Advance Directives

Advance directives and POLST forms are both advance care planning tools, but they are different in many ways. This can be challenging because there are different words for these tools in each state. Here are the words you need to know:

Advance Directive

Used to legally name the person who you want to make medical decisions for you when you cannot communicate or participate in those discussions. This person is called a surrogate (more below).
Also used to provide information about your values, religious beliefs, what you enjoy doing, and any general treatment wishes.
In your state, this document may be called an advance directive, living will, or health care power of attorney.

POLST Form

POLST is a portable medical order. Some states call it something else (view list of POLST names in the U.S.).

Surrogate

This is the person who makes your medical decisions if you cannot communicate. You legally appoint this person in an advance directive. In your state, this person may be called a surrogate, a proxy, a health care power of attorney, or a decision-maker.
In most states, if you can’t communicate, this is the person your provider will talk with about creating or updating your POLST form.

How Health Often Changes Over Time

This graphic shows how health can change over time and when an advance directive and POLST form are most appropriate to use.

The pink line shows your health over time. Most people are in Stage 1 or Stage 2. For those over 18, an advance directive is appropriate. Regardless of age (except in a couple of states), a POLST is appropriate in Stage 3.

Comparing Advance Directives and POLST forms

View this chart and watch this video to learn key differences between advance directives and POLST forms.

Chart Comparing Advance Directives and POLST

View full size chart or Download PDF

	Advance Directives	POLST Form
What is it?	Legal Document	Medical Order
Who should have this document?	All adults	Anyone (regardless of age) who is seriously ill or frail
Why would I need this?	To tell others who you want to make medical decisions for you, if you can’t communicate Tell others what medical treatments you would want, your values, what you care about.	Order providers to give specific treatments during an emergency Supports the patient across care settings
Who fills it out?	The individual	Health care professional (after discussion with patient)
Can I use it to appoint my surrogate?	Yes	No
Can emergency responders use it?	No	Yes—It tells them if the patient was CPR and if the patient wants to go to the hospital
Is the document easily found?	Not always. Be sure you give a copy of your advance directive to your provider and surrogate.	Yes. You have a copy, your provider has a copy, and it may also be in a registry.

POLST is More Specialized than Advance Directives

Watch video from National POLST

Next Steps

If you are seriously ill or have advanced frailty, you might like to next review basics About POLST.
If you want to complete an advance directive or learn more about them, visit the Prepare For Your Care and Five Wishes websites.
For help in choosing a surrogate, you might like to read How to Choose a Health Care Proxy & How to Be a Health Care Proxy from The Conversation Project.