POLSTS are simple forms which can help patients express their wishes in the event they cannot express them for themselves.
A “POLST” is a Practitioner’s Order for Life Sustaining Treatment. New Jersey practitioners use a form available from the New Jersey Hospital Association, http://www.njha.com/polst/. The form can be downloaded at http://www.njha.com/media/572698/POLST-Fillable-Form.pdf
A POLST is a one-page document that talks about a patient’s treatment goals, the types of medical interventions they do or do not want, and if they cannot make decisions for themselves, who should make those decisions for them.
To be effective, a POLST has to be signed by a health care practitioner like a Doctor, Advance Practice Nurse, or Physician’s Assistant, and it has to be signed by the person making the decision, their health care representative, or if they are incapacitated, their legal guardian.
A POLST has four different sections. The first one is a place where the patient can write in their wishes. This section can explain the patient’s goals, for example, I want to attend my grandchild’s graduation in June, or I want to die peacefully at home. The second section talks about treatment interventions. It may limit transfer to a hospital, it may refuse fluids and nutrition and intensive care, or it may call for full treatment, depending on the wishes of the individual signing the form. The third section addresses resuscitation and airway management. This is a very important section. If you do not want to be placed on a ventilator for any reason, this is where a hospital will find that instruction. If you do not want CPR, this is where an EMT will find that instruction. The last section tells the practitioner if a surrogate decision maker can modify the POLST or not, and identifies the surrogate decision maker by name and address. This is a very important document to have if you do not want to be placed on a ventilator, or you do not want to be resuscitated if you go into cardiac arrest.
If your loved one has a POLST, a good place to keep it is on a refrigerator – so that if there is an emergency, an EMT is more likely to see it- and it is a good idea for loved ones to have a copy which they keep in an accessible place. Right now, there is not yet a registry for POLSTs. If you have a POLST, you can ask a hospital or doctor to add it to your electronic health record.
It is important to know that a POLST may contradict a living will. If a hospital has a POLST and a living will, the hospital will abide by the wishes you expressed most recently. If you have questions about POLST, contact Fredrick P. Niemann, Esq. toll-free at (855) 376-5291 or email him at fniemann@hnlawfirm.com. Please ask us about our video conferencing consultations if you are unable to come to our office.
Written by Nicole C. Tomlin, Esq. of Hanlon Niemann & Wright