The POLST program is for those with severe illness or frailty to assure their treatment wishes are honored at the end of life. The POLST form is a tool for translating the treatment goals of seriously ill patients into medical orders in a easily recognizable, portable manner. Health professionals discuss with their patients (or the patient’s representative or surrogate) available treatment options as related to their specific illness and current condition. Clinicians then document patient preferences on the POLST form, a standardized medical order and ensure that it travels with the patient if transferred to another setting of care. (Sabatino, C., Karp, N. 2011. Improving Advance Illness Care: The Evolution of State POLST Programs, AARP Public Policy Institute).

POLST is a national effort. POLST programs utilize the POLST form to improve the end-of-life experience. The POLST program encourages end-of-life planning based on conversations between patients, their loved ones, and medical providers. Because the POLST form translates seriously ill patients’ treatment preferences to medical orders and coordinates the transfer of these orders between care settings, the POLST program therefore better assures patient preferences will be honored by medical providers.

The POLST form is completed for patients who are seriously ill, with a life-limiting illness. The patient may request a POLST form or their physician, APRN or PA may suggest it. The POLST form is only used when a patient is so ill they cannot express their wishes by themselves; then their provider can consult the POLST form to determine what the patient wants and what the course of treatment should be.

The POLST form has two parts: 1) medical orders for treatment and, 2) a summary of patient preferences. This form, usually bright pink for easier recognition, is transferred with the patient if and when they are transferred between home, hospital, nursing home or long-term care facility. This assures continuity of care and that treatment reflects the agreed to level of care desired by the patient.

The Nevada POLST was designed by Nevadans for Nevadans. Over many years and through surveys, interviews and meetings with patients, their representatives and health care providers the idea of a Nevada POLST evolved to become the form and program that was unanimously passed by the Nevada State Legislature in 2013.

Experiences in other states demonstrates that the Nevada POLST program can improve our end-of-life experience. Please share your experience with POLST with us by sending an email.

Printing and Ordering POLST Forms

Because the POLST constitutes a medical order, forms are available only to health care professionals and medical facilities. Individuals interested in completing a POLST should contact their physician, APRN or PA. If you are a healthcare provider, click here to order Nevada POLST forms.