What is a POLST Form and Why Do I Want One?

While serving residents and their families in a skilled nursing facility, the discussion of a POLST form came up A LOT!  I had no idea what a POLST form was at first but I quickly learned and became a champion of it's purpose.

POLST stands for Physicians Order for Life Sustaining Treatment.  This is a legal document that clearly states what your wishes, as the patient, would be for life-sustaining treatment.  This form becomes crucial when you are unable to state what your wishes are.  It lets medical professionals know whether you are "Full Code" (do everything you can to keep me alive) or "DNR" (Do Not Resuscitate) and is kept with all of your legal documents and in your medical file.  In my grandparents home a copy of this form was hung on the door in the hall closet.  That way, if the paramedics were called and the situation arose, Nonna and Nonno's wishes for care were already decided and easily accessible.

Describing this form to residents and their families was sometimes difficult, especially if the patient was already in a situation where they were unable to state what their wishes were.  Family members didn't want to make a decision that someone i the family would later be upset with them about.

Let me give you a worst case scenario ...... The patient is 92 years old, suffers from a few different diseases including lung cancer which has been diagnosed as terminal.  He is currently unconscious and non-responsive and his three children are faced with deciding what to do.  This may look pretty clear to someone in the medical field but when you put emotional ties into the situation it becomes extremely difficult to make a decision. 

Let's look at another scenario, this one a little more public.  Do you remember Terri Schiavo?   Terri Schiavo, age 27,  collapsed in her Florida home in full cardiac arrest on February 25, 1990. She suffered massive brain damage due to lack of oxygen and, after two and a half months in a coma, her diagnosis was elevated to vegetative state.  For the next few years doctors attempted physical therapy and other experimental therapy, hoping to return Terri to a state of awareness. In 1998 Terri's husband, Michael, petitioned the court to have her feeding tube removed, thereby, allowing her to pass away. He was certain that she would not want to live in this condition. He was opposed by her parents and after 14 different appeals, numerous court proceedings and several years, the feeding tube was removed on March 18, 2005.  That is 15 years AFTER she collapsed. Terri passed away at Pinellas Park Hospice on March 31st. 


Nonno, my Italian grandfather was on hospice care when the Terri Schiavo story was captivating audiences around the world.  He was bedridden and rarely conscious.  He passed away on April 3, 2005.  What a blessing it was to know what his wishes were.  No one wondered. No one doubted. No one was second guessing. 


Working in the health care field I have seen the importance of having a POLST form filled out and letting my family know what my wishes are.  I wouldn't want to be living in a vegetative state for years on end like Terri Schaivo did.  I wouldn't want my family second guessing each decision.  I would want my wishes to be carried out.  


I hope you will pass this info on to your family and friends. I have included links below so you can print out your own POLST form, fill it out with your family and have your Doctor sign it.  Make copies available so that all who come into contact with you for your care are aware of your wishes. You will be so glad that you did.


POLST FORM in Spanish

POLST FORM in English