What Is a POLST Form and Why Does My Parent Need One?
By CRYSTAL BAI •
The short answer: A POLST (Physician Orders for Life-Sustaining Treatment) is a medical order — signed by a physician — that specifies exactly what emergency treatments a seriously ill person does and doesn't want. Unlike a living will, which is a general statement of wishes, a POLST is a standing medical order that emergency responders and hospital staff must follow. It is essential for anyone with a serious or terminal illness.
What Is a POLST?
POLST stands for Physician Orders for Life-Sustaining Treatment. It is known by different names in different states (MOLST in New York, MOST in some southern states, DNAR in others), but the concept is the same: a brightly colored, single-page medical form — usually pink or orange — that translates a seriously ill person's end-of-life wishes into actual physician orders.
Because it is a physician order, first responders, emergency room staff, and nursing facility staff are legally required to follow it. A living will does not have this legal force in an emergency — but a POLST does.
What Does a POLST Cover?
A standard POLST form addresses three key areas:
- CPR: Should responders attempt cardiopulmonary resuscitation if the person's heart stops? (Yes / No / Attempt resuscitation for a specified time)
- Medical interventions: Should the person be taken to the hospital? Should they receive IV fluids, feeding tubes, breathing machines, or other interventions? (Full treatment / Selective treatment / Comfort measures only)
- Artificially administered nutrition: Should the person receive a feeding tube if they cannot eat?
Who Needs a POLST?
POLST forms are not for healthy people. They are specifically for:
- People with a terminal illness (cancer, advanced heart failure, COPD, ALS, etc.)
- Frail elderly people who would not want aggressive resuscitation
- People in the last months to year of life
- Anyone on hospice or receiving palliative care
If your parent is in any of these categories, a POLST is essential. Without one, paramedics who arrive at the home are legally required to attempt full resuscitation — even if that's the opposite of what the person wanted.
How to Get a POLST
A POLST must be signed by a physician (or, in some states, a nurse practitioner or physician assistant). The process:
- Talk with the person about their wishes — what interventions they want and don't want
- Bring those wishes to the primary care physician or specialist
- The physician completes and signs the POLST
- Post the original POLST prominently — on the refrigerator, near the front door, or wherever first responders will see it first
A death doula can facilitate the conversation about wishes and help the family prepare for the physician meeting.
Frequently Asked Questions
What is the difference between a POLST and an advance directive?
An advance directive (living will) is a general statement of preferences, written by the patient. A POLST is a specific physician order that translates those preferences into emergency instructions. An advance directive cannot be followed in an emergency; a POLST can.
Does a POLST override CPR?
Yes. A POLST with 'Do Not Attempt Resuscitation' checked is a legal physician order that first responders must follow. Without a POLST, they are required to attempt resuscitation regardless of a patient's wishes.
Where should we keep the POLST form?
On the refrigerator door is the standard recommendation — first responders are trained to look there. Also keep copies with caregivers, in the hospital bag, and in any facility the person might be transferred to.
Can a POLST be changed?
Yes. A POLST can be revoked or changed at any time by the patient (while they have decision-making capacity) or by their healthcare proxy. If wishes change, get a new POLST signed by the physician.
Can a death doula help us complete a POLST?
A death doula can facilitate the values conversation that precedes a POLST and help the family prepare for the physician meeting, but the POLST must be signed by a licensed physician, nurse practitioner, or PA. The doula makes the process less frightening and more aligned with the patient's actual wishes.
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