What is the difference between a POLST (Physician Orders for Life-Sustaining Treatment) and an Advance Healthcare Directive?

A question our attorneys get asked often by clients is what the difference is between a POLST and an Advance Healthcare Directive.

A POLST form does not replace an advance directive – they work in tandem. While all adults should have an Advance Directive, not all should have a POLST form.

Both provide information about treatment wishes but they give different information.


Advance Healthcare Directive

Voluntary Voluntary
Medical Order Legal Document
Completed by a health professional Completed by individual
For unhealthy or those with serious medical conditions For healthy, capable adults
First responders and professionals base action on this form The agent named under the advance directive makes the decisions that result in the medical orders
It does not designate an individual to make decisions but gives advance medical orders. An individual is appointed to make decisions
Depending on the State, agent named to make healthcare decisions in Advance Healthcare Directive can complete, change or void a POLST The agent named to make decisions cannot modify the document
Specific medical orders are communicated General wishes about treatment are communicated.
Healthcare professional is responsible for reviewing the POLST with the patient, or agent named in Advance Healthcare Directive whenever the patient is transferred to a new facility, or when there is a change in the patient’s medical condition Up to the individual how often to review or update


Is one better than the other?  Most people should have an Advance Healthcare Directive.  However, only those who are currently at risk, including advanced frailty, should consider a POLST.

For more information on these and other estate planning documents, please contact us today.