What Is a POLST Form and When Do I Need One?
By CRYSTAL BAI •
The short answer: A POLST form (Physician Orders for Life-Sustaining Treatment) is a medical order — signed by a physician or other authorized clinician — that translates your end-of-life wishes into immediately actionable medical instructions. Unlike a living will (a personal preference document), a POLST is a doctor's order that emergency responders and medical teams must follow. It is designed for people with serious illness or advanced age — not for healthy adults.
POLST vs. Advance Directive: Key Differences
| Advance Directive / Living Will | POLST | |
|---|---|---|
| What it is | Personal preference document | Medical order signed by a clinician |
| Who it's for | All adults | Seriously ill or frail elderly patients |
| Legal force | Guides clinicians; not immediately actionable | Immediately actionable medical order |
| Who can complete it | Any competent adult | Physician, NP, or PA (in most states) |
| Used by first responders? | Usually not | Yes — EMS must follow it |
When Is a POLST Appropriate?
A POLST is appropriate for people who:
- Have a serious or life-limiting illness (advanced cancer, heart failure, COPD, dementia)
- Are frail elderly with multiple comorbidities
- Are enrolled in hospice
- Would be surprised if they lived more than 1–2 years
A POLST is not appropriate for healthy younger adults — an advance directive is the right document for them.
What a POLST Covers
POLST forms typically address three decisions:
- CPR: Attempt resuscitation or do not attempt resuscitation (DNAR/DNR)
- Medical interventions: Full treatment (all possible interventions), limited interventions (IV fluids/antibiotics but no ICU), or comfort measures only
- Artificial nutrition: Long-term feeding tube, trial period, or no artificial nutrition
POLST by State: Different Names, Same Concept
The form is called different things in different states:
- POLST (most states)
- MOLST — Medical Orders for Life-Sustaining Treatment (NY, MD, OH)
- MOST — Medical Orders for Scope of Treatment (NC, SC)
- TPOPP — Transportable Physician Orders for Patient Preferences (WA)
- POST — Physician Orders for Scope of Treatment (TN, WY)
Where to Keep Your POLST
Keep the original (usually on bright pink or orange paper for visibility) where first responders can find it — on the refrigerator door (a common standard), your bedside table, or in a visible location near your front door. Copies should go to your physician's office and hospital EHR. Your hospice team will maintain it in your care file.
Frequently Asked Questions
What is a POLST form?
A POLST (Physician Orders for Life-Sustaining Treatment) is a medical order signed by a physician that translates your end-of-life wishes into immediately actionable instructions for emergency responders and medical teams. It is distinct from a living will, which is a personal preference document.
Who should have a POLST?
People with serious illness, advanced frailty, or a terminal prognosis — not healthy younger adults. A POLST is appropriate when you are enrolled in hospice, have advanced cancer or organ failure, or wouldn't be surprised to die within 1–2 years.
Does EMS have to follow a POLST?
Yes. In states that have adopted POLST as a medical order, emergency medical services (EMS) are required to honor a signed POLST form. This is the key difference from an advance directive — a POLST is immediately actionable in the field.
What is the difference between a POLST and a DNR?
A DNR (Do Not Resuscitate) order addresses CPR only. A POLST is broader — it covers CPR, the level of medical intervention desired, and artificial nutrition. A POLST may include a DNR instruction, but it covers more ground.
What is a MOLST?
A MOLST (Medical Orders for Life-Sustaining Treatment) is the same concept as a POLST under a different state name, used in New York, Maryland, and Ohio, among others. All POLST-equivalent forms serve the same purpose: translating wishes into actionable medical orders.
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