Physicians Orders for Life Sustaining Treatment. Does any other profession love the acronym more than the medical profession? I think not. They have a batch of letters for just about any occasion. This particular batch is an important one if you are of a certain age or have a diagnosis that could mean something unexpected could happen. By unexpected, I mean in a life threatening sense. In the “I might just have a potentially fatal event at any time,” sense. Say a heart attack or seizure kind of event. To be honest, with COVID-19, this feels like all of us.
A POLST is exactly what it says it is. It is a signed document – signed by a doctor – that directs emergency care in a situation where the person receiving that care is unable to direct it themselves. It’s aimed at first responders; the people who show up when you or your partner dials 911. Or the paramedics who show up at the restaurant when you keel over into your bouillabaisse. It directs these folks with your wishes regarding CPR and other emergency medical interventions and it directs them as a medical order.
This form is NOT an advanced directive and is not intended to take the place of an advanced directive in any way. It is supplemental to an advanced directive and as such, care must be taken that a POLST does not conflict with an existing AD. Everyone should have an advanced directive for health care in place. Not everyone needs a POLST. If you’re young and in good health – totally unnecessary. But if you have a chronic condition that could be life threatening or are simply in the age bracket that is the epitome of Humpty Dumpty (fine on the outside but more fragile than you look) a POLST can prevent a lot of pain.
You’ll hear me say this again and again. You can have everything in order and still not go out how you would like. Every i dotted and every t crossed. ALLL the paperwork finished, filed, and dispersed to parties in question. You’d like to punch your ticket for “died in your own bed, surrounded by loved ones and magnolias, and in a comfortable opiate haze.” But then you keel over into that bouillabaisse, and those paramedics show up and defibrillate, intubate, and break a bunch of ribs in the process. Next thing you know you’re a pincushion in an ICU, no visitors cuz COVID, with some surgeon considering opening you up to fix that punctured lung despite a 1% chance you’ll survive.
I am trying to scare you here. It’s part of you making informed decisions. A POLST does not guarantee that you’ll get your magnolia and opiate send off either. BUT it does mean you have a little more control than if you didn’t get a doctor to sign an order saying “comfort measures only.” Your POLST will reflect YOUR wishes, and the understanding that your doctor is informed of them. Done correctly, posted and carried correctly – it is the best way to ensure that your wishes come first.
Editorial note: Not every state has a POLST. Some call it something else, some have a limited form, some have nothing like it. Lucky Washingtonians DO have this option.
#POLST #endoflife #zerotohero