You may have heard about a new kind of health care directive in Nevada, called a Physician Order for Life-Sustaining Treatment (POLST) form. Here, we discuss what a POLST form is and when you might need one.
A POLST form is a doctor’s order that helps you keep control over medical 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.
A doctor 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. If a member of the medical staff does not ask you whether you want to create a POLST form, you may ask for one.
To be legally valid, a POST form must be signed by:
In Nevada, a POLST form is printed on brightly colored paper so it will 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.
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. It may also indicate whether you have chosen to donate your organs after death. The POLST form helps medical providers understand your wishes at a glance, but it is not a substitute for a properly prepared health care declaration (living will) and durable power of attorney for health care. Taken together, a health care declaration and durable power of attorney for health care provide more information than a POLST form, including information about your health care agent and more detailed health care wishes.
You need to consider a POLST only if you're facing a life-threatening medical condition. If you're healthy, you need only a declaration and a durable power of attorney for health care to provide a full set of wishes for your treatment in the event of an unexpected accident or medical crisis.
On the other hand, a patient diagnosed with a terminal illness or frailty that requires care in a medical setting -- or ongoing care at home -- may need a POLST in addition to traditional health care directives. That’s because a declaration and medical power of attorney may not be enough to prevent medical personnel from resuscitating a patient in an emergency. For that, it's important to have a medical order such as a POLST or DNR order. If you feel strongly that you don’t want emergency measures at the end of life -- or if you’re caring for someone who feels that way -- find out about making a POLST in addition to traditional health care directives.
For details about preparing health care directives, see Nevada Living Wills and Durable Powers of Attorney for Health Care: What You Need to Know.
For more on Nevada estate planning issues, see our section on Nevada Estate Planning.