California recently adopted the Physician's Orders for Life Sustaining Treatment (POLST) paradigm for patients to make their health care wishes known. I was thrilled to have the opportunity to help a patient fill one out for the first time during a hospice admission at a nursing home yesterday. Unsure what a POLST document is?
What is a POLST and do I Need One?
Currently, seven states (Washington, Oregon, California, New York, West Virginia, North Carolina, and Tennessee) and certain areas of Wisconsin, have POLST programs, meaning they recognize and endorse the POLST document. Several other states are currently working to implement their own program but, surprisingly, there are still many states that don't have a POLST program nor are working to develop one (here's an opportunity for many of you to lobby for a program in your state!).
I'm curious how many of you have filled out a POLST document for yourself or a loved one and how many of you health care professionals use the document regularly.
I read “What is a POLST?” and it sounds just like the medical power of attorney that is used in my state. I feel ours has the added bonus of putting someone else in charge of making the decisions. “DNR” is a dangerous thing to select without having another person involved. I mean, I would only want DNR activated in certain circumstances: it would depend on the assessment of my quality of life afterward.
I never heard of this, but I love the idea! Anything that increases a patient’s say in their own care gets my approval.
There is actually a significant difference in the Advance Directive and the POLST document. An advance directive gives instructions for medical care AFTER receiving emergency care and being transported to a hospital. A POLST document makes your wishes known to emergency and medical personnel what care you would like to receive in your place of residence BEFORE transport to a hospital. It’s still very important to have Advance Directives IN ADDITION to a DNR or a POLST.