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
|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.
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