Differences Between Advance Directives and POLST
Characteristic | Advance Directives | POLST |
|---|---|---|
Eligibility | All adults, regardless of current health | A person of any age with a serious illness or frailty when the health care professional would not be surprised if the patient died within the next year or two |
Who writes it | The person, with or without an attorney | A doctor or, in some states, a nurse practitioner or physician assistant after care planning has been discussed with the person (or parent, guardian, conservator, agent, or other surrogate decision maker) |
Where completed | Any setting | Medical settings |
What it communicates | Preferences (not medical orders) regarding possible future treatment alternatives and appointment of a substitute medical decision maker (health care agent) | A doctor's medical orders for major critical care decisions that could arise because of the patient's current medical condition |
Decisions by surrogates (substitute decision makers) | Surrogates cannot make an advance directive for the patient | Surrogates can participate in and consent to POLST when patients lack the capacity to make their own decisions |
Emergency medical care | Generally does not apply to emergency care | Applies to emergency care |
Responsible for providing the documents to health care professionals wherever care is provided | Patient's and family's responsibility | Health care professional's responsibility |
Who reviews and revises the document as needed | The person who made the advance directive | The health care professional with the person or surrogate |
Use of both documents for the same person | Specifies general goals and wishes through all stages of the person's life and serves as a starting point for discussing POLST | Complements advance directives by converting the person's general goals and wishes into specific medical orders |
POLST = Provider Orders for Life-Sustaining Treatment. | ||