POLST vs DNR: two different end-of-life forms
They both ensure that your older adult’s wishes for end-of-life treatment are respected by EMTs and hospitals, but there are key differences.
To help you choose the right form for your older adult, we explain:
- What a POLST and a DNR are
- The main difference between them
- Why they’re necessary
- Where to get the forms
What is a POLST form?
POLST stands for Physician Orders for Life-Sustaining Treatment. It’s a one page form, usually on bright pink paper, that specifies the end-of-life treatments that someone does or doesn’t want.
If your older adult stops breathing or their heart stops beating, EMTs and hospitals must follow the instructions on a POLST because it’s a medical order signed by a doctor. It’s legally recognized in many, but not all, U.S. states.
A POLST is usually recommended for terminally ill or very frail seniors who have made their end-of-life wishes clear.
What is a DNR?
DNR stands for Do Not Resuscitate and is also a signed medical order written by a doctor. It tells health care providers and emergency medical personnel not to do CPR on your older adult if they stop breathing or if their heart stops beating.
The DNR is only a decision about CPR (cardiopulmonary resuscitation). It does not affect any other treatments, such as pain medicine, other medicines, or nutrition.
For doctor’s orders about other end-of-life treatments, your senior may want a POLST instead.
POLST vs DNR: the most important difference
The primary difference between and POLST and DNR is that a POLST covers a variety of end-of-life treatments. A DNR only gives instructions about CPR.
With a POLST, seniors can specify:
- If they do or don’t want CPR
- What type of life-prolonging medical interventions they’d want on top of comfort care, if any
- Under what circumstances they would want to be moved to a hospital
- If they would want a feeding tube and if so, for how long
With only a DNR, during an emergency, decisions about other interventions or treatments beyond CPR would be left to EMTs or hospitals.
Why do seniors need a POLST or a DNR?
Without a DNR or POLST, hospitals and EMTs are required to do their best to resuscitate someone who is not breathing or doesn’t have a heartbeat. They cannot stop these efforts without a signed medical order.
How to get a POLST or DNR
After talking with your older adult, discuss their end-of-life preferences with their doctor.
The doctor should have access to the appropriate forms for your senior’s state and must sign the official form. They can also make sure the form is filled out accurately and completely so it won’t be rejected during an emergency.
It’s essential to use a form that’s legally recognized in your older adult’s state. No matter which forms are legally recognized, it’s important to discuss end-of-life preferences with their doctor. They can advise you on how to ensure those wishes will be carried out.
Make sure the DNR is easily accessible
A POLST or DNR can only be honored if people know it exists. Notify doctors, nurses, caregivers, family members, and assisted living staff about your older adult’s wishes and that they have a signed POLST or DNR.
Make sure doctors, hospitals, and assisted living communities have the form on file and/or post it prominently in your senior’s room. Print copies on neon colored paper for your hospital essentials kit and for family members.
At home, make sure the form is posted prominently near your older adult’s bed or on the refrigerator – EMTs are likely to look there.
By DailyCaring Editorial Team
Image: Tracee Dunblazier