About Physician Orders for Life-Sustaining Treatment (POLST) Forms

A POLST form helps you get the end-of-life treatment you want. Find out more about POLST, POST, MOLST, and MOST forms in your state.

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In recent years, more and more states have adopted a tool that allows you to express your wishes for end-of-life care. Nearly all states (see the chart at the end of this article) now allow you to keep doctor-signed orders in your medical records. These brightly colored documents—most often called POLST forms—are meant to travel with you when you move between health facilities. They clearly and briefly lay out your preferences for medical treatment when you're close to the end of your life.

• What Does POLST (or POST, MOLST, or MOST) Stand For?
• What Is a POLST Form?
• POLST Forms vs. Health Care Directives vs. DNR Orders
• How to Make a POLST Form
• POLST Forms in Your State

What Does POLST (or POST, MOLST, or MOST) Stand For?

POLST forms are orders that are signed by a qualified medical professional. As such, you'll usually see the term "physician order" or "medical order" in the terminology used. Here are some of the more common acronyms used by different states:

• POLST: Physician (or sometimes Provider or Practitioner) Order for Life-Sustaining Treatment
• POST: Physician Order for Scope of Treatment
• MOLST: Medical Order for Life-Sustaining Treatment
• MOST: Medical Order for Scope of Treatment
• TPOPP: Transportable Physician Order for Patient Preferences

Though the forms go by different names in different states, their purpose remains the same.

What Is a POLST Form?

A POLST form is an order signed by your doctor or another health care professional that gathers together your most significant wishes for end-of-life-care. This order is placed in your medical records and is "portable"—meaning it typically travels to any health care setting (like a hospital or hospice) with you. In most states, a POLST form is printed on brightly colored paper (usually pink or green) so it will easily stand out in a patient's files.

A POLST form includes directions to medical providers about life-sustaining measures, including:

• Whether you want a provider to attempt cardiopulmonary resuscitation (CPR)
• Whether you want intubation, antibiotic use, and IV fluids, and
• Whether you want medically assisted nutrition, such as feeding tubes.

Those who make POLST forms are typically close to death due to age or serious medical conditions. While everyone should have an advance health care directive (discussed below), not everyone needs a POLST form.

POLST Forms vs. Health Care Directives vs. DNR Orders

If POLST forms sound like other health care documents, that's because they do have some overlapping functions. But there are differences.

DNR (Do Not Resuscitate) Orders

DNR orders tell medical providers not to administer CPR in the event of a medical emergency. Most state POLST (or MOLST) forms include a DNR section—where you can state whether you want CPR to be attempted. However, POLST forms are more comprehensive in that they address other medical treatments as well.

In many states, POLST forms are now used instead of, or in addition to, DNR orders. (Note that in Texas, if you state in your POLST form that you don't want to be resuscitated, you'll also need to complete a DNR order and attach it to your POLST form.)

Advance Health Care Directives

POLST forms also cover some of the same topics addressed by a health care directive. (A health care directive also goes by many names, depending on your state. For example, some states use the term "advance directive." Other states use two separate documents, often called a "living will" and a "medical power of attorney." You can check what term your state uses for a health care directive.)

However, a POLST form isn't meant to be a substitute for a properly prepared health care directive. POLST forms are often used in emergency situations, and as a result are shorter and cover fewer circumstances. Health care directives allow you to do more than POLST forms. For example, one of the most important functions of a health care directive is the ability to appoint a health care agent to oversee your medical care and to specify your wishes for life-sustaining care far into the future. This helps ensure that someone will be available to make health care decisions on your behalf, including decisions you might not have anticipated.

Every adult should have an advance health care directive. (To make one, try WillMaker, which you can use to create a health care directive and other estate planning documents that are valid in your state.)

How to Make a POLST Form

When you enter a hospital, hospice, or other health care setting, a member of the staff may ask whether you want to complete a POLST form. If you do, you'll discuss your health care wishes, and the medical provider will complete the form. To make the form valid, you (or your health care agent) must sign it, and the provider must sign it, too.

If no one asks you whether you want to complete a POLST, you can also ask for one. As long as the form is available in your state or in the facility where you are receiving care, a staff member can help you with it. To view a sample POLST form from your state, see the chart below.

POLST Forms in Your State

You can look up your state's POLST information in the chart below. You'll find the specific terminology (such as POLST, POST, MOLST, MOST, COLST, TPOPP) your state uses, as well as relevant state laws. You'll also find links to sample POLST forms in your state.

Note that although Nebraska did operate some pilot programs, the state did not conform to National POLST Paradigm standards and lacked a uniform approach.