You may have heard about a new kind of health care directive in Montana, called a Provider Orders for Life-Sustaining Treatment (POLST) form. Here, we discuss what a POLST form is and when you 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 (often called "Comfort One" in Montana), 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, as explained just 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. 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 POLST form must be signed by:
In Montana, a POLST form may be 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 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 living will and durable power of attorney for health care.
Taken together, a living will and durable power of attorney for health care provide more information than a POLST form, including details about your health care agent, more complete health care wishes, and your preference for organ donation.
You need to consider a POLST only if you're facing a life-threatening medical condition. If you're healthy, you need only a living will and health care power of attorney 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 a traditional health care directive. That’s because a living will 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 form 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 Montana, see Montana Living Wills and Durable Powers of Attorney for Health Care: What You Need to Know.
For more on Montana estate planning issues, see our section on Montana Estate Planning.