More about POLST

A POLST form is recommended for all adults who may be entering their final phase of life and who what to make clear their preferences for end of life care. Unlike a living will or advance directive, it is a set of medical orders that must be followed by all medical personnel. This includes first responders, emergency room doctors, and all medical staff in hospitals, nursing facilities and assisted living facilities.  The following is a summary of each section of the POLST form. For a more detailed explanation you may watch the POLST videos at www.goalsofcare.org or visit www.njha.com/POLST.

In section A, we write what is most important to the person during this remaining time, 

Here we write the patient's information

Section B asks about the scope of care, either full efforts to prolong life, limited (middle of the road) efforts or comfort only. A person may also decide on avoiding going to the hospital here.

Section C asks about artificial nutrition

Section D asks about CPR (chest compressions and breathing machines)

Section E asks if its OK for the next of kin to change this form if the patient looses the ability to speak with doctors (this section is skipped if the POLST form is being completed for someone who already lost the ability to make decisions

Here we write the next of kin’s information

Section F is for signatures

© 2020 Your CarePlan