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The Rise of POLST: Family education to Improve End of Life Care

June 2, 2017

Honoring the wishes of patients regarding medical treatment is an important part of end-of-life care. POLST (Physician Orders for Life-Sustaining Treatment), originally piloted in Oregon and California, is a national model for advance-care planning that supports shared, informed medical decision-making, portability of advance directives across health-care settings, and continuity of care. In New York State, it is known as MOLST (Medical Orders for Life-Sustaining Treatment).

POLST & Advance Directives 

A POLST Paradigm Form does not replace an advance directive — but they work together. While all adults should have an advance directive, not all should have a POLST Paradigm Form.

Both provide information about treatment wishes but they give different information:

  1. Advance Directive: This is called different things in different states (e.g., living will, health care power of attorney) but, regardless of the term, this describes a legal document you use to provide guidance about what types of treatments you may want to receive in case of a future, unknown medical emergency. It also is where you say who can speak for you to make medical treatment decisions when you cannot speak for yourself (called a “surrogate”). All adults should have an advance directive.
  2. Physician Order for Life-Sustaining Treatment (POLST) Form: This is called different things in different states (e.g., MOLST, MOST, POST) but, regardless of the term, a POLST Form is a medical order for the specific medical treatments you want during a medical emergency. Only individuals with a serious illness or advanced frailty near the end-of-life should have this form.

 

 

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