Physician orders for life-sustaining treatment (POLST) is a physician order that provides a specific plan for end-of-life care that considers both patients’ preferences and physician’s judgment that is based on medical evaluation of the patient (Mack & Dosa, 2019). The POLST allows patients and physicians to come up with default orders related to end-of-life care that can be clearly and succinctly conveyed to different healthcare practitioners and healthcare facilities when the patient is at home, in transit between locations, in the emergency department, or long-term care facility (Mack & Dosa, 2019).
When should this form be completed?
A POLST should be completed for patients who have less than one year to live, which includes patients in end-stage organ diseases, patients in metastatic stages, patients receiving palliative and hospice care, and patients with terminal diagnoses. A POLST should also be considered for patients who reside permanently in long-term care facilities (Mack & Dosa, 2019).
Who can complete the form?
A POLST form should be completed by professionals who have undergone special training related to the form and who work with the patient’s physician or the physician himself in collaboration with the patient. A POLST should therefore consider the patient’s current health situation, their treatment preferences, and future health conditions (Mack & Dosa, 2019).
Who needs to sign the form to make it a legal document?
Both the patient and the physician must sign a POLST to make it a legal document. Among patients who do not have the capacity to make medical decisions, the legally recognized decision-maker for the patient can be involved in completing and signing the POLST in collaboration with a physician (Mack & Dosa, 2019).
Part III
The differences between an Advance Health Care Directive and the POLST
There are several differences between an Advance Health Care Directive and the POLST. One of the main differences between the AD and the POLST is that the advance directive is a direction from a patient, and it’s not a medical order. In contrast, a POLST form is made up of specific medical orders that are specific to limited patient populations and which address a specific critical medical decision (Carr & Luth, 2017). The advance directive and therefore be filled by any competent adult across the population while a POLST form only targets individuals whose death is imminent such as those having a terminal diagnosis does permanently residing in long-term care facilities, individuals with end-stage organ diseases, or final stages of cancer and those receiving palliative or hospice care. The ad is a legal document, while a POLST is a medical order. The AD is completed by an individual, while the POLST is completed by healthcare professionals in collaboration with a patient (Mack & Dosa, 2019).
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