What Is a POLST Form and How Is It Different From an Advance Directive?
By CRYSTAL BAI •
The short answer: A POLST (Physician Orders for Life-Sustaining Treatment) is a medical order — signed by a physician — for seriously ill or frail patients, specifying what treatments to perform or avoid. Unlike an advance directive, POLST is immediately actionable and travels with the patient across care settings.
What Is a POLST Form?
POLST (Physician Orders for Life-Sustaining Treatment) — also called MOLST, MOST, POLST, or POST depending on the state — is a medical order form used for patients with serious illness, advanced frailty, or who are near the end of life. Unlike a standard advance directive, a POLST is signed by a physician and constitutes an actual medical order that must be followed by healthcare providers in all settings.
What POLST Covers
CPR: Full resuscitation or no CPR (DNR). Medical interventions: Full treatment, limited interventions, or comfort measures only. Artificial nutrition: Long-term, trial period, or no artificial nutrition by tube. Some states include sections on hospitalization preferences, antibiotics, and IV fluids.
POLST vs. Advance Directive: Key Differences
Advance directive: Written by a competent adult in advance; includes healthcare proxy designation and general wishes; becomes operative when capacity is lost. POLST: Created with a physician for current serious illness; constitutes medical orders; effective immediately; doesn't designate a healthcare proxy. Both are needed — they serve different purposes.
Who Should Have a POLST
POLST is designed for: people with serious illness or advanced frailty; people in nursing facilities or home health settings; people at increased risk of needing emergency intervention. It's not appropriate for healthy adults (use a standard advance directive instead).
Frequently Asked Questions
What is a POLST form?
A POLST is a physician-signed medical order for seriously ill or frail patients specifying preferences for CPR, medical interventions, and artificial nutrition — effective immediately across care settings.
Is a POLST the same as a DNR?
Not exactly. A POLST includes a CPR section that can function as a DNR, but it also covers broader medical intervention preferences beyond just CPR.
Do I need both an advance directive and a POLST?
Yes, for seriously ill patients. They serve different purposes: an advance directive appoints a healthcare proxy and states general wishes; a POLST creates specific medical orders for current treatment decisions.
Can a death doula help with POLST completion?
Yes. Many death doulas are trained in advance care planning conversations including POLST, and can help patients and families understand the options and complete the form.
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