Advance care directives and “living wills” are intended to provide health care workers with guidance on the type of care a patient wants to receive. However, studies show they are not consistently followed and may in fact have little effect on care, in part because the instructions provided within them are often not explicit.
A new alternative – available in many states and under development in others – is Physician Orders for Life-Sustaining Treatment (POLST). The POLST is a standardized form indicating whether a patient wants any of a list of treatments to prolong life.
The list of treatments on a POLST form includes hospitalization, CPR, intensive care, intubation, antibiotics, assisted breathing, and others. After the patient completes the form, a physician reviews and signs it, and it becomes part of the individual’s permanent medical file. It is then available to and honored by all health care facilities.
The Journal of the American Geriatrics Society published a study showing patients who had completed POLST forms were 59 percent less likely to receive medical treatment they did not want than those having only a “Do Not Resuscitate” order.
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