POLST and Advance Care Planning (ACP)

Standard of Care

The current standard of care during an emergency is to do everything possible in an attempt to save someone’s life, unless there is a medical order to the contrary.

Advance Care Plan Documents

ACP documents allow individuals to share their treatment preferences in the event they can no longer speak for themselves. There are two kinds:

Legal DocumentsMedical Orders
Includes• Advance Directives
• Living Wills
• Health Care Power of Attorney
• Do Not Resuscitate (DNR) Orders
• POLST forms. Name varies by state (view POLST map).
PurposeIdentify a surrogate decision maker. Provide general wishes about treatments individual wants.Orders emergency personnel to provide specific treatments during a medical emergency.
Who NeedsAll competent adultsSeriously ill and frail individuals
(view guidance)
Can be Used in an EmergencyNo. These are used to develop care plans, but are not orders EMS can follow.Yes. These are medical orders signed by health care professionals.

» Download this chart as a PDF (Standard of Care; Advance Care Planning documents, Legal vs. Medical).

Advance care planning means taking steps to share your personal goals, values, religious, cultural beliefs and what matters for your quality of life. You will discuss it with your health care professional and loved ones so that in the event of a medical crisis, either unexpected or from a known serious illness or advance frailty, health care professionals have information they can use to match the type of treatment they may provide to you to what you want to receive.

Advance care planning includes two key parts:

  1. Conversations with health care professionals and loved ones; and
  2. Documenting treatment wishes or preferences.

Conversations with Your Health Care Professional and Loved Ones

The more you share your personal goals, values, religious, cultural beliefs and what matters for your quality of life with your health care professional and loved ones, the more likely you are to receive exactly the treatments you wanted. This sharing becomes even more important when you are seriously ill or frail because you will likely know what your treatment options are and choose treatments appropriate for what benefits you want to achieve. For example, if you have a chronic heart condition you and your health care professional can discuss what will happen, and your odds of surviving, cardio-pulmonary resuscitation (CPR).

Conversations should include your wishes/preferences for health care treatments, personal goals, values, religious or cultural beliefs that affect your decisions. For additional help in having these difficult conversations, look at Prepare For Your Care, The Conversation Project, and Gowish.org.

Documenting Your Treatment Preferences

POLST forms and advance directives help put this information in writing to prevent misunderstandings and to help make sure that the treatment you may receive is what you actually want. See POLST & Advance Directives for more information.