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 or DNAR) 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. Typically, a POLST form also provides other information about your wishes for end-of-life health care, such as your directions about tubes to help you breathe or take in fluids and nutrition.
Alabama is one of just a few states that is not yet developing a POLST program. But that doesn’t mean you can’t get many of the benefits of a POLST form. Alabama offers other health care forms that allow you to convey the same set of wishes to your health care providers.
To cover the same ground as a POLST, you need to prepare the forms below that are relevant to your situation, and then make sure that health care providers know your wishes. Here are the forms to consider:
Living will. A living will documents the type of care you want (or don't want) if you become incapacitated and unable to speak for yourself. A living will bears no relation to the conventional will or living trust used to leave property at death; it's strictly a place to spell out your health care preferences.
Durable power of attorney for health care. This document does the important job of appointing someone you trust to be your health care agent, often called your “proxy” in Alabama, to make any necessary health care decisions for you and to see that doctors and other health care providers give you the type of care you wish to receive.
In Alabama, these two documents are often combined into a single form called an advance directive for health care. To learn more, see Alabama Living Wills and Advance Directives for Health Care: What You Need to Know.
DNR order. A DNR order -- often called a DNAR order in Alabama, for "Do Not Attempt Resuscitation" -- tells emergency medical personnel what to do if you stop breathing or your heart stops beating. Specifically, the order tells them that you don’t want cardiopulmonary resuscitation (CPR), artificial breathing tubes, electric heart shocks, or other invasive emergency techniques. To learn more, see Do Not Resuscitate Orders -- and if you want to prepare a DNR order, talk to your doctor. A DNR order is valid only if a doctor signs it. In Alabama, a doctor can also help a patient create something called a "portable DNAR order" that, like a POLST form, travels with the patient from one medical care setting to another.
The best way to be certain that medical professionals know and understand your health care preferences is to name your health care proxy in an advance directive or durable power of attorney for health care. Your proxy will be legally empowered to speak for what you want if you become unable to speak for yourself.
You may also want to consider giving copies of your health care forms to:
Finally, some states have an advance directive registry where you can put your documents on file. Alabama doesn’t have such a registry but you may want to consider putting your documents on file at the U.S. Living Will Registry. Some doctors and hospitals check such registries before providing care to patients.
To find out more about POLST forms and to stay informed about efforts to create a POLST program in Alabama, visit Polst.org.