POLST and Advance Care Planning (ACP)
Healthcare professionals play a central role in advance care planning by guiding patients through conversations about their goals, values, beliefs, and what matters most for quality of life. These discussions — especially with patients who are seriously ill or frail — help clarify treatment options and ensure care aligns with patient priorities. By encouraging open dialogue and supporting documentation of preferences, clinicians provide patients, families and their care partners with the clarity needed to make informed choices and to receive care that truly reflects their wishes.
The Standard of Care and Seriously Ill or Frail Patients
The current standard of care during an emergency is to do everything possible in an attempt to save someone’s life. For seriously ill or frail patients, however, standard life-saving treatments are unlikely to prevent death, and furthermore, these treatments can be painful, traumatic, and not how many patients want to spend their final moments.
About ACP
Advance Care Plan Documents: Legal and Medical
There are basically two kinds of advance care documents designed for patients to share their treatment preferences in the event they can no longer speak for themselves: legal and medical.
- Legal documents, such as advance directives, living wills and health care power of attorney, identify a surrogate decision maker and provide general wishes about treatments an individual wants. However, they are not orders that EMS providers can follow.
- Medical orders, like the POLST form, provide emergency personnel with the specific treatments that are desired during an emergency. They are meant for seriously ill and frail patients, and they are signed by health care professionals.
Learn more about a standard of care with these resources.
Resources for Guiding a Conversation With Your Patients
Here are a few tips and resources when preparing for a POLST conversation with your patients:
- Suggest to your patients that they think about what makes a good day for them and what goals they have.
- Encourage them to invite their surrogate (or proxy or health care power of attorney), a family member, a friend, or spiritual advisor to the conversation.
- Have them look at the free Conversation Starter Guides are available from The Conversation Project.
- Suggest they consider using the digital advance care planning platform, MyDirectives.
- Have them bring their advance care plans, such as an advance directive, living will, or health care power of attorney.
- Prepareforyourcare.org provides free advance directive forms to download, if your patient needs a place to get started.
Explore Membership in the National POLST Collaborative
Learn more about the benefits of joining NPC as a state program, organization, or individual member.