Make Sure End-of-Life Wishes Are Honored with a POLST Form

POLST

A POLST supplements a living will

One of the main goals of planning for end of life is to help your older adult document their wishes.

That way their preferences can still be carried out even if they’re not able to speak for themselves. A living will like the Five Wishes form helps with this.

But another document that might benefit some older adults is the POLST form. It’s a separate document that specifically covers end-of-life treatment preferences. 

Emergency medical personnel and hospitals must follow the instructions in a POLST because it’s a signed doctor’s order.

We explain what a POLST is, why someone might want it in addition to their living will, who typically uses it, what treatments it covers, and which states legally recognize the POLST form.




Advertisement

 

What is a POLST?

POLST stands for Physician Orders for Life Sustaining Treatment. 

It’s a medical form that’s legally recognized in many U.S. states and specifically spells out the end-of-life treatments that someone does or doesn’t want.

However, a POLST is not the same as a living will or advanced directive

It’s a simple one-page document that’s usually printed on bright pink paper so it’s easy for EMTs and medical staff to recognize. Medical personnel must follow the instructions on a POLST.

 

Why have both a POLST and a living will?

Someone who feels strongly about their end-of-life choices may want to have a POLST in addition to a living will.

This is needed because if somebody isn’t breathing or doesn’t have a heartbeat, EMTs and medical staff are required to immediately begin CPR and provide full medical treatment – no matter the person’s age, medical condition, and even if they have a living will saying they don’t want this treatment.

If someone doesn’t want CPR or invasive treatments, having a signed living will isn’t enough to stop them from happening because a living will isn’t a doctor’s order. 

So, if your older adult feels strongly about not being resuscitated or given aggressive treatments during an emergency, having a POLST available will ensure that their wishes will be fulfilled.

 

Who typically would want a POLST?

A POLST is typically used by seriously ill or frail patients. 

It allows them to specifically choose the treatments they do or don’t want. 

And it makes sure their wishes are honored, especially by emergency medical personnel, hospital staff, and assisted living and nursing home staff.

 

What does the POLST form cover?

The POLST form is very straightforward.

There are 3 sections with checkboxes to select specific preferences about three types of treatment:

  1. Do you want CPR?
  2. What level of medical interventions do you want?
  3. Do you want a feeding tube?

 

Which U.S. states legally recognize the POLST?

POLST isn’t legally recognized in every state in the United States yet. 

Check the National POLST website to see if it’s used in your older adult’s state and to get additional details.

Some states use a variation of the POLST name for the same form. So, don’t be surprised to see acronyms like MOLST, MOST, or something similar.

 

Next Step  Find out more about POLST at the National POLST Paradigm

 

Recommended for you:

 

By DailyCaring Editorial Team
Image: Lumina Hospice & Palliative Care

 

This article wasn’t sponsored and doesn’t contain affiliate links. For more information, see How We Make Money.


4 Comments

  • Reply August 9, 2019

    Thomas Taylor

    Being a marketer for hospice, we always honored the POLST form but we always informed the patients or family what it means to be resuscitated and the injury that can happen. Most of our patients opted for no life saving measures unless it was a fairly non invasive procedure or therapy. The POLST gives a lot more options than the DNR (Do not resuscitate).

  • Reply August 7, 2019

    Donna Caissie

    Unfortunately, a POLST doesn’t always work. I’ve heard stories of ER physicians ignoring the POLST and even saying they don’t care that the patient has a POLST, and then going on their merry way and doing everything the POLST says they can’t do. In one particular case, the ER physician revived the patient, admitted the patient to the hospital, and it took the patient’s relatives weeks to convince the hospital to let the patient go home to die. This hospital did everything they could to ignore the patient’s and family’s written wishes.

    • Reply August 7, 2019

      DailyCaring.com

      It’s terrible that happened! However, it’s important to note that having a POLST is better than not having one at all (if the person is firm about what they do or don’t want).

      Not having one means that there is no chance of having the patient’s exact wishes followed. At least if a POLST exists, there is a legally-recognized medical order to show to medical personnel. Typically, a POLST will be honored.

      But unfortunately, having medical professionals refuse to follow a POLST seems to be a gray area in the law. The National POLST Paradigm website has a legislative guide here — http://polst.org/wp-content/uploads/2017/02/2014.02.20-POLST-Legislative-Guide-FINAL.pdf

      In their document, Issue 9 on page 21 addresses the situation you’ve described.

      One way to prevent this situation from happening is to make sure ahead of time that the POLST will be valid at the hospital the person would most likely be brought to in an emergency. If the person has a record at that hospital, the POLST should be able to be entered into it.

Leave a Reply