The National POLST Paradigm is an approach to end-of-life planning that emphasizes patients’ wishes about the medical treatments they receive. The POLST Paradigm – which stands for Physician Orders for Life Sustaining Treatment – emphasizes: (i) advance care planning conversations between patients, health care professionals and loved ones; (ii) 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 (iii) ensuring patient treatment wishes are honored. The decisions from these conversations may be documented as actionable medical orders on a POLST form. A POLST form is a tool that helps ensure patient treatment wishes are known and will be followed by health care professionals during a medical crisis, when the patient cannot speak for him/herself.
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 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.