What is a POLST?

A POLST form is a portable medical order, signed by a health care provider, that tells emergency personnel and other providers which treatments a seriously ill or frail person does and does not want. National POLST says it records choices such as whether to attempt CPR, whether to go to the hospital, and whether to receive intensive care with a breathing machine. Having one is entirely optional.

An advance directive is a legal document, while a POLST is a medical order. National POLST explains that advance directives, living wills and health care powers of attorney name a decision maker and state general wishes, but emergency medical services cannot follow them as orders. A POLST gives specific emergency treatment instructions, is meant for seriously ill or frail people, and is signed by a health care professional.

Not exactly. A POLST can record a decision not to attempt CPR, but National POLST says it also covers whether the person wants to go to the hospital or stay where they are, and whether they want intensive care and a breathing machine. It states general goals of care too, which guide other decisions such as antibiotics and artificial nutrition, not only what happens in emergencies.

The health care provider must sign a POLST form for it to be valid, because it is a medical order. National POLST says most states, and the National POLST Form, also require the patient or the patient's surrogate, such as a health care agent or representative, to sign. It should be completed only after a conversation with the patient or surrogate about diagnosis, prognosis, treatment options and goals of care.

In most cases they are different state names for the same kind of portable medical order. National POLST says POLST is no longer an acronym nationally, having originally stood for physician orders for life-sustaining treatment, and that programs go by different names depending on the state, including MOLST, POST, MOST and LST. Its state directory shows what the form is called in each state.