Understanding POLST Forms


POLST is an acronym for Physician Orders for Life-Sustaining Treatment. This form is intended to communicate quickly in the event of an emergency your wishes for life sustaining treatment. It can be used by first responders in the event 911 is called, doctors, healthcare aides, family, friends, and even neighbors.

The form is voluntary and us often used by individuals who are at an advanced age or have serious health conditions to make their wishes both clear and specific. So what exactly is on the form? It usually contains your preference for resuscitation, your medical conditions, and your wishes regarding antibiotics, and artificially administered fluids and nutrition.

Your Frequently Ask Questions Answered by the Washington State Medical Association  

Does the POLST form need to be signed?

Yes. A physician, nurse practitioner, or certified physician assistant must sign the bright green form in order for it to be a physician order that is understood and followed by other health care professionals.

If I have a POLST form do I need an advanced directive too?

IF you have a signed POLST form, it is recommended that you also have an advance directive, though it is not required. You may obtain more information about advance directives from your physician.

What if my loved one can no longer communicate his/her wishes for care?

If you are the designated health care representative, you can speak on behalf of your loved one. A physician can complete the POLST form based on your understanding of your loved one’s wishes. If you have been designated the Durable Power of Attorney and are in a position to make health care choices for a loved one, be sure to have communicate and understand the wishes of your loved one before a crisis arises.

In what setting is the POLST form used?

The completed POLST form is a physician order form that will remain with you if you are transported between care settings, regardless of whether you are in the hospital, at home, or in a long-term care facility.

Where is the POLST form kept?

If you live at home you should keep the original bright green POLST form in a prominent location (e.g., on the front of the refrigerator, on the back of the bedroom door, on a bedside table, or in your medicine cabinet.) If you reside in a long-term care facility, your POLST form may be kept in your medical chart along with other medical orders.

How do I obtain a copy of the POLST form?

From your physician or other health care provider. CLICK HERE to view the form.  For more information visit https://www.wsma.org/POLST

If you or a loved one have entered the health care maze, you can be bombarded with paperwork and forms. It can be difficult to understand what is necessary and how to go about talking about, let alone making important and difficult decisions. As an RN or MSW, a Certified Geriatric Care Manager can be a wonderful place to start. A one hour consultation with an eldercare expert can help equip you with the answer you need to move forward and find your way to the care that is right for you. Sound Options has been guiding families in the Puget Sound Region since 1989. Give us a call to consult today at 800.628,7649


Published on October 9, 2013.