Why a POLST Form is an Essential Tool for Caregivers

If you provide long-term care for a loved one with a serious illness or condition, learn more about the Physician’s Orders for Life-Sustaining Treatment (POLST) form and how it can protect your loved one—and you.

As caregivers, we are so busy tending to our loved one’s quality of life from day to day that it’s often difficult to think about end-of-life issues. That was certainly true for me when my mother was living with advanced dementia in a nursing home.  As I’ll explain shortly, I thought I had everything in place to honor her preferences for her end of life, but protecting her from unnecessary medical intervention turned out to be more complicated, and traumatic, than I expected.

If your loved one already has a Health Care Proxy and Living Will, that’s terrific. You may also have asked their doctor to sign an “Out of Hospital Do Not Resuscitate” (DNR) order. But a 4^th document, less well-known, is equally as important: the Physician’s Orders for Life- Sustaining Treatment (POLST) form (available in many, but not, all states; see below).

Why do we need POLST forms?

A neon-pink POLST formFirst of all, neither Health Care Proxies nor Living Wills are honored by EMS crews in an emergency. A DNR form should be honored by EMS crews, by law, but a POLST form is neon pink, designed to grab the attention of EMS crews in a commanding kind of way. It’s also more detailed, and updated and signed by your loved one’s physician on a regular basis, so it carries more weight than these other forms with EMS crews, hospitals, and elder care facilities.

A POLST is for patients with serious health conditions who

• Want to avoid or receive life-sustaining treatment
• Reside in a long-term care facility or require long-term care services, or
• Might die within the next year.

The POLST form details the patient’s preferences for:

• Resuscitation instructions when the patient has no pulse and/or is not breathing
• Instructions for intubation and mechanical ventilation when the patient has a pulse and the patient is breathing
• Treatment guidelines
• Future hospitalization and transfer
• Artificially administered fluids and nutrition
• Antibiotics, and
• Other instructions about treatments not listed.

Read more (posted in caregivers.com)