What is a POLST form and who should have one?
By CRYSTAL BAI •
The short answer: A POLST (Physician Orders for Life-Sustaining Treatment) is a medical order — signed by a physician — that translates your end-of-life wishes into actionable instructions for emergency responders and medical staff. Unlike a living will, which is a preference document, a POLST is a physician's order that must be followed. It is intended for people with serious illness or advanced age, not healthy adults.
POLST vs. living will: critical differences
| POLST | Living Will |
|---|---|
| A physician's order — legally binding | A preference document — advisory |
| Followed immediately by EMS and medical staff | Must be interpreted and applied by clinical team |
| For people with serious illness or advanced age | For any adult planning ahead |
| Requires physician signature | Requires witness signatures (no physician needed) |
| Intended for imminent end-of-life decisions | Intended for future hypothetical scenarios |
What a POLST form covers
A POLST typically covers three core decisions:
- Cardiopulmonary resuscitation (CPR): Attempt resuscitation / Do not attempt resuscitation
- Medical interventions: Full treatment / Limited interventions / Comfort-focused care only
- Artificial nutrition: Long-term feeding tube / Trial period / No artificial nutrition
Who should have a POLST
POLST is designed for people who:
- Have a serious, life-limiting illness (cancer, heart failure, COPD, dementia)
- Are frail or elderly with declining health
- Have a prognosis of one year or less
- Are enrolled in hospice care
A healthy 40-year-old does not need a POLST. They need a living will and a healthcare proxy. A POLST is for people for whom end-of-life decisions are near-term, not hypothetical.
POLST by state name
The form is called different things in different states:
- POLST — most states
- MOLST (Medical Orders for Life-Sustaining Treatment) — New York, Maryland
- MOST (Medical Orders for Scope of Treatment) — North Carolina, Colorado
- TPOPP (Transportable Physician Orders for Patient Preferences) — some states
- POST — Oregon originally, now various
How to get a POLST
- Discuss your wishes and health situation with your physician
- Your physician completes and signs the POLST form
- Keep the original visible and accessible at home (refrigerator is standard)
- Give copies to any facilities, your healthcare proxy, and family members
- Review and update whenever your health situation changes