You may have heard about a new kind of health care directive in Hawaii, called a Provider Orders for Life-Sustaining Treatment (POLST) form. Here, we discuss what a POLST form is and when you need one.
What Is a POLST Form?
A POLST form is a set of medical orders that helps you keep control over health care at the end of life. Like a Do Not Resuscitate (DNR) order, the form tells emergency medical personnel and other health care providers whether or not to administer cardiopulmonary resuscitation (CPR) in the event of a medical emergency. A POLST form may be used in addition to -- or instead of -- a DNR order. The POLST form may also provide other information about your wishes for end-of-life health care.
How to Make a POLST Form
A health care professional can help you create a POLST form if you enter a medical facility or health care setting -- such as a hospital, nursing home, or hospice care in a facility or at home. To be legally valid, a POLST form must be signed by a doctor or an advanced practice registered nurse. (Hawaii Statutes § 327K-2.) If a member of the medical staff does not ask you whether you want to create a POLST form, you may ask for one.
In Hawaii, a POLST form is usually printed on bright lime-green paper so it will easily stand out in your medical records. The form travels with you if you move from one health care setting to another. You can change it or cancel it at any time.
How Does a POLST Form Differ From Other Health Care Directives?
A POLST form differs from a DNR order in one important way: A POLST form also includes directions about life-sustaining measures in addition to CPR, such as intubation, antibiotic use, and feeding tubes. The POLST form helps medical providers understand your wishes at a glance, but it is not a substitute for a properly prepared Advance Health Care Directive.
An Advance Directive provides more information than a POLST form, including details about your health care agent, more complete health care wishes, and your preference for organ donation. Therefore, if you have a POLST form, you do not need a DNR order, but you should still complete an Advance Directive to provide a full set of wishes about your care.
For details about making an Advance Directive, see Hawaii Living Wills and Advance Health Care Directives: What You Need to Know.
For More Information
To learn more, and to view an example of the Hawaii POLST form, visit the website for Hawaii’s hospice and palliative care organization, Kokua Mau. To prepare a POLST form for yourself or a loved one, talk to your doctor.