New Jersey Implements POLST

The New Jersey Department of Health and Senior Services recently released a new option for patients to communicate their goals and wishes for treatment in end of life situations.  POLST stands for Practitioner Orders for Life-Sustaining Treatment.  New Jersey is one of many states that has put POLST in place.

The New Jersey POLST form, a one page document, is designed to be completed by the physician or advanced practice nurse in consult with the patient.  There is a section in which the goals of care for the patient are to be completed.  A second section titled, “Medical Intervention”, lists 3 choices of treatment from which the patient must choose, full treatment, limited treatment or symptom treatment only.  There are also sections covering artificially administered nutrition, cardiopulmonary resuscitation and airway management.

The POLST form is intended for use by patients who are seriously ill, frail and weak, afraid of losing mental capacity to make decisions in the near future, or living in a nursing home or on hospice.  In other words, POLST is designed to be completed when end of life is near.

Does the POLST form replace an advance directive?  No, it doesn’t but rather it complements an advance directive.  You’ll need to appoint a health care representative to make decisions for you, which an advance directive will do.

But, what is important to understand is that the POLST form is designed to be used when the patient is near the end of his/her life.  You wouldn’t complete it while healthy.  Everyone, however, should have an advanced directive, which can be completed at any time, as long as the patient has the legal capacity to do so.

POLST is intended to encourage a conversation with the physicians as to what medical treatment and measures the patient wishes or does not wish to be administered, at a time when these decisions are most meaningful.  The conversation is not the hypothetical one it is when the person is still healthy.   The New Jersey POLST form can be found at http://www.njha.com/media/84188/NJPOLSTFORM.pdf.