A Provider Order for Life Sustaining Treatment (POLST) document are portable medical orders for seriously ill or medically frail / fragile individuals. It is a document that reflects / documents a conversation that has occurred between the patient and their provider about treatment they chose to have or chose to forgo. This will allow an individual’s final wishes will be respected and honored. The POLST form should be completed by the patient’s provider, NOT the patient.

It is a living document, that when signed by both the patient (or patient’s designated health care decision maker if patient’s condition warrants) and the patient's provider, that lists a set of actual orders for first responders to follow should they be called to assist the patient. It can be changed, updated or revoked at any time by the patient or patient’s designated health care decision maker (POA) if patient’s condition warrants. 

Not everyone needs a POLST form and there is no exact algorithm to predict who needs one, but it is suggested that a POLST be completed for anyone on hospice, anyone with a life limiting illness (i.e. end stage cancer / lung / cardiac disease), anyone over the age of 90 or anyone over the age of 80 that has been hospitalized more than twice within the last 6 months. Medically fragile children can also benefit from having a completed POLST form.

POLST forms are nationally recognized in nearly every state and Washington, D.C., but the level of recognition varies by state. If you feel you or your loved one may benefit from a POLST form, talk with your medical provider and familiarize yourself with the availability of the POLST in your state.