Research: POLST in Nursing Homes

A recent article in The Gerontologist evaluated the POLST Forms of nursing home residents in California. The authors collected data on 941 residents in 13 nursing homes across California. They examined whether the POLST Form was signed by the patient or a surrogate, and looked at treatment preferences for resuscitation, medical intervention, and nutrition.

The authors found that approximately half of the POLST Forms expressed preferences for each of the less intensive treatments: Do Not Resuscitate, limited medical interventions, and no artificially-administered nutrition. The proportion of individuals that elected any of the less intensive treatments is smaller than what has previously been reported in the literature. The authors hypothesized that this was due to their sample being more ethnically and age diverse than in previous studies. Indeed, they found evidence that nursing homes with older patients and more White patients were more likely to opt for less intensive treatments, while those with larger Hispanic populations were more likely to opt for artificially-administered nutrition.

These data indicate that there is a need to further explore how social characteristics influence the preferences expressed on POLST Forms.

Rahman, AN, M Bressette, ZD Gassoumis, and S Enguidanos (2015). “Nursing Home Residents’ Preferences on Physician Orders for Life Sustaining Treatment.” The Gerontologist, accessed 6/2/2015 at