POLST, or Physician Orders for Life-Sustaining Treatment, is an approach to end-of-life care that encourages discussions between patients and their health care providers. The goal of POLST is to enable patients to choose the treatment they want or do not want, and to ensure that those preferences are honored.
On a POLST form, the patient selects (1) whether or not they wish to be given CPR; (2) what degree of medical intervention they want in an acute situation: “comfort measures only,” “limited additional interventions,” or “full treatment;” and (3) the extent to which they want artificial nutrition to be administered, if at all. The POLST form is a single page, brightly colored, and designed to be immediately recognizable and used by doctors and first responders alike.
The POLST form is signed by the patient’s doctor (or, in some states, nurse practitioner or physician’s assistant) and is a medical order. A copy is kept in the patient’s medical record, so it can be easily accessed in an emergency. Some states allow the forms to be logged into an electronic registry.
The POLST Paradigm, the national organization behind POLST, advises that POLST forms are not for everyone. They are recommended for “seriously ill or frail patients for whom their physicians would not be surprised if they died in the next year.”
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Planning with POLST