What is a POLST form?
The Physician Orders for Life-Sustaining Treatment (POLST) form is an advance directive-like, portable form used in many states across the US. Over a year ago, it was made legal for use in Illinois.
The form allows for patients with their doctor’s input to put their end-of-life decisions into medical orders on a form. This form can be used in all places of care like the home, nursing home, ambulance, or hospital.
What kind of end-of-life decisions can patients make on a POLST form?
- Patients can decide what kind of care they want if their heart stops beating.
- They can decide what kind of care they want if they stop breathing.
- They can decide to have cardiopulmonary resuscitation (CPR).
- They can decide if they want intubation and mechanical ventilation.
- They can also decide not to be resuscitated. This is often called a Do-Not-Resuscitate order, or DNR.
- If they decide to be DNR, they can decide what kind of care they want before their heart stops beating.
What kind of care might they want before their heart stops beating?
They might want comfort measures only such as medications and oxygen to manage distressing symptoms, limited additional interventions like antibiotics, IV fluids, and cardiac monitoring, or full treatment such as intubation and mechanical ventilation.
If a POLST form is completed, is there still a need for advance care planning (ACP) and the completion of Power of Attorney for Health Care (POA-HC) form?
Yes! A completed POLST form does not take the place of ACP and/or completing a POA-HC form. These actions allow for the patient to name an agent to speak for them if they can’t speak for themselves, and to describe in more detail the care they want at end of life.
So if the patient has a POA-HC document, what is the benefit of having a POLST document too?
Having a POLST document is beneficial because in an emergency situation where the patient can’t speak for themselves, their decisions about life-sustaining treatment can be acted on immediately without having to locate the agent they have named.
Who should complete the POLST form?
Only some people need a POLST form including…
- patients who are at the end of a life-limiting illness.
- the frail elderly.
- patients who a doctor thinks may not live more than one year.
Are there any changes coming to the POLST form in Illinois?
Yes there is an amendment to original law re: POLST that is currently awaiting the governor’s signature. Proposed changes in the amendment include the following. The DNR acronym on the border of the current form will be removed.
The new form will provide for additional care options such as IV solutions, feeding tubes, and pain medication. In addition, the new POLST will authorize a patient’s advance practice nurse, physician assistant or senior medical resident to sign the order form in addition to the patient’s physician.
How can I get a POLST form?
If you believe you or family member should consider completing a POLST form, please discuss this with your physician. For more information about the Illinois POLST form, call OSF Supportive Care at (309) 624-6002.