National POLST is an approach to end-of-life planning that emphasizes eliciting, documenting and honoring patients’ treatment preferences using a portable medical order (a POLST form).
Ideally, POLST emphasizes:
- Advance care planning conversations between patients, health care professionals and loved ones;
- Informed shared decision-making between a patient and his/her health care professional about the treatment the patient would like to receive at the end of his/her life; and
- Ensuring patient treatment wishes are honored. The POLST form is the most visible part of POLST — helping to ensure patient treatment wishes are communicated to health care professionals when the patient cannot speak for him/herself — but the most important part is the conversation and process for completing the form.
A POLST form is not for everyone. The POLST decision-making process and resulting medical orders are intended for patients who are considered to be at risk for a life-threatening clinical event because they have a serious life-limiting medical condition, which may include advanced frailty.
For these POLST-appropriate patients, their current health status indicates the need for standing medical orders. For healthy patients, an advance directive is an appropriate tool for making future end-of-life care wishes known to loved ones.