Interview with Carol Kinsel, Senior Care Solutions, and Susan Taylor, RN, Mercy Faith and Health Partnership. Watch the full video interview POLST – What is it, Why is it Important and Who Needs it?
What is the difference between the Advanced Healthcare Directive and the POLST form?
The Advanced Healthcare Directive allows you to choose an individual to make decisions for you in the event you are unable to do so yourself. This document also allows you to outline the type of care you wish to receive and the type of care setting for the delivery of care when needed. Everyone over the age of 18 should have an Advanced Healthcare Directive in place and it is recommended the document be reviewed every decade. This document should also be reviewed and/or updated in the event of the death of your healthcare agent, a divorce or other major life change, and later in life, as we begin to decline with age.
The POLST, which stands for Physician’s Order for Life Sustaining Treatment, is an actual medical order (outside of the hospital setting) and directs healthcare providers to follow orders described in the form. Individuals are not required to have a POLST, as it is optional, but the form can be extremely beneficial, if on record. It is never a requirement to be admitted to any healthcare setting. (In California it is a bright pink document easily recognized by medical providers and emergency personnel–other states may have their own version of the form.) This form allows for you to outline your wishes and goals for care and is reviewed and signed by both you and your physician.
Who should have a POLST?
Anyone, of any age, who has a chronic progressive illness or who is medically frail, should have a POLST in place.
Where can one find a POLST form?
A POLST form can be obtained by reaching out to your primary care physician or by clicking here, California POLST. It is recommended you discuss the details of this document with the physician, nurse practitioner or physician’s assistant to fully understand the verbiage used and to ensure you make informed decisions prior to completion. Appointments for healthcare planning can be scheduled with your primary care physician—this service is covered under your health insurance. Once complete, this POLST form will be signed by both you and your physician.
Where should the POLST be kept and who should have a copy of this document?
Your agent named in the Advanced Healthcare Directive should have a copy of your POLST, in addition to your primary care physician. You should of course also have a copy and it is recommended that the form be kept attached to the side of the refrigerator or over the head of the bed, if medically frail. Should emergency medical services be called to the home, they will know to look for the POLST in these areas and be able to easily identify the form. A quick review of the POLST allows EMS personnel to determine the kind of care you wish to receive in the field, such that they can respond accordingly.
Is there a benefit to having a Medical Alert Bracelet as well?
If an individual is wearing a medical alert bracelet, a copy of the POLST will be kept on record with the company you have initiated service with. If the POLST is not easily accessible or visible when emergency personnel arrive at the home, they will have immediate access to this information. It is also advised to carry a card in your wallet stating you have a POLST in place and who your healthcare agent is.
What is the specific language used on the POLST form?
The POLST will list options / choices such as the following:
If you have died a natural death, do you want CPR attempted? Emergency medical personnel will try to restart your heart unless otherwise stated on this form. Do you wish to have full treatment; breathing tube, aggressive IV therapy, selective treatment or treatment based on comfort care only or is artificial nutrition desired? These decisions are based on your personal wishes and values and it is recommended you discuss the options listed on the POLST with your physician prior to completion.
For further information either contact your physician’s office or Senior Care Solutions.
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Video interview content adapted and written by Carol Kinsel.