POLST and MOLST Forms: An Important Tool for End-of-Life Care

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Doctors and medical professionals are giving seriously ill and frail people more control over their end-of-life medical care. But understanding the various forms involved in taking control over those choices can be a bit confusing. Here’s what you need to know about POLST and MOLST forms.

What are POLST and MOLST forms?

POLST stands for Physician Orders for Life-Sustaining Treatment. MOLST stands for Medical Orders for Life-Sustaining Treatment. Though they’re known by different terms based on where you live, both forms aim to improve end-of-life care for seriously ill and frail people who are not expected to live beyond a year. The forms help give people more autonomy and control over what medical treatment they want.

The POLST program, which began in Oregon in 1991, exists in some way across most states. The MOLST program, in contrast, is established only in Connecticut, Maryland, Massachusetts, New York, Ohio, and Rhode Island.

A terminally ill person, or their authorized health care proxy, begins the process by having a conversation with the healthcare provider about treatment options. These options are based on the person’s current medical state and how their disease may progress. The POLST or MOLST forms distill that information into a single sheet of brightly colored paper, making it easy for all medical staff to see at a glance the patient’s preference for life-sustaining medical treatment.

The treatments covered on the form could range from their desire to have cardiopulmonary resuscitation performed, the use of artificial nutrition, or the level of medical intervention desired in a medical emergency. These preferences for treatment are recorded on the standardized medical order, which is then kept at the front of the patient’s medical records so they can be easily accessed in different medical care settings.

Both POLST and MOLST orders must be honored by medical professionals administering care and treatment, including first responders.

How is a POLST or MOLST different from an advance directive?

An advance directive (sometimes also called an advance care directive or a living will) is a document that outlines your wishes for your health care in case you’re unable to speak for yourself. The key differences between an advance directive and a POLST or MOLST:

  • While just about anyone can (and should!) create an advance directive, POLST forms are only for those who are seriously ill or frail.
  • An advance directive outlines broad treatment wishes. A POLST form can translate those wishes  into specific medical orders.
  • An advance directive allows you to appoint a surrogate or health care proxy, while a POLST does not. This means that in the event that your medical condition changes and your POLST no longer makes sense, but you’re unable to make treatment decisions for yourself, your doctors can turn to your proxy to guide your treatment.
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