Understanding the Differences Between POLST and Advanced Directives

QUESTION

What is the difference between a POLST (Physician Orders for Life Sustaining Treatment) and an Advanced Directive? 1. An Advanced Directive provides designation of a medical surrogate for decision-making while a POLST does not. 2. A POLST is completed by an individual while an Advanced Directive is signed by a healthcare professional. 3. Emergency Medical Services (EMS) can use an Advanced Directive while a POLST is designed for in hospital care. 4. An Advanced Directive provides medical orders while a POLST does not.

ANSWER

Understanding the Differences Between POLST and Advanced Directives

Introduction

In healthcare, two essential documents exist to help individuals express their healthcare preferences and guide medical decisions in specific situations: the Physician Orders for Life Sustaining Treatment (POLST) and the Advanced Directive. While both serve as valuable tools for healthcare decision-making, they have distinct purposes and characteristics. This essay will elucidate the differences between these two important healthcare documents.

1. Designation of a Medical Surrogate

One notable difference between a POLST and an Advanced Directive is the designation of a medical surrogate or healthcare proxy.
Advanced Directive: An Advanced Directive often includes the appointment of a healthcare proxy or surrogate decision-maker. This individual is authorized to make medical decisions on behalf of the patient when they are unable to do so themselves.
POLST: A POLST form, on the other hand, does not typically designate a medical surrogate. Instead, it focuses on documenting specific medical orders and preferences regarding life-sustaining treatment.

2. Completion Process

The process of completing these documents differs:
Advanced Directive: An Advanced Directive is typically initiated and completed by the individual. It is a written document expressing their healthcare preferences and wishes.
POLST: A POLST form, on the other hand, is usually completed with the involvement of a healthcare professional, such as a physician or nurse. It involves a conversation between the healthcare provider and the patient or their authorized representative.

3. Applicability and Use

The scenarios and settings in which these documents are used vary:
Advanced Directive: An Advanced Directive is a legal document that can be used in various healthcare settings, including hospitals, nursing homes, and even by Emergency Medical Services (EMS) when available.
POLST: A POLST form is primarily designed for in-hospital care and is often used to provide specific medical orders to guide treatment, especially in situations where the patient has advanced or serious illness. While some states may allow EMS personnel to honor POLST orders, this can vary by location and regulations.

4. Medical Orders

The nature of the information contained in these documents differs:
Advanced Directive: An Advanced Directive primarily provides healthcare preferences and goals of care, but it does not include specific medical orders.
POLST: A POLST form includes medical orders that detail specific interventions, such as cardiopulmonary resuscitation (CPR), intubation, and artificial nutrition, based on the patient’s preferences and medical condition.

Conclusion

In summary, while both the Physician Orders for Life Sustaining Treatment (POLST) and Advanced Directives are important tools in healthcare decision-making, they serve different purposes. An Advanced Directive provides healthcare preferences and often designates a medical surrogate, while a POLST focuses on medical orders for life-sustaining treatment in specific medical situations. Understanding these differences is essential for individuals and healthcare providers to ensure that the appropriate documents are used to honor a patient’s wishes and provide the most suitable care.