Video 4: The Difference Between an Advance Directive and a POLST Form
How is a POLST form different from an advance directive?
There are some very important differences between a POLST form and advance directive:
- POLST forms are not meant to replace advance directives. Each may complement the other, and people may have both. Generally, in most states, advance directives may be written for all adults, whether they are facing serious illnesses or not. POLST forms are generally reserved for those people who are facing serious illnesses and may be entering into the final phase of life.
- Both an advance directive and a POLST form instruct medical staff on how to treat you during a serious illness or during the final phase of life. However, there are some very important differences between the two:
- An advance directive only becomes active if or when you are unable to speak to your doctors for yourself. The doctor must confirm your inability to participate in medical decision-making and then interpret what is written on your advance directive.
- The POLST form is active from the moment it is signed and directs the actions of health care professionals in all circumstances.
A written advance directive or living will may only be completed by an adult person capable of making his or her own medical decisions. It may contain instructions to be followed should the person lose the capacity to speak to doctors. It may also contain the name of someone designated to make decisions for the person if he or she becomes unable to participate in the decision-making.
A POLST form may be completed by a patient who is able to make their own decisions and for someone who does not have capacity to make their own decisions. This means that people with dementia, or any illness that prevents them from participating in the conversation about their goals of care, may have a POLST form completed for them. In the situation where the patient cannot make his or her own decisions, a health care proxy or next of kin may speak with the doctor to complete the POLST form.
Finally, the POLST form is a set of medical orders that must be followed by the medical teams caring for the patient; these orders do not require further discussion or interpretation. Unlike many advance directives, the POLST form gives clear instructions to the medical staff at the point of contact on specific treatments during the final phases of life.
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