Every day, people nearing the end of their lives receive unwanted medical treatment. Whether these are burdensome ICU stays, long-term feeding tubes, artificial ventilation, or even hospitalization at all, many receive the unwanted treatments that only delay the inevitable and making the dying process worse. Maybe they only wanted a treatment that would enable comfortable without extending their life. Maybe these people wanted to be able to pass away naturally at home. Because many cannot voice their preferences, the default action is for first responders and physicians to seek to extend their lives. If only they could easily inform these medical professionals of their treatment preferences...
Enter the POLST form.
“What is a POLST form?”
The acronym P-O-L-S-T stands for Physicians Orders For Life-Sustaining Treatment. This is typically a one-page, front-and-back form with checkmark-boxed questions that individuals use to tell first responders and physicians what kind of life-sustaining treatment they wish to receive in the event that they would require it to remain alive.
“How does a POLST form differ from an Advance Directive?”
The differences between a POLST form and an Advance Directive largely have to do with the logistical challenges posed by the needed speed of required treatment. In many instances, first responders have to quickly assess what kind of treatment someone wants. If the person is incapacitated, first responders and physicians may end up delivering treatment the person does not want. While an Advance Directive does convey what kind of treatment someone does or does not want (for example, ventilation, feeding tubes, or even simple CRP services), finding this information at a moment’s notice in an Advance Directive during an emergency situation can be difficult. Some Advance Directives are many pages long and may be written in complex legalese.
A POLST form, on the other hand, is typically one front-and-back form with around 10 treatment questions that are marked with checkboxes. At a glance, anyone can immediately know what kind of treatment the listed party wants and does not want. Many are instructed to leave it attached to their refrigerator in case first responders need to quickly reference it in an emergency situation. This makes the POLST form somewhat of an outline or “cliff notes” version of an Advance Directive when the information is quickly needed.
How does a POLST form differ from a Do Not Resuscitate (DNR) form?
Like an Advance Directive, a POLST form can work in concert with a DNR order. While a DNR order that can be displayed with a wrist band or other insignia and denotes not wishing to receive a CPR-related treatment, a POLST form provides additional details, such as the duration of life-saving treatment or hospitalization. A POLST is not a substitute for a DNR, but the two can work together to make sure the patient’s wishes are respected.
Who is a POLST intended for?
Unlike an Advance Directive that is a great idea to have no matter your age, a POLST form is especially recommended for people who may be in their last year of life or have any other form of an irreversible life-limiting condition. The POLST form is best suited to keep individuals from receiving unwanted treatments, making it not completely necessary for younger, healthy, able-bodied individuals.
With that being said, because of it’s succinct nature, a POLST form can be used as a tool to help those in the 50s, 60s, and 70s start seriously considering making their end-of-life wishes known to loved ones and physicians.
What if someone changes their POLST preferences?
If someone changes their end-of-life treatment preferences, the POLST form is completely amendable. It can be adjusted at any time. As long as they are able, one can make changes to their POLST form.
What is required for a POLST to be legally binding?
The only requirement for a POLST form to be legally binding is for it to be signed by the patient or a representative and the patient’s legal healthcare representative.
If you would like a printed copy of the POLST form or would like to speak to someone about end-of-life care, look no further than the friendly people at Cura HPC Hospice & Palliative Care in Tulsa, OK.