Advance Care Planning: Physician Orders for Life-Sustaining Treatment (POLST)

Patient-centered care is at the heart of modern healthcare, aiming to address the unique needs of each individual and empower patients to be active participants in their care. As part of this approach, advanced care planning is crucial in ensuring that a person's healthcare preferences are known and honored, especially when they cannot make decisions for themselves. This planning involves the creation of legal documents (advance directives, living wills, and healthcare power of attorneys) and medical orders that reflect an individual's goals, values, and beliefs, guiding their medical treatment. At the end stages of your or a loved one's life, these documents and medical orders become increasingly important to guide treatment. It can be difficult to anticipate, but advance care planning guarantees that the patient receives the specific care they desire during this stage of their life. It also alleviates the burden of decision-making from loved ones and establishes clear instructions for medical professionals. For individuals who are critically ill, the POLST form helps communicate their treatment wishes when they may be unable to speak for themselves.

What is a POLST Form?

The Physician Orders for Life-Sustaining Treatment (POLST) form is an important aspect of advanced care planning. Unlike traditional advance directives, the POLST form is a set of medical orders that provides seriously ill or frail patients with more specific control over their end-of-life care. It is a signed medical order that your healthcare team can act upon, allowing individuals to express their preferences regarding various medical treatments in detail. The POLST form is printed on bright pink paper and signed by the patient (or their appointed decisionmaker) and a healthcare professional, ensuring that the patient's wishes are clearly communicated and legally recognized. When patients cannot communicate their wishes, the POLST form serves as a clear guide for family members and caregivers, eliminating any confusion about the types of treatments the patient does or does not want. Having a clear plan in place can bring peace of mind to the patient and their family members during a difficult time. The POLST form is a valuable tool for outlining care preferences during an emergency or at the end of life, which can help reduce stress and alleviate feelings of burden, guilt, and depression in caregivers or family members. With a set plan in place, loved ones can focus on grieving and processing their emotions without the added pressure of making difficult decisions.

Who is POLST for?

The POLST form is designed for seriously ill individuals or those in very poor health, regardless of age. This form is valuable for patients with specific beliefs, values, and wishes who want a more direct say in their healthcare treatments, especially as their medical condition progresses or worsens. By completing a POLST form, individuals can ensure that their preferences for CPR, comfort treatments, hospitalization, and artificial nutrition are clearly documented and followed by all healthcare providers. Ultimately, the POLST form is an important component of end-of-life care, ensuring patients' wishes are respected and their care is tailored to their needs and preferences. 

Preparing the POLST Form

Preparing a POLST form is optional, but if a person decides not to fill it out, they opt to receive the "standard of care," which is the type of healthcare automatically provided to anyone in a similar situation. A healthcare professional fills out the POLST form, and this process starts clarifying discussions between the patient, their healthcare team and loved ones on their treatment wishes at this stage of their life.

If your loved one can no longer communicate their wishes for care, then a healthcare professional can fill out the form based on the family members' understanding of what they would have wanted; then, an appointed decisionmaker can sign the POLST form on behalf of the loved one. 

After Completing the POLST Form

Once the POLST form is completed and signed, it becomes part of the patient's medical record and stays with them at all times, whether at home, in a healthcare facility, or during care transitions. The form travels with the patient, ensuring that their treatment wishes are known and honored across different healthcare settings and by all medical professionals. Faxed copies and photocopies on any color paper will be honored as valid. To ensure medical professionals know that a patient has a POLST, an individual can wear a bracelet or medallion to alert them. The California Emergency Medical Services Authority keeps a list of approved vendors for California POLST/DNR bracelets and other medallions. 

Seeking Guidance Through the Process

At Alertive Healthcare Medical Group, our providers understand the importance of the POLST form in ensuring that patients receive care that aligns with their treatment wishes and values at the end of their lives. We are committed to assisting our patients and their loved ones in completing the POLST form, guiding them through the process, and helping them make informed decisions about their treatment options, including resuscitation, comfort-focused treatment, and artificial nutrition. Our goal is to support patients in expressing their healthcare preferences and to ensure that their wishes are respected by all healthcare professionals involved in their care.

In summary, the Physician Orders for Life-Sustaining Treatment (POLST)  form is a powerful tool that allows seriously ill individuals more specific control over their healthcare treatments, ensuring their preferences are clearly communicated and legally recognized. By completing a POLST form, patients can take an active role in their advanced care planning, providing guidance to their healthcare providers and loved ones and, ultimately, ensuring that their end-of-life care reflects their values and wishes.

If you or a loved one are considering completing a POLST form, we are here to support you through this process and to help you make informed decisions about your treatment options. Please get in touch with our office by calling 951-724-4954 or booking online to inquire how we can assist you or a loved one with advanced care planning.