Physician orders for life-sustaining treatment, or POLST, is a form that expresses your preferences for end-of-life treatment, and medical professionals are usually obligated to follow it. With a POLST form you can state whether you want CPR, a feeding tube, and other types of care. POLSTs are created by a doctor to document a patient’s wishes and it is voluntary to make one — you can’t be forced to.
POLSTs are commonly used by elderly patients who are severely ill and near death, differentiating them from other advance directives, which even healthy individuals can benefit from creating. Every state has some form of POLST, which may have a slightly different name, like MOLST (medical order for life-sustaining treatment), but they should cover the same ground.
Health care professionals are typically obligated to follow the patient’s wishes as documented on their POLST form
POLST forms are a voluntary part of advance planning, and not everyone needs one
Since POLST is a medical order, you need to have a doctor prepare it
POLST is not a substitute for advance directives like a health care proxy, living will, or even a DNR order
POLST forms typically contain instructions about your preferences for life-sustaining medical treatment, and must be completed by a doctor. They are commonly divided into three parts. The first section is about CPR, and whether or not the patient wants to be resuscitated if they are found without a pulse. The second section usually outlines the scope of medical intervention and treatments a patient wishes to receive once they’re breathing, including antibiotics and medications, IV fluids, dialysis, breathing support, and comfort care (palliative care). The third section states when and if the patient should receive artificial nutrition and hydration, as through feeding tubes.
When you come in contact with any medical personnel they are generally required to follow the guidelines set out in your POLST. However, in some states emergency medical personnel, like EMTs, are legally required to try and resuscitate you regardless of your POLST — unless you've filled out a separate out-of-hospital DNR (do not resuscitate) order.
POLSTs aren’t meant to replace advance directives, which individuals can create on your own, so you should still get other documents, like a power of attorney and health care proxy (medical power of attorney) in order.
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Not everyone needs a POLST form, which is best suited for seriously ill patients who are nearing the end of life. Frail elderly individuals, people with advanced illness, like heart disease, lung disease, or cancer, might consider getting a POLST. A portable medical order can conveniently communicate your wishes if you come in contact with many different medical providers, like if you’re transferred in and out of different hospitals, nursing homes, or rehab facilities.
If a POLST isn’t right for your situation, you can still outline your preferences for medical treatment through other means, like a living will — one of the four essential estate planning documents that everyone should have.
POLST forms are standardized and easy to complete. They are signed by patient and doctor, but before that can happen both parties need to have a discussion about the patient’s medical condition and their preferences for treatment. The doctor can guide you through potential types of health care you may or may not want to receive and create the POLST order according to your wishes. In some states a physician assistant or nurse practitioner may be able to complete the POLST instead of a doctor. The chart below lists what the POLST form is called in your state and a link to the program or form if applicable.
POLSTs do not expire. You can revoke the POLST form by voiding it and creating a new one. You can also authorize someone you trust to sign the form on your behalf or change it, should you become incapacitated.
|Alabama||Alabama Coalition for Advanced Care Planning|
|Alaska||POLST - Comfort One Program|
|Arizona||POLST - Portable Medical Orders|
|Arkansas||POLST - Physician Order for Life-Sustaining Treatment|
|California||POLST - Physician Orders for Life-Sustaining Treatment|
|Colorado||MOST - Medical Orders for Scope of Treatment|
|Connecticut||MOLST - Medical Orders for Life Sustaining Treatment|
|Delaware||DMOST - Delaware Medical Orders for Scope of Treatment|
|D.C.||MOST - Medical Orders for Scope of Treatment|
|Florida||POLST - Physician Orders for Life-Sustaining Treatment|
|Georgia||POLST - Physician Orders for Life Sustaining Treatment|
|Hawaii||POLST - Provider Orders for Life-Sustaining Treatment|
|Idaho||POST - Physician Orders for Scope of Treatment|
|Illinois||POLST - Practitioner Orders for Life-Sustaining Treatment|
|Indiana||POST - Physician Orders for Scope of Treatment|
|Iowa||IPOST - Iowa Physician Orders for Scope of Treatment|
|Kansas||TPOPP - Transportable Physician Orders for Patient Preferences|
|Kentucky||MOST - Medical Orders for Scope of Treatment|
|Louisiana||LaPOST - Louisiana Physician Orders for Scope of Treatment|
|Maine||POLST - Physician Orders for Life-Sustaining Treatment|
|Maryland||MOLST - Medical Orders for Life-Sustaining Treatment|
|Massachusetts||MOLST - Medical Orders for Life-Sustaining Treatment|
|Michigan||MI-POST - Michigan Physician Orders for Scope of Treatment|
|Minnesota||POLST - Provider Orders for Life-Sustaining Treatment|
|Mississippi||MPOST - Mississippi Physician Orders for Sustaining Treatment|
|Missouri||TPOPP - Transportable Physician Orders for Patient Preferences|
|Montana||POLST - Provider Orders for Life-Sustaining Treatment|
|Nebraska||POLST - Provider Orders for Life-Sustaining Treatment|
|Nevada||POLST - Provider Order for Life-Sustaining Treatment|
|New Hampshire||POLST - Provider Orders for Life Sustaining Treatment|
|New Jersey||POLST - Practitioner Orders for Life-Sustaining Treatment|
|New Mexico||MOST - Medical Orders For Scope of Treatment|
|New York||MOLST - Medical Orders for Life Sustaining Treatment|
|North Carolina||MOST - Medical Orders for Scope of Treatment Form|
|North Dakota||POLST - Physician Orders for Life-Sustaining Treatment|
|Ohio||MOLST - Medical Orders For Life Sustaining Treatment|
|Oklahoma||OkPOLST - Oklahoma Physician Orders for Life-Sustaining Treatment|
|Oregon||POLST - Portable Orders for Life-Sustaining Treatment|
|Pennsylvania||PAPOLST - Pennsylvania Orders for Life Sustaining Treatment|
|Rhode Island||MOLST - Medical Orders for Life Sustaining Treatment|
|South Carolina||POST - Physician Orders for Scope of Treatment|
|South Dakota||MOST - Medical Orders for Scope of Treatment|
|Tennessee||POST - Physician Orders for Scope of Treatment|
|Texas||MOST - Medical Orders for Scope of Treatment|
|Utah||POLST - Provider Order for Life Sustaining Treatment|
|Vermont||COLST - Clinician Order for Life Sustaining Treatment|
|Virginia||POST - Physician Orders for Scope of Treatment|
|Washington||POLST - Portable Orders for Life Sustaining Treatment|
|West Virginia||POST - Physician Orders for Scope of Treatment|
|Wisconsin||POLST - Physician Orders for Life Sustaining Treatment|
|Wyoming||WyoPOLST - Providers Orders for Life Sustaining Treatment|
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