What is a POLST?
A Physician’s Order for Life-Sustaining Treatment (“POLST”) is a medical order that tells emergency health care professionals what to do in case of a medical crisis when you cannot speak for yourself. No agent (or surrogate) is named. The document is prepared by a medical professional and communicates orders for any person who is seriously ill or frail and near the end of life. It gives specific orders for specific circumstances and is designed for use by emergency personnel. Because the POLST form is completed when someone is seriously ill or frail, their diagnosis and prognosis is known so more specific treatment decisions can be chosen and documented. A copy of the signed POLST order is a legally valid medical order.
How is it Different from a Health Care Directive?
An Advance Health Care Directive (“AHCD”), on the other hand, is a legal document created by an individual and not a medical order. It names an agent who is authorized to speak on your behalf regarding your medical wishes. It is used to provide guidance about what types of treatments you may want to receive in case of a future, unknown medical emergency. When you can't speak for yourself, your health care team will review your advance directive and talk to your agent to develop a treatment plan. All adults should have an advance directive but not everyone needs a POLST.
My Forms are Complete, Now What do I do with Them?
I am always asked about what to do with completed documents. How are health care professionals supposed to access them and treat you accordingly? My usual advice is to provide a copy to your named agent and any close friends or family. You can also maintain a copy in plain sight in your home so that an emergency responder can see it if you are unable to produce it yourself while some clients choose to carry a physical copy but these options are not always foolproof.
Fortunately, California is working on a pilot project in Contra Costa County and the City of San Diego to test the development and implementation of electronic registries (“eRegistries”). The registries will enable the submission, storage, and retrieval of POLST forms in various healthcare settings. If the project is successful, California could implement an electronic access point for health care professionals statewide thus safeguarding that your wishes are met.
Please call me if you would like to learn more about health care planning at (949) 387-8707 or email me at email@example.com. I’d love to hear from you!
For more information about the eRegistry pilot program check out https://www.chcf.org/project/polst-eregistry-pilot-initiative/
For more information about POLST forms please check out https://emsa.ca.gov/dnr_and_polst_forms/