatments you want to receive and the kind of treatments you want to avoid. The decisions documented on the POLST form include whether to:
- Attempt cardiopulmonary resuscitation (CPR)
- Administer antibiotics and IV fluids
- Use a ventilator to help with breathing
- Provide artificial nutrition by tube
Additionally, POLST states that ordinary measures to improve the patient’s comfort, and food and fluid by mouth as tolerated, are always provided.
Does the POLST form replace traditional advance directives?
POLST complements an advance directive and is not intended to replace that document. An advance directive is still necessary to appoint a legal health care decision maker, and is recommended for all adults, regardless of their health status.
What happens to my POLST form after it is completed and signed?
The original POLST form, on bright green paper, stays with you at all times. In a hospital, nursing home or assisted living facility, the form will be in your medical record or file. If at home, place your form in a visible location so it can be found easily by emergency medical personnel, usually on a table near your bed, or on the refrigerator.
Can I change my POLST form?
Yes, you can change your POLST at any time should your preferences for treatment change. It is a good idea to review the decisions on your POLST form when any of the following occur:
- You are transferred from one setting to another – for example you go from your home to the hospital, or you are discharged from the hospital to a nursing home.
- There is a change in your overall health, or you are diagnosed with an illness.
- Your treatment preferences change for any reason.
What happens if I don’t have a POLST form?
Without a POLST form, emergency medical personnel, nurses and doctors would not know your treatment wishes. You will most likely receive all possible treatments, whether you want them or not. Talking about your treatment choices with your loved ones and doctor before a problem occurs can guide them and help ensure you get the care you want.
Who would benefit from having a POLST form?
Most people are too healthy to need a POLST. If something suddenly happened, many healthy seniors would want everything done while more was learned about what was wrong and about their chances of recovery. Healthy people should have an advance directive. Later, if the patient became sicker or frailer, they or their surrogate (for example, their power of attorney for health care) can complete a POLST to turn their treatment wishes into medical orders.
What are my options for life-sustaining treatment?
You have the power to determine the kind of treatments you want to receive and the kind of treatments you want to avoid. To help you understand your options, visit Honoring Choices Pacific Northwest for information that will help you begin these conversations with your family and health care professionals.