Both an advance healthcare directive (also called a living will or healthcare proxy) and a POLST (Physician Orders for Life-Sustaining Treatment) form are important documents to prepare ahead of time as they provide information about treatment wishes. However, they give different information, are used in different ways, and at different times. Neither are replacements for each other. Rather they work in tandem to communicate patient wishes clearly to treatment providers and loved ones so that difficult life events surrounding an illness, injury, or end-of-life is made less stressful.
An advance directive provides an idea of what treatments the patient would like to receive when they can no longer speak for themselves and identifies a surrogate who can help make treatment decisions on behalf of the patient. To be clear, an advance directive does the following:
(1) appoints a person or persons to make health care decisions for the individual if and when the individual loses the capacity to make health care decisions (typically called a “health care power of attorney”); and/or
(2) provides guidance or instructions for making health care decisions, typically in end-of-life care situations (often called a “living will”), although not limited to these. An advance directive is a direction from the patient, not a medical order.
On the other hand, a POLST form gives medical orders. These orders address a limited number of critical medical decisions to be followed in a medical crisis. For example, it provides clarity as to whether the patient wishes to receive CPR in the event they stop breathing. That’s why POLST forms, which can be completed by any adult, are most appropriate for individuals with a serious illness or frailty near the end-of-life.
All adults should have an advance directive but an advance directive does not give medial orders. So in many cases a person should have both in place, as a POLST form will be an important compliment to an advance healthcare directive.
Watch our short video for more information about how these work together and what is involved in the process of completing them.