Definition & Meaning
The Physician Orders for Life-Sustaining Treatment (POLST) Form is a medical document designed to communicate a person's preferences regarding life-sustaining treatments. It is a legally recognized form in the United States that guides healthcare professionals in providing or withholding interventions based on the patient's wishes. The form typically includes decisions about treatments such as resuscitation, intubation, mechanical ventilation, tube feeding, and other critical care preferences.
Subsections:
- Purpose: It aims to ensure that a patient's treatment preferences are known and respected by their medical team, especially during emergencies when the patient may not be able to communicate their choices.
- Components: Generally includes sections that outline the desired scope of treatment, such as full treatment, selective treatment, or comfort-focused treatment.
How to Use the POLST Form
Using the POLST form requires thoughtful consideration and consultation. Patients, often with their healthcare providers, make specific choices about what treatments they would or wouldn’t want to receive at the end of life.
- Discuss with Healthcare Providers: One should discuss their wishes and health status with a doctor or medical professional to understand the options and implications.
- Complete the Form: Fill out the form with clear instructions regarding preferred treatments.
- Review Regularly: Regularly review and update the form to ensure that it reflects current wishes and medical conditions.
Key Steps:
- Ensure the form is as specific as possible to avoid ambiguity.
- Keep a signed version readily accessible for emergencies.
How to Obtain the POLST Form
Obtaining a POLST form can vary slightly from state to state, but is generally straightforward.
- Healthcare Facilities: These forms are available at hospitals, clinics, and other healthcare institutions.
- Medical Offices: Many physician offices have these forms and can assist in filling them out.
- Online Resources: Some state health departments offer downloadable versions of the POLST form on their websites.
Considerations for Obtaining:
- Ensure the form is the correct version used in your state.
- Consult a healthcare provider when collecting the form to ensure understanding of each section.
Steps to Complete the POLST Form
Filling out a POLST form involves several critical steps to ensure it accurately represents one's wishes.
- Patient Information: Enter personal identification information carefully.
- Medical Orders: Specify preferences for cardiovascular treatment, medical interventions, antibiotic use, and nutrition.
- Signatures: Obtain signatures from the patient or their surrogate and a healthcare professional.
Detailed Breakdown:
- Cardiopulmonary Resuscitation (CPR): Decide and document if CPR should be attempted in case of heart failure.
- Medical Interventions: Decide on the level of medical intervention desired, whether full treatment, selective treatment, or comfort measures only.
Who Typically Uses the POLST Form
The POLST form is commonly used by individuals with serious illnesses or those who are in frail health, often including:
- Elderly Individuals: Those with significant medical conditions or nearing end-of-life may benefit.
- Patients with Chronic or Terminal Illness: Individuals for whom unexpected medical crises may occur.
- Family Members and Caregivers: Who advocate for an incapacitated person’s wishes.
Benefits:
- Streamlines communication among patient, family, and healthcare team.
- Helps in making informed and respected medical decisions.
Legal Use of the POLST Form
The POLST form carries legal weight in the U.S., ensuring that patients’ medical treatment preferences are respected.
- Legally Binding: Once properly completed and signed, the form acts as a legal guide for medical personnel.
- Recognized Across Facilities: It is valid in various healthcare settings, including hospitals, nursing homes, and at-home care environments.
Key Legal Aspects:
- Must be signed by a licensed medical professional and the patient or their surrogate.
- Cross-referencing with state-specific laws and regulations is crucial for ensuring compliance.
Key Elements of the POLST Form
The form itself is structured to capture a variety of patient preferences as clearly as possible.
- Medical Interventions: Includes choices for medical interventions a patient is willing to accept, such as intubation or dialysis.
- Artificial Nutrition: Preferences regarding receiving artificial nutrition through tube feedings.
- Antibiotics: Guidance on the use of antibiotics for treating infections.
Additional Information:
- The form is typically one page, with a standardized format that is easy for caregivers and medical personnel to follow.
State-Specific Rules for the POLST Form
Each U.S. state may have specific regulations governing the use of the POLST form, impacting how it should be completed and implemented.
- Variations by State: States may offer differing frameworks or additional sections based on regional laws.
- State Registries: Some states maintain registries for the POLST forms, allowing healthcare providers to access them during emergencies.
Critical Considerations:
- Patients should verify state-specific requirements and ensure their POLST form complies with local laws.
- Engage with state-specific healthcare resources or legal advisors for detailed guidance.
