Advance healthcare planning: There are three related documents to be aware of. A couple are overlapping — the Living Will and Physician Orders for Life-sustaining Treatment (POLST) — but serve different functions. The third is the power of attorney for healthcare. All of these fall into the category of advance directives for healthcare.
From this NIH page: Advance Care Planning: Advance Directives for Health Care
"The two most common advance directives for health care are the living will and the durable power of attorney for health care.
- Living will: A living will is a legal document that tells doctors how you want to be treated if you cannot make your own decisions about emergency treatment...
- Durable power of attorney for health care: A durable power of attorney for health care is a legal document that names your health care proxy, a person who can make health care decisions for you if you are unable to communicate these yourself."
Here's an official Advance Health Care Directive Form provided by the State of California. It contains both a Living Will and Power Of Attorney For Health Care, plus advisory comments.
There's another document known as Physician orders for life-sustaining treatment (POLST). Although a living will covers similar ground, the POLST constitutes orders to medical staff directing treatment. It must be signed by a physician. Again, from the NIH:
"Physician orders for life-sustaining treatment (POLST) ... forms: These forms provide guidance about your medical care ... They serve as a medical order... Typically, you create a POLST... when you are near the end of life or critically ill [Not necessarily - more on this below] and understand the specific decisions that might need to be made on your behalf. These forms may also be called portable medical orders or physician orders for scope of treatment (POST). Check with your state department of health to find out if these forms are available where you live."
A California version is here, and contains three medical sections as shown in the top image:
- Whether or not to resuscitate
- Medical treatment, options being full, selective, or comfort only
- Whether or not to provide artificially administered nutrition.
Here's information from Cedars Sinai that addresses important practical details about the POLST:
"Ideally, a POLST form is completed when the prospect for a patient having significant health decline is more likely than not, but before the patient is acutely ill" — This seems much wiser than waiting until nearing the end of life!
Making sure that the POLST is at hand when needed: “Where should a patient’s POLST form be kept? If a patient lives at home, the original pink POLST form should be kept where emergency responders can find it."
This document also covers:
- What should be done when a patient arrives in the ED or is admitted into the hospital (Make sure the POLST is entered into the medical record)
- Can the directives contained on a POLST form be changed?
- Are there other circumstances in which a POLST can be disregarded? (Yes)
Regarding that last item:
"If fulfilling the instructions on a POLST form would entail providing medically ineffective healthcare or healthcare that is contrary to generally accepted healthcare standards, the POLST may be disregarded."
Unfortunately that seems to provide plenty of wiggle room if the healthcare provider wants to ignore the POLST. Be that as it may, much better to have a POLST than not, especially if one just wants to be kept comfortable and avoid heroic life sustaining interventions.
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