Polls show that a vast majority of Americans agree on the benefits of advance care planning—the process of discussing end-of-life options with physicians and loved ones. However, few people have actually had such conversations. For example, one study with late-stage cancer patients reported that only about one in four had end-of-life care discussions with his or her oncologist.
A type of advance care planning document, the Physician Orders for Life-Sustaining Treatment (POLST) form, helps health professionals translate the care preferences of seriously ill or frail individuals into actionable medical orders. After a provider elicits a person’s treatment wishes, the POLST form is used to document his or her choices regarding specific life-sustaining treatments, such as cardio pulmonary resuscitation (CPR) or artificial nutrition, in the event the patient cannot communicate. POLST forms vary among states and some have different names, but all share core elements: they are voluntary, they address a person’s current medical condition, they physically accompany a person between care settings, and they are easily revised as a person’s medical condition or treatment preferences change.
A National POLST Paradigm Task Force promotes public policy principles and quality standards for POLST programs, which are created either through legislation or consensus among health professionals, patients and other stakeholders. State legislatures can be instrumental in establishing POLST Paradigm programs by creating patient protections, authorizing state health departments to establish a POLST process or by allocating funding. The National POLST Paradigm Task Force supports state efforts to create POLST Paradigm programs and endorses programs that meet specified quality standards. As of December 2015, the Task Force had endorsed 19 of the 46 states with a POLST program.
Resources: The National POLST Paradigm, www.polst.org. The Pew Charitable Trusts, www.pewtrusts.org.
* Endorsed by the National POLST Paradigm Task Force.