When and How to Update Your POLST Form: A Guide to Ensuring Your Wishes Are Followed
A Physician Orders for Life-Sustaining Treatment (POLST) form is a medical order created by a doctor, nurse practitioner, or physician assistant that outlines specific treatments a patient wants—or does not want—in an emergency. Unlike a Health Care Proxy or Living Will, which are legal documents, a POLST form is a doctor-signed medical directive that must be followed by healthcare professionals, including emergency responders.
It is designed for individuals who are seriously ill, have a chronic progressive condition, or are nearing the end of life to ensure that their treatment preferences are honored in urgent situations.
Not Everyone Needs a POLST
Unlike a Health Care Proxy or Living Will, which are recommended for all adults, a POLST form is not necessary for healthy individuals. If you are young, in good health, or do not have a life-limiting illness, a Health Care Proxy (Medical Power of Attorney) and advance directives may be sufficient for future medical planning.
Who Should Have a POLST Form?
A POLST form is recommended for:
✔️ People with a serious, progressive, or life-threatening illness
✔️ Individuals who are frail or elderly and may require immediate medical interventions
✔️ Those who want to make specific decisions about emergency treatment, such as do-not-resuscitate (DNR) orders, ventilator use, or artificial nutrition
If you are healthy or simply planning for future medical decisions, a Health Care Proxy is a more appropriate document, as it appoints someone to make healthcare decisions for you if you cannot.
A Real-Life Example: When a POLST Can Help
Eleanor’s Story
Eleanor, 82, had always been clear with her family: She didn’t want aggressive medical interventions if her health declined. She had been living independently but was diagnosed with advanced heart failure and chronic kidney disease.
One night, Eleanor collapsed at home, and her son called 911. The paramedics arrived and, without immediate guidance, were prepared to administer full life-saving interventions, including CPR, intubation, and ICU care.
However, Eleanor had completed a POLST form with her doctor just a few months earlier. Her form clearly stated Do Not Resuscitate (DNR) and requested comfort-focused care only. Because Eleanor’s son had the POLST form readily available, the paramedics honored her wishes and transported her to the hospital for comfort care rather than attempting aggressive measures that she did not want.
Had Eleanor not had a POLST form, she likely would have received full emergency interventions, despite her wishes to avoid them. Her family was grateful that she had planned ahead and that they didn’t have to make difficult decisions in the moment.
Moral of the Story:
A POLST is critical for people like Eleanor, who have a serious illness and specific medical preferences about what treatments they do—or do not—want. It provides clarity when every second counts and ensures that healthcare professionals honor your choices in an emergency.
When Should You Revise Your POLST Form?
Because medical conditions and personal wishes evolve, a POLST form should be reviewed and potentially updated under the following circumstances:
- A Change in Health Status
- If a medical condition worsens or improves significantly, treatments in the POLST form may no longer align with the patient’s preferences.
- Example: A patient recovering from a critical illness may now opt for full medical interventions, while someone whose illness has progressed may choose comfort-focused care instead.
- A Move Between Care Settings
- If a patient transfers from a hospital to hospice, a nursing home, or home care, the form should be reviewed to ensure it reflects the care available in the new setting.
- A Change in Treatment Preferences
- Over time, individuals may rethink their decisions about interventions like CPR, ventilators, or artificial nutrition. Regular discussions with healthcare providers help ensure that the form reflects current wishes.
Important Nuances and Considerations
✔️ State-Specific Forms: POLST forms are state-specific, meaning the exact format and regulations vary. It is crucial to use the correct form for your state of residence to ensure its validity.
✔️ “Medical Order” vs. “Legal Document”: A POLST is a legally recognized medical order, not just a form. It carries legal weight and must be followed by healthcare professionals, including paramedics, hospital staff, and long-term care providers.
✔️ Portability: A POLST is designed to be portable—it should travel with a patient across different care settings (hospital, nursing home, assisted living, home). Its portability is a key advantage.
✔️ Not a Substitute for All Planning: A POLST does not replace a Health Care Proxy, Living Will, or Advance Directive. Instead, it should be used in conjunction with other estate and healthcare planning tools.
✔️ More Than Just DNR: While the example above focused on DNR, a POLST form includes more than just resuscitation preferences. It can also outline preferences for ventilators, artificial nutrition, antibiotics, and other medical interventions.
✔️ Guidance from a Medical Professional: Completing a POLST form should not be done alone. A discussion with a doctor, nurse practitioner, or physician assistant is essential to ensure that the form accurately reflects the patient’s medical condition and treatment preferences.
How Gentreo Helps with Advance Care Planning
While Gentreo does not create POLST forms, it does offer:
✔️ Health Care Proxy Forms – A legal document that allows you to name someone you trust to make medical decisions on your behalf if you cannot. Unlike a POLST, it applies to all medical decisions, not just emergency interventions.
✔️ The Gentreo Digital Vault – A secure platform where you can store and share your POLST, Health Care Proxy, and other important medical documents, ensuring that your family and healthcare providers can easily access them when needed.
💡 Even if you have a POLST, it’s essential to have a Health Care Proxy. If a medical situation arises that is not covered by your POLST, your appointed healthcare agent can advocate for you.
Final Thoughts
A POLST form is not for everyone—it is designed for those with serious illnesses or frailty who want to ensure their specific treatment preferences are followed in emergencies. If you do have a POLST, reviewing and updating it regularly is important, especially when health conditions change.
For those who do not need a POLST but still want to plan ahead for medical decision-making, having a Health Care Proxy and using Gentreo’s Digital Vault can ensure your wishes are honored.
Don’t wait until it’s too late; start your estate planning journey with Gentreo today. By doing so, you’ll not only protect your loved ones but also gain the peace of mind that comes with knowing your legacy is secure. Click HERE to join now.
This article is for informational purposes only and should not be considered legal advice. Consult with a qualified attorney or estate planning professional for personalized guidance.
