You may have heard about a new kind of health care directive in Illinois, called a Physician Orders for Life-Sustaining Treatment (POLST) form or, sometimes, a DNR/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 standard 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. In 2015, Illinois's POLST form replaced other types of DNR orders in the state, which is why it is sometimes called a DNR/POLST form.
A POLST may provide additional information about your wishes for end-of-life health care, discussed below.
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, the following people must sign the POLST:
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 Illinois, a POLST form is usually printed on brightly colored 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.
A POLST form differs from a standard 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 durable power of attorney for health care.
In Illinois, a durable power of attorney for health care 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, even if you have a POLST form, you should complete a health care power of attorney to provide a full set of wishes about your care.
You need to consider a POLST only if you're facing a life-threatening medical condition. If you're healthy, you need only 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 health care 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. 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 a durable power of attorney for health care.
For details about making essential health care directives, see Illinois Living Wills and Durable Powers of Attorney for Health Care.
For general information about how to document your health care wishes, see the Living Wills & Medical Power of Attorney section of Nolo.com.