What is a....

What is a POLST Form?

Physician Orders for Life Sustaining Treatment (POLST) is a medical order that helps give people with serious illness more control over their care during a medical emergency. POLST can help make sure you get the care you want, and also protect you from getting medical treatments you DO NOT want.

POLST forms are used only when you cannot communicate and you need medical care. When that is the situation, the POLST form directs healthcare providers to give you the treatment you chose.

POLST was designed for patients with serious illness, or those who are medically frail, regardless of their age to have a way to communicate their treatment preferences with emergency personnel.

A POLST can prevent unwanted or medically ineffective treatment, reduce patient and family suffering, and help ensure that patients' wishes are honored.

There are multiple names for POLST (MOLST, MOST, POST, etc.)

POLST is a medical order so you need to visit your health care provider who will complete and sign the POLST form based on your wishes.

POLST forms are medical orders that travel with you. Wherever you are, your POLST form tells health care providers what treatments you want and your goals of care, even if you transfer from hospital to nursing home, back to your home, or to hospice or another setting.

What information is typically included on the POLST form? The decisions documented on the POLST form include whether to:

• Attempt cardiopulmonary resuscitation,
• Administer antibiotics and IV fluids,
• Use intubation and mechanical ventilation, and
• Provide artificial nutrition.

You can change or void your POLST form, at any time.