The Physician Orders for Life-Sustaining Treatment (POLST) Paradigm program is designed to improve the quality of care people receive at the end of life. It is based on effective communication of patient wishes, documentation of medical orders on a brightly colored form and a promise by health care professionals to honor these wishes.* * *
Effective communication between the patient or legally designated decision-maker and health care professionals ensures decisions are sound and based on the patient’s understanding their medical condition, their prognosis, the benefits and burdens of the life-sustaining treatment and their personal goals for care.
Pennsylvania – Orders for Life Sustaining Treatment (POLST) is a medical order that gives patients more control over their end-of-life care. The POLST form specifies the types of medical treatment that a patient wishes to receive towards the end of life.
These medical orders are signed by both a patient’s physician, physician’s assistant, or certified registered nurse practitioner and the patient or the patient’s surrogate.
Completion of a POLST form is only a small step in the process of a patient’s decision-making, and it is critical that this form be used as part of a program for end of life decisions that includes educational support and other aspects of planning for providers and patients.
This form was developed by the Pa. Department of Health’s Patient Life Sustaining Wishes Committee and was designed to be consistent with Pennsylvania law. There are significant advantages to using a form that contains standardized language and is produced in a distinctive and easily recognizable format.
In order to maintain continuity throughout Pennsylvania, please follow these printing instructions:
*** Print POLST form on 110# Pulsar Pink card stock. ***
See additional instructions on the POLST form related to completing and using the form.
As additional educational materials are developed for the POLST form and for POLST programs in Pennsylvania, they will be added to this introduction.
- End of Life Experiences in Pennsylvania -- A Background paper (May, 2005; PDF, 38 pages); and
- Improving End-of-Life Experiences for Pennsylvanians (2006; PDF, 40 pages) -- Report and Recommendations to the Governor by the Task Force for Quality at the End of Life.
The new Pennsylvania POLST form is virtually identical, except for layout and explanations, to the sample form contained in the 2007 Final Report.
The law and medical privacy rules consider friends and non-married companions less than “real” family.
In order to involve them in one’s own medical decisions, specific legal declarations must be made. These are known as advance health care directives, or simply, advanced directives.
There are two main types: a health care power of attorney and a living will. Most people should consider having both. * * *
Here are some questions to consider when making advance directives:
- Who would you trust to follow your wishes? Who can make tough choices? Who is willing and able to serve as your health care agent?
- How you would like to be cared for if you can no longer speak for yourself? What life-sustaining treatment and other care you would want at the end of your life?
- What personal wishes and values do you want your health care agent to consider when making decisions about your care?
My friend, Attorney Robert B. Wolf, of Pittsburgh, PA, noted my posting in one of his P&T Hot Tip Emails, which was reposted online by Smithfield Trust Company.
Bob served on the group that prepared the new PA POLST form:
I was privileged to serve on the Patient Life Sustaining Wishes Committee, and to work with leaders in Pennsylvania, such as Dr. Judy Black and Marian Kemp of Highmark and David Barnard, of the University of Pittsburgh in this effort.He advised further: "We are currently working on educational materials for healthcare providers, and after that for patients and families."
For a comprehensive list of currently-available POLST resources, see: Resources: Pennsylvania Physician Ordered Life-Sustaining Treatment (POLST), posted by the University of Pittsburgh's Institute on Aging.