What you need to know about POLST

If you have severe illness or frailty, the Nevada POLST (Physician Order for Life-Sustaining Treatment) program will assure that you receive the medical treatments you want near the end of your life. Until recently, there was no reliable way to do that within Nevada, but in 2013 our legislature enacted Nevada POLST legislation .

The unanimous approval and signing into law of the Nevada POLST has created the ability to represent one’s treatment wishes as medical orders that emergency medical services and your doctor are to honor. The medical orders on the POLST are relevant even if you lose the ability to say for yourself what you want.

POLST also helps you talk with your health care team and understand treatment options specific to your condition. It also helps you talk to your loved ones about your choices. In this way, POLST can help reduce patient and family confusion and misunderstandings, and make sure that your wishes are known and honored.

POLST is not for everyone.
For healthy patients, an Advance Directive is an appropriate tool for making future end-of-life care wishes known to loved ones. The POLST is designed to ensure that seriously ill patients can decide with their physician what treatments are most appropriate. Medical orders are written based on these decisions and those orders are then to be honored by medical providers.

What does POLST do?

  • POLST makes your treatment wishes known to doctors and other members of your health care team. Too often, patients near the end of their lives may get treatment they do not want. The default is to provide more aggressive care at the end of life, but these treatments may not help patients live longer or better. Sometimes this treatment can cause pain, and prolong the process of dying. POLST gives you a way to tell doctors, nurses, and other healthcare team members what types of treatment you may or may not want. (You may find these decision guides helpful)_
  • POLST makes your wishes clear to your family members and caregivers. Sometimes, family members have their own ideas about what types of treatment their loved ones would or would not want. POLST makes sure your family members and caregivers know exactly what treatments you do and do not want. No one has to guess or feel burdened with making decisions for someone else.

Who should have a POLST?
Doctors say that any seriously ill patient should have a POLST form. Completing a POLST is entirely up to you. It’s your choice and completely voluntary.

Is POLST different from an Advance Care Directive?
Yes. An Advance Directive allows you to choose the person you want to speak for you, and provides a general guide to what you want. POLST is different because:

  • POLST tells your exact wishes about certain medical treatments;
  • POLST is a signed medical order that your health care team can act upon; and
  • POLST goes with you to your home, the hospital, or long-term care facility. It goes where you go, so it is always available. However, to assure it is available in all instances, you may register it with the Nevada Secretary of State’s Living Will Lockbox

It is a good idea that seriously ill people have both an Advance Directive, including a Living Will (Declaration) and a Durable Power of Attorney for Health Care. The Living Will (Declaration), states what care you want or don’t want regarding resuscitation, nutrition and hydration in general terms. The Durable Power of Attorney for Health Care, names someone else to speak for you when you cannot. A POLST form offers specific choices of treatments that you may or may not want near the end of life and puts these in terms that can be transferred as medical orders to your medical record. POLST also provides your health care provider information about organ donation and your Advance Directives, so should they need this information, it too is available.

Who can help me fill out a POLST form?
Your doctor, nurse, social worker, or chaplain can help fill out the POLST form. Unlike an Advance Directive, it should be completed with a health care professional who knows, understands and can explain what the treatment options may mean for you. Make sure you talk with your doctor about the treatments you want or don’t want (these decision guides may help). The form must be signed and dated by your doctor and by you or your legal representative.

What do I do with my POLST form?
Once signed, the POLST form will be copied and become part of your medical record, but the original pink form stays with you all the time.

    • If you are at home, put it near your bed or on your refrigerator so it is readily available if needed.
    • If you are in a hospital, nursing home, or assisted living facility, it will be in your chart or file.
    • If you are moved between locations, your POLST form will go with you.
    • To assure your POLST and Advance Directive are available 24/7, you may register them with the Nevada Secretary of State’s Living Will Lockbox. You will receive a wallet card to carry that, in an emergency, will provide quick access to these important documents.

What if I want to change my POLST form?
You and your doctor can change your POLST form whenever you want or whenever medically necessary.

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