POLST for Patients

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Learn What a POLST Form Is, Who It’s For, and How it Helps

A POLST form is a portable medical order for patients who have a progressing serious illness or frailty due to aging. It tells health care providers what these patients want if they become unresponsive and what their goals of care are given their current medical condition. Having a POLST form is completely optional and up to the patient.

Who is a POLST form for?

A POLST form is meant for people who are very sick or very frail. Normally, when a person becomes unresponsive, healthcare professionals will do everything possible to try to save a life. But for seriously ill and frail people, those treatments can be painful, chaotic, and ineffective. A POLST form lets you clearly state which treatments you want and don’t want, so your wishes are followed if you can’t speak for yourself. If you are healthy, you do not need a POLST form, and an advance directive is the preferred health planning tool.

  • Example Scenarios

    Advanced heart disease: After several hospitalizations for heart failure, Maria knows her heart is getting weaker. She wants to avoid CPR or a ventilator if her heart stops, choosing instead to stay comfortable at home surrounded by family.

    Late-stage cancer: John’s cancer has spread and no longer responds to treatment. He talks with his doctor about using a POLST form to request comfort-focused care and avoid aggressive measures like resuscitation or ICU transfer.

    Advanced frailty in old age: At 91, Ruth is very frail and spends most of her time in bed. She and her daughter decide to complete a POLST form to document that she wants natural death at home and does not want to be taken to the hospital or given a feeding tube if she stops eating.

    Early stage dementia: Tom is 75 and has just been diagnosed with dementia. He manages the activities of daily living well, and shares a home and life with his 75-year-old wife. Tom’s overall health is good. Tom talked to his care team and wants every effort made to be resuscitated, should he suffer a medical emergency. He wants any other illnesses he experiences identified and aggressively treated. Tom will use the options of full interventions and CPR for now, understanding that as his condition changes, it is his option to revisit the POLST form and change it as his preferences change.

How it Works

How the POLST Form Works

For a person with progressive serious illness, falling unconscious at home is very possible. When emergency responders arrive, without clear instructions, they must try everything possible to keep the patient alive – CPR, a breathing tube, or rush transportation to the ICU – even if those treatments are painful or unlikely to help. This is the standard of care that is followed without any communication of patient wishes via advance care planning. A POLST form prevents this by giving EMS and doctors the patient’s exact wishes in the form of a medical order. This tells healthcare providers right away whether to use life-saving treatments and transport you to the hospital or focus on keeping you comfortable in the setting you are in. This supports having the care you receive match what you truly want.

If I already have an advance directive, why do I need a POLST?

Advance directives and POLST forms are both advance care planning tools, but they are not the same.

  • An advance directive is a legal document that authorizes someone to make health care decisions for you and spells out your general treatment wishes.
  • A POLST form, however, is the translation of a patient’s wishes into a signed medical order, which makes it easier for medical personnel to follow in case of emergency. It contains more specific wishes in the form of an order.

POLST is More Specialized Than Advance Directives

Comparing Advance Directives and POLST

Click below to see the overview of some key differences between Advance Directives and POLST forms:

  • What is it?

    Advance Directives: Legal Document

    POLST Form: Medical Order

  • Who should have this document?

    Advance Directives: All adults

    POLST Form: Anyone (regardless of age) who is seriously ill or frail

  • Why would I need this?

    Advance Directives:

    • 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.

    POLST Form:

    • Order providers to give specific treatments during an emergency.
    • Supports the patient across care settings.

  • Who fills it out?

    Advance Directives: The individual

    POLST Form: Health care professional (after discussion with patient)

  • Can I use it to appoint my surrogate?

    Advance Directives: Yes

    POLST Form: No

  • Can emergency responders use it?

    Advance Directives: No

    POLST Form:  Yes—It tells them if the patient was CPR and if the patient wants to go to the hospital

  • Is the document easily found?

    Advance Directives: Not always. Be sure you give a copy of your advance directive to your provider and surrogate.

    POLST Form: Yes. You have a copy, your provider has a copy, and it may also be in a registry.

POLST in an Emergency

How will EMS know I have a POLST?

Emergency responders are trained to look for a POLST form. At home, families and care partners are asked to keep the form in an easy-to-find spot, like on the refrigerator or near the bed. In nursing homes or hospitals, the POLST form is placed in your medical chart so staff can give it to emergency medical providers right away. Some states also have electronic POLST registries or bracelets that alert responders so that your wishes can be seen quickly and honored in an emergency.

FAQs About the POLST Basics

  • What information is on a POLST form?

    Orders on a POLST form include whether you want cardiopulmonary resuscitation (CPR) attempted, whether you want to go to the hospital or stay where you are, whether you want to receive care in an intensive care unit and be on a breathing machine, and if you want a feeding tube, if you are unable to swallow.

  • Where can I get a POLST form?

    A POLST form should come from your health care provider, although many states provide access to their state-specific form online. Since the POLST form is a medical order, it should be completed and signed by you and your doctor.

  • Does a POLST form replace an advance directive?

    No. Both advance directives and POLST forms are advance care plans. They support each other but do different things. For seriously ill patients, it’s best to have both an advance directive and a POLST form, and confirm that they are aligned.

Your Next Step

Reflect on Your Life Goals and Wishes, and Talk with Your Doctor and Loved Ones

Next, take time to reflect on what’s important to you and how you want to spend the rest of your life.

Go to Next Step