Physician Orders for Life-Sustaining Treatment (POLST) is a medical order for people likely to have a life-threatening medical emergency, such as older people and individuals with critical chronic conditions.
This medical order helps them decide and specify the type of medical intervention they want to receive in a medical emergency. It is especially beneficial for people experiencing end-of-life conditions, but who don’t want aggressive medical treatment.
Difference Between POLST and Advance Directive
Although similar, the Physician Orders for Life-Sustaining Treatment (POLST) is different from an advance medical directive in several ways. For one, the POLST is a portable medical order. This means that emergency responders and care providers can access it anytime and anywhere and follow its directives, even outside the healthcare facility.
This is unlike an advance directive, which emergency providers may not be aware of. For instance, when an emergency provider responds to an emergency outside the facility, they will do all it takes to save the individual, even if s/he has an advance directive. But, with a POLST, they will be aware of the patient’s wishes and follow them.
Also, while any adult, including healthy adults, can get an advance directive, the POLST is specifically for critically ill and older people who are likely to experience a life-threatening emergency. However, the POLST doesn’t replace an advance directive, and you can have them both.
When to Consider Getting a POLST
As previously mentioned, POLST is for people who are seriously ill or elderly, and nearing the end of life. So, you should consider getting a POLST medical order if you or your loved one are in this category and you don’t want aggressive emergency care such as CPR, feeding tubes, etc.
How to Get and Use a POLST
If you think you or your loved one needs a POLST order, here are the steps to get and use one.
Step #1: Have a conversation with your medical provider about getting a POLST. This will help you understand your medical options during an emergency and decide which directives to include in your POLST order. You may include a health surrogate, family member and or healthcare agent in the discussion, so they are aware of your wishes.
Step#2: Fill out the POLST form to tell emergency care providers and responders what to do when you experience a critical medical emergency. Sign it and have your physician sign it too, as it isn’t valid until both signatures are on the form. A valid form also requires a witness signature.
Step #3: The original POLST form should be with you at all times. This will enable emergency care responders to be aware of your medical care wishes during an emergency, especially outside the health facility. Post on your refrigerator or other highly visible area so when emergency personnel arrive, it will be seen. An executed POLST on any colored paper is legal and valid as is photocopies and faxed forms.
In summary, POLST gives you control to establish the medical care you want to receive during an emergency, and you should have one as part of your end-of-life care plans. Every State in the US has its own POLST form and process. You can check your State’s requirements here.
The Illinois Department of Public Health is currently revising the State’s POLST form following the new legislation that took effect on January 1, 2022. However, the changes are yet to be finalized, and you can still get POLST with the old forms. You can contact MBCR if you need any help getting a POLST medical order.