The POLST Form: An Explanation on "Physician Orders for Life Sustaining Treatment"
POLST forms are legal documents indicating your preferences for medical care.
The POLST form is a legal, end-of-life planning document that complements advance directives. While advance directives enable individuals to appoint healthcare representatives and provide instructions for all future life-sustaining treatments, the POLST form enables individuals to provide medical orders for their current treatment.
For more information on the POLST form, read through the information below.
What is a “POLST form?”
The POLST form is a legal document that stands for Physician Orders for Life Sustaining Treatment. These medical orders are designed to ensure that individuals’ end-of-life care preferences are honored. The POLST document outlines – for healthcare professionals – the type of care a person would like in the event of an emergency medical situation.
Who should complete the POLST form?
The POLST form is intended for patients with serious, progressive, chronic illnesses, as their medical conditions indicate the need for such standing medical orders. For healthy individuals, advance directives are recommended for making future end-of-life care wishes known.
What does the POLST form address?
• CPR (Cardiopulmonary Resuscitation) - Individuals can decide whether or not CPR is wanted if he or she has no pulse and is not breathing.
• Medical Interventions - Individuals can choose among three care options. The first, is “comfort measures only,” which includes only the relief of pain and suffering through medications, positioning, wound care, oxygen and suction, and decline transport to the hospital if comfort can be managed at home. Or, individuals can chose “limited additional interventions,” which includes comfort care along with IV fluids and cardiac monitoring. Lastly, individuals can choose “full treatment,” which includes ALL care options such as breathing assistance, mechanical ventilation, and the option of being transferred to the hospital.
• Antibiotics - Individuals can choose to “decline antibiotics,” to use “limited antibiotics if infection occurs” or to “use antibiotics to help prolong life.”
• Artificially Administered Nutrition - An individual can “decline tube feeding,” “agree to a trial period of tube feeding,” or “agree to long-term artificial nutrition.”
How is the POLST forrm different from advance directives or “Do Not Resuscitate Orders”?
Advance directives are to be completed in advance by any adult wishing to outline his/her wishes regarding assigning someone to speak on their behalf or what treatments he/she would like in an end-of-life situation. These can be done years in advance or closer to when the time comes, so long as the individual is able to make such decisions. Any adult can create these documents at any time.
A POLST document is completed in conjunction with the patient, family and physician to determine what current treatment an individual with a life-limiting illness wants. POLST is different from a Do Not Resuscitate Order (DNR) because it provides patients with a wider variety of options rather than just the options for “full code” status (also known as “Full Treatment”) and “comfort care only.”
What are the benefits of completing the POLST form?
Emergency medical professionals are legally required to carry out certain life-sustaining treatments, like CPR. If you do not want such treatments, you must have a POLST form (or a DNR) completed that states your preferences as such.
What states use POLST?
Just as every state offers its own version of advance directives, different state have different versions of the POLST form. Some states even call the POLST form by different names, like MOST, MOLST, POST, or TPOPP. Although some states will honor POLST forms completed in another state, it’s generally best to complete the forms in all the states relevant to you.
How can you complete a POLST document?
Depending on the state, you can either download the POLST form and complete it in conjunction with a member of your healthcare team or request the POLST form from your physician. In all cases, the POLST form must be signed by a medical professional in order for it to be legally binding. For the most up-to-date information on POLST forms, plese visit http://www.polst.org.
This article was written for eFuneral's Online Resource Center by Chelsea Gumucio, eFuneral’s Liaison Social Worker. Chelsea is a State of Ohio-Licensed Independent Social Worker with experience working as an advocate, educator, and counselor. She previously served as an Alternative Home Care Hospice Social Worker in Cleveland, Ohio. Those thinking about end-of-life should visit eFuneral for help researching, planning, and arranging a wide variety of funeral-related services.