POLST Program: End-of-Life Care
What is POLST?
POLST stands for Physician Orders for Life Sustaining Treatment and is a national approach to end-of-life planning based on conversations between patients, loved ones, and medical providers. POLST is designed to ensure that seriously ill patients can choose the treatments they want. It is a voluntary program, and a key objective is to improve the understanding and communication of a patient’s medical care choices when patients move among different care settings, such as nursing home to hospital or hospital to hospice.
What is the process for participating in the POLST program?
A POLST form, which is considered an actionable medical order, must be completed and signed by a health care professional in close consultation with the patient. The form always remains with the patient, regardless of whether the patient is in the hospital, at home, or in a nursing home. The POLST form ensures patients that healthcare professionals will provide only the care that patients themselves wish to receive.
How does POLST work?
As a actionable medical order, emergency personnel, such as paramedics, EMTs, and emergency physicians, must follow these orders. Without a POLST form, paramedics EMTs, and emergency room physicians are required to provide every possible medical treatment to sustain life.
What if the patient can no longer communicate his or her wishes for care?
A family member or someone who has durable power of attorney for healthcare may be able to speak on behalf of a loved one. A healthcare professional can complete the POLST form based on the surrogate’s understanding of the patient’s wishes.
Is POLST available in northern New Hampshire and what organizations are involved?
Under the direction of the New Hampshire Healthcare Decisions Coalition, a multidisciplinary statewide group, POLST got its start in the Seacoast region and Concord in 2004–2005 and has since spread to other areas of the state. The POLST program is available and recognized at Weeks Medical Center and several other hospitals in the North Country, along with nursing homes, home health agencies, and emergency service organizations.
Does the POLST form replace the advance directive?
No, the POLST form complements the advance directive and is not intended to replace it. An advance directive is necessary to appoint a legal healthcare representative and provide instructions for future treatment and does not guide emergency medical personnel. A POLST form should accompany the advance directive and provides medical orders for current treatment and guides the actions by emergency medical personnel.
Who should I speak with about the POLST program?
You should first speak with your primary care provider to discuss your goals of care and whether POLST is right for you or your loved one.
By Glenn Adams, DO
Glenn Adams is a primary care family physician based at the Groveton Physicians Office. For more information or for an appointment, please call 603-788-5095.