How is POLST
Different from an
Advance Directive?
POLST complements an Advance Directive
and does not totally replace that document.
You may still need an advance directive to
appoint a legal healthcare administrator.
It is recommended that all adults have an
advance directive regardless of their health
status. If there is a conflict between the
documents, have a conversation with your
practitioner as soon as possible to determine
the most current preferences.
The promise of POLST is that it empow-
ers you to make the important decisions
about your end-of-life care. Have the
POLST conversation with your medical
professional 
The Promise of POLST:
Goals of Care
Taking Charge of Your Healthcare
Treatment at the End of Life
This section details how you want to live your
life in the time you have left. What is most im-
portant to you as you deal with a life-limiting
illness? Do you have personal goals or family
milestones you would like to reach? How much
do you want to know about your illness? How
much does your family know about your priori-
ties and wishes? These are all issues you should
consider. Your POLST form will allow you to
make known any personal, cultural or spiritual
practices related to your care.
Talking about your wishes during a serious, life-al-
tering illness can be difficult, emotional and, and
for some of us, is a conversation we would rather
avoid. But it’s a conversation you must have as an import-
ant and necessary part of good medical care. You have the
right to participate fully in all your healthcare decisions –
and that’s even more important near the end of life.
The best way to make your preferences known is by talking
with your healthcare provider and filling out the Practi-
tioner Orders for Life-Sustaining Treatment form, or POLST. POLST is a medical order form that empowers individuals by carefully detailing their personal wishes regarding end-of-life care.
with your healthcare provider and filling out the Practi-
tioner Orders for Life-Sustaining Treatment form, or POLST. POLST is a medical order form that empowers individuals by carefully detailing their personal wishes regarding end-of-life care.
Medical Interventions
POLST can help you make meaningful personal choices regarding your care – and ensure that
every member of the healthcare teams understands and respects those choices. Individuals fill
out the POLST form together with their physician or advance practice nurse. It’s signed by all
of you and then becomes a permanent part of your medical record. Your POLST form will trav-
el with you and must be honored in all his/her healthcare settings. And you can modify your
POLST form at any time.
The form also will allow you to work with your
medical professional to clearly define the types
of medical interventions you want – or don’t
want. For example, you may specify that you
want comfort measures only, which is medical
treatment intended to eliminate pain and suf-
fering. You may specify an array of other treat-
ment options such as intravenous fluids or an-
tibiotics. Or you may state your wishes for full
treatment, including all options available to
sustain your life which could include a feeding
tube and cardio pulmonary resuscitation.
You should have a
POLST form if you are:
Make Your
Wishes Known:
Choices to Discuss
with Your Healthcare
Professional
Seriously ill with a life-limiting ad-
vanced illness
Frail and weak and have trouble per-
forming routine daily activities
There are two very important parts of the
POLST form for you to describe your goals
and wishes at the end of life: your “goals of
care” and the medical interventions that
you do and do not want.
Afraid of losing the capacity to make
your own healthcare decisions in the
near future
Living in a nursing home or hospice.
