You may have heard about a new kind of health care directive in Maine, called a Physician Orders 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. The POLST form may also provide other information about your wishes for end-of-life health care, as explained below.
In Maine, a growing number of health care providers and organizations are offering the POLST form, but it is not yet available everywhere in the state. If you enter a participating medical care facility or setting, a health care professional can help you create a POLST.
To be legally valid, the POLST must be signed by a licensed physician, nurse practitioner, or physician assistant. In addition, to ensure your wishes will be carried out, you (or your legally appointed health care representative) should also sign the POLST. The POLST form is usually printed on bright 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.
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 directive for health care. A Maine advance directive provides more information than a POLST form, including information about your health care agent, your wishes for organ donation after death, who should carry out your wishes for burial or cremation, and other important instructions.
You need to consider a POLST only if you're facing a life-threatening medical condition. If you're healthy, you need only an advance directive 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 benefit from a POLST in addition to traditional health care directives. That’s because an advance directive 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 making health care directives in Maine, see Maine Living Wills and Advance Health Care Directives: What You Need to Know.
For general information about how to document your health care wishes, see the Living Wills & Medical Powers of Attorney section of Nolo.com.