A POLST form — which stands for Physician Orders for Life-Sustaining Treatment — is not like a typical advance directive. It's a physician's order, and that distinction matters enormously in a medical emergency.
What Makes a POLST Different?
A living will expresses your preferences. A POLST translates those preferences into medical orders that healthcare providers — emergency responders, hospital staff, nursing home workers — can act on immediately without further interpretation or physician authorization.
While a living will must be reviewed and interpreted, a POLST is actionable. If an EMT arrives at your home and sees a POLST on your refrigerator (a common recommendation) indicating that you don't want CPR, they are required to follow it.
What a POLST Covers
POLST forms vary somewhat by state (they're called MOLST, MOST, or POST in some states), but typically address:
- CPR preferences: Attempt resuscitation (full code) or allow natural death (DNR)
- Medical interventions: Full treatment, limited interventions (comfort-focused but may include IV fluids and some treatments), or comfort measures only (pain relief and symptom management, no hospitalization unless necessary for comfort)
- Artificial nutrition: Trial period of tube feeding, long-term tube feeding, or no tube feeding
Who Is a POLST For?
A POLST is designed for people who:
- Have a serious or advanced illness
- Are elderly and frail
- Reside in or are transitioning between care facilities
- Have a medical condition where following a general living will might be ambiguous
POLST is not typically used for healthy adults — those individuals are better served by a standard advance directive completed before any crisis arises.
How to Get a POLST
A POLST is completed in conversation with your physician and must be signed by a physician (or nurse practitioner or physician assistant, in some states). It's not something you complete on your own — it requires a medical professional to review your condition and sign off on the orders.
Steps to obtain a POLST:
- Talk to your physician about your goals of care and preferences
- Discuss the options on the form together
- Your physician completes and signs the form
- You receive a copy; copies go in your medical record and to any care facilities
- Keep the original in a visible, accessible location at home
Is a POLST Instead of or in Addition to a Living Will?
A POLST is typically used in addition to — not instead of — a living will and healthcare proxy. Together, they create a comprehensive healthcare planning system: your living will expresses your general values and preferences, your healthcare proxy advocates for you in real time, and your POLST gives immediate medical authority to specific orders in emergency situations.
For the full picture, see our complete guide to advance directives.