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POLST: Saying ‘No’ When You Are Too Healthy To Have One      


At 64 years old Fernando does not look his age. He works full time as a hospital chaplain and lives a very active life. Together with his wife, Gisela, he loves to spend his spare time traveling, hiking, biking and walking. They are very involved with their community and church. And they take good care of themselves – eating well and exercising often.

Aside from heart surgery a few years ago to repair a blocked artery, Fernando has enjoyed very good health.

Recently, when he visited a new primary care doctor for his annual exam, he was very surprised to be asked if he had a POLST (Portable Orders for Life-Sustaining Treatment). POLST is designed for people who are in frail health. It is not meant for healthy people like Fernando.

“There is nothing in my medical history to show that I should have a POLST,” Fernando said. “I have no serious health problem. And I’m not the right age group. Any doctor can look at me and see that I’m not at that place.”

Fernando does have an Advance Directive, which allows healthy people like him to give basic instructions about the care they want if they become too sick to speak for themselves, and to name someone to make decisions for them.

Fernando with his wife Gisela

Fernando with his wife Gisela

But he is too young and healthy to have a POLST. POLST is for people with serious illness who want their wishes about the treatments they do and do not want to become medical orders that must be followed in an emergency. The medical order states the care you would want if you had an emergency today. It is completed with a doctor.*

As someone who works in a hospital, Fernando knows that having a POLST too early can create problems. You might be denied life insurance, for example. Or it might be difficult for your family to know what to do when you do become sick, because your POLST says what you want when you are still healthy.

It was easy for Fernando to say ‘no.’ But he thinks that it might not be so easy for others who do not understand when is the right time to have a POLST.

“It’s very important that people know that it’s OK to ask questions and say ‘no’ if a POLST is not right for them.”

Click here to download Taking a burden off your loved ones with a POLST form


* “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.