Many states are offering a new document to help you keep control of your medical care at the end of life, called a POLST form—short for "Physician Orders for Life-Sustaining Treatment." The form may go by another name in your state, such as POST, MOLST, MOST, COLST, or TPOPP.
This article explains the basics of POLST forms: what they are, how they can help you, and how to make one if the need arises.
A POLST form is a medical order form that is signed by your doctor or another qualified health care professional and placed in a patient's medical records. POLST forms are used in health care settings—for example, hospitals or hospice facilities—and they typically travel with a patient from one setting to another. POLSTs help medical providers give patients the kind of end-of-life care that they want. In most states, a POLST form is printed on brightly colored paper so it will easily stand out in a patient's files.
A POLST form includes directions to medical providers about life-sustaining measures—such as cardiopulmonary resuscitation (CPR), intubation, antibiotic use, and feeding tubes. If this sounds familiar to you, that's because POLSTs are similar to other health care directives in some respects. For example, DNR orders may be used to tell medical providers not to administer CPR in the event of a medical emergency. In many states, POLST forms are now used instead of, or in addition to, DNR orders.
Also, POLST forms cover many of the same topics addressed by advance health care directives or living wills. However, a POLST form is not meant to be a substitute for a properly prepared advance directive. Advance directives allow you to do more than POLST forms—for example, you can use an advance directive to appoint a health care agent to oversee your medical care and to specify your wishes for life-sustaining care far into the future.
Every adult should have an advance health care directive, while POLST forms are most commonly prepared for those who are terminally ill or aged and very close to the end of life. For more information about making an advance directive, see the Living Wills & Medical Powers of Attorney area of Nolo.com.
The main point of a POLST form is that it gathers together a patient's most significant wishes for end-of-life-care and makes those wishes very obvious to medical providers in any health care setting.
When you enter a hospital, hospice, or other health care setting, a member of the staff may ask whether you want to complete a POLST form. If you do, you'll discuss your health care wishes and the medical provider will complete the form. To make the form valid, you (or your health care agent) must sign it, and the provider must sign it, too.
If no one asks you whether you want to complete a POLST, you can ask for one. As long as the form is available in your state or in the facility where you are receiving care, a staff member can help you with it.
As mentioned above, POLST forms go by different names in different states. If the form is available in your state, it may be called Physician Orders for Scope of Treatment (POST), Medical Orders for Scope of Treatment (MOST), Medical Orders for Life-Sustaining Treatment (MOLST), Clinician Orders for Life-Sustaining Treatment (COLST), Transportable Physician Orders for Patient Preferences (TPOPP), or something similar.
To learn about the specifics of POLST forms where you live, see POLST Forms in Your State.
Currently, more than half the states offer some variation of the POLST form, and that number is steadily growing. If your state does not yet offer a POLST form or similar document, you can still take steps to ensure that your wishes for end-of-life care are known and followed. Read Living Wills and Powers of Attorney for Health Care: An Overview for more information on creating a health care directive.