What is POLST?
POLST (Portable Orders for Life-Sustaining) is a medical order for people with serious illness or frailty. If you are someone with a serious illness, you can complete a POLST form with your doctor to direct the kinds of treatment you want in a medical crisis. POLST orders give you more control over the treatments you do or do not want to receive in an emergency situation. The form works to guide treatment decisions if you later lose the ability to speak for yourself.
The POLST order is signed by your doctor* after a discussion with you and/or your surrogate/health care decision-maker. Since it is a medical order that will be followed in an emergency, it is important that it reflect your wishes now, in your current state of health. Click here to watch a video of about POLST and how it’s different from advance directives.
Does a POLST Form Replace the Advance Directive?
The POLST form complements the advance directive and is not intended to replace it. An advance directive is necessary to appoint a legal health care representative and provide instructions for future life-sustaining treatments. The advance directive is recommended for all adults, regardless of their health status. A POLST form should go with an advance directive when appropriate. For more information go to: www.oregonhealthdecisions.org
What is The Conversation Project?
The Conversation Project is a resource designed to help patients and families discuss their wishes about end of life care. The Conversation Project created a Starter Kit that helps facilitate the conversation.
What Happens in an Emergency?
To ensure that your POLST form is found and known in a time of emergency, your information is entered into the Oregon POLST Registry—unless you choose not to participate and have checked the opt-out box on the form.
What if I Change My Mind?
POLST records your wishes for medical treatment now, in your present state of health. If your wishes change, talk with your doctor as soon as possible so that a new POLST can be completed and if you've opted in to the Registry, so that the update can be sent to the Registry.
Why is the POLST Form Available Only in English?
The POLST form is read by emergency medical personnel, nurses, and doctors who may speak only English. Medical orders that travel with you from one place to another must be written in English to be sure that every health care professional understands clearly what treatments you do and do not want. A Spanish form is available to help explain the orders to Spanish speaking persons, but the only form that is valid is in English.
Why is POLST Important?
When you have a serious illness or frailty it is very important to make sure your loved ones and doctors know what kinds of medical treatment you want, and do not want. The POLST program was developed to help you achieve this goal.
Is POLST Required?
No. Filling out a POLST form is completely up to you. It’s your choice. It’s always voluntary and can be changed any time at your request.
Should I Have a POLST Form?
POLST is for those with a serious illness—such as advanced heart disease, advanced lung disease or cancer that has spread—or for those who might be older and frail, and might not want to go to the intensive care unit (ICU).
POLST is not for everyone. For example, many people in their 60s are too healthy to need a POLST form. If something suddenly happened, many healthy older adults would want everything done while more was learned about what was wrong and their chances of recovery. Healthy people should have an advance directive. Later, if you become sicker or frailer, you or your surrogate/health care decision-maker can complete a POLST form to turn your treatment wishes into action.
Who Completes and Signs the POLST Form?
If you are able to communicate for yourself, you can complete the POLST form with your doctor. If you are unable to speak for yourself, your surrogate/health care decision-maker can complete a POLST form on your behalf. Because the POLST form contains medical orders, it must be signed by a physician (M.D. or D.O), nurse practitioner (N.P.), physician assistant (P.A.), or doctor of naturopathy (N.D.).
Should I Sign the POLST Form Too?
If you are able to communicate your wishes in a POLST form, we strongly recommend that you sign the form and discuss opting in or out of the Registry.
Who Can Speak for Me if I Can No Longer Communicate?
If you are unable to communicate, someone else may be able to complete a POLST form with your doctor on your behalf. An advance directive is the legal document that allows you to choose a surrogate/health care decision-maker.
What is the Oregon POLST Registry?
All POLST forms in Oregon are sent to the Oregon POLST Registry, if the patient agrees. The Registry is a database that connects health care professionals with a patient’s POLST form whenever they are needed. The Registry allows health care professionals treating you to access your POLST orders if the paper copy cannot be found. Information in the Registry is protected and confidential. Learn more about the Oregon POLST Registry by clicking here.
These resources were designed to provide more in-depth information on POLST and whether it might be right for you or your loved one. If you have additional questions, talk to your doctor about whether POLST is right for you in your current state of health.
* “Doctor" refers to who can sign a POLST form. POLST forms need a physician (M.D. or D.O.), nurse practitioner (N.P.), physician assistant (P.A.), or doctor of naturopathy (N.D.) signature.