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.
POLST |
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.