Why You Should Discuss POLST With Your Doctor
09/07/10
It’s my goal to help keep the community educated on resources and information in the area of Senior Care. Many people are not familiar with the POLST form, which, in 2009, became a legally recognized mechanism by which patients can provide specific instructions for their end-of-life care.
The Advance Directive largely identifies a surrogate decision-maker should you become unable to make decisions about your health care. The POLST is intended to help you and your doctor discuss and develop specific plans to reflect your wishes. It also helps doctors, other health professionals and emergency personnel honor your wishes for life-sustaining treatment, especially in an emergency. The POLST is designed to be an adjunct to an Advance Directive.
Following is an overview of this document incorporating some of the questions and answers from the POLST California website.
What does ‘POLST’ stand for?
POLST stands for Physician Orders for Life-Sustaining Treatment.
What is the POLST form?
POLST is a physician order that helps give seriously ill patients more control over their end-of-life care. Produced on a distinctive bright pink form and signed by both the doctor and patient, POLST specifies the types of medical treatment that a patient wishes to receive towards the end of life. As a result, POLST can prevent unwanted or medically ineffective treatment, reduce patient and family suffering, and help ensure that patients’ wishes are honored.
What information is included on the POLST form?
The decisions documented on the POLST form include whether to:
• Attempt cardiopulmonary resuscitation,
• Administer antibiotics and IV fluids,
• Use a ventilator to help with breathing, and
• Provide artificial nutrition by tube.
Does the POLST form replace traditional Advance Directives?
The POLST form complements an Advance Directive and is not intended to replace that document. An Advance Directive is still necessary to appoint a legal health care decision maker, and is recommended for all adults, regardless of their health status.
Who completes the POLST form?
A health care professional, usually a doctor, nurse, or social worker, completes the form after having a conversation with the patient to understand his/her wishes and goals of care. Both a doctor and the patient must sign the POLST form in order for it to be valid.
What happens to my POLST form after it is completed and signed?
The original POLST form, on bright pink paper, stays with you at all times.
• In a hospital, nursing home, or assisted living facility, the form will be in your medical record or file.
• If at home, place your form in a visible location so it can be found easily by emergency medical personnel – usually on a table near your bed, or on the refrigerator.
Can I change my POLST form?
Yes, you can change your POLST form at any time should your preferences change. It is a good idea to review the decisions on your POLST form when any of the following occur:
• You are transferred from one setting to another, for example you go from your home to the hospital, or you are discharged from the hospital to a nursing home;
• There is a change in your overall health, or you are diagnosed with an illness;
• Your treatment preferences change for any reason.
What happens if I don’t have a POLST form?
Without a POLST form, emergency medical personnel, nurses and doctors would not know your treatment wishes. You will most likely receive all possible treatments, whether you want them or not. Talking about your treatment choices with your loved ones and doctor before a problem occurs can guide them and help ensure you get the care you want.
Where do they use POLST now?
POLST was originally developed in Oregon. There are a number of states which currently have POLST programs in place or that are developing POLST programs. California State POLST Legislation (AB 3000 (Statutes 2008, Chapter 266)) went into effect on January 1, 2009.
How can I get a POLST form?
Patients can request the form from their health care provider. It is important to discuss your goals of treatment with your health care provider so you can decide if POLST is right for you, and how to document your decisions appropriately on the form. The form can also be found at caPOLST.org, along with other helpful resources. Locally, you can call Senior Care Authority at 707.939.8744 or e-mail info@seniorcareauthority.com.
Frank M. Samson is Founder of Senior Care Authority based in Sonoma and also hosts “The Aging Boomers” on KSVY 91.3 or can be listened to live at www.ksvy.com, every Monday at 2pm PT. The company provides free assistance to families in helping them find In-Home Care, Independent and Assisted Living for their loved ones. He can be reached at 707.939.8744 or e-mailed at frank@seniorcareauthority.com. The company website is www.seniorcareauthority.com.
