Thank you to the Indiana POST Program for creating this overview. Some information may be specific to the Indiana POST Program.
The National POLST Paradigm helps patients get the medical treatments they want, and avoid the medical treatments they do not want, when they are seriously ill or frail. It's about helping people live the way they want until they die.
The POLST Paradigm—which stands for Physician Orders for Life Sustaining Treatment—encourages patients and their health care professionals to talk about what patients want at the end of life. The conversation should include:
- Patient's diagnosis. What disease(s) or medical conditions does the patient have?
- Patient's prognosis. What is the likely course of the disease or condition? What will happen to the patient over time?
- Treatment options. What treatments are available to the patient? How do they help? What are the side effects?
- Goals of care. What is important to the patient? What makes a good quality of life?
After talking, the patient and his/her health care professional may be able to make informed, shared decisions about what treatments the patient wants, or does not want, and put them on a POLST form. This form is a medical order that emergency personnel can follow whenever, and wherever, the patient has a medical emergency and can't speak for himself/herself.
It is different from an advance directive. Even with an advance directive, if the patient has a medical emergency, emergency personnel will do everything possible to attempt to save the patient's life, including CPR and putting the patient on a breathing machine. They are required by law to do so.
Patients who are seriously ill or frail may not want that level of treatment. The POLST form is a way for the patient to say "Yes, I want CPR and full treatment" or "No, I want to stay where I am and be made comfortable", or something in the middle. The POLST form can be changed or voided at anytime. It is up to the patient what they want their POLST form to say.
We invite you to learn more about the POLST Paradigm!