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WHAT An end of life care instruction form printed on bright pink paper, and signed by both a doctor and patient that clearly says what kinds of medical treatment patients want once they near end of life care.
WHYTo give seriously ill patients more control over their treatment.
WHEREThe Coalition for Compassionate Care of California.
Sacramento, California, USA.

Program Description

The POLST form stays in place when the patient later loses the ability to say what he or she wants. POLST can help reduce patient and family suffering and the decision making conflict between family members.

Most importantly the aim of POLST is to make sure that patient wishes are known and honored by sharing these wishes with doctors, nurses, and other health care team members.

The POLST form covers details on end of life wishes including:

-Resuscitation -Comfort Measures
-DNR (do not resuscitate)
-Antibiotics -Intravenous (IV) Fluids
-Artificial Nutrition/Tube Feeding

POLST differs from an Advance Health Care Directive in that POLST is:

-For the seriously ill
-Is more specific about exact wishes about certain medical treatments
-Is a signed medical order that your health care team can act upon
-It goes with you to your home, your hospital, or your long-term care facility. It goes where you go.

The program recommends that seriously ill people have both an Advance Health Care Directive and a POLST form.

POLST is available in multilingual formats including:


Several other advance directive forms are available to those who wish to make their end of life wishes known including:

Basic advance directive form - Includes wishes for end-of-life care and designation of a surrogate decision-maker

Easy-to-Use Advance Directive forms - Simple language and graphics make this Advance Directive very easy to use. English, Spanish, Chinese, and Vietnamese

Thinking Ahead My Way, My Choice, My Life at the End - An advance directive workbook and DVD developed by and for people with developmental disabilities. English, Spanish, and Chinese

Five Wishes - A user-friendly advance directive that addresses medical, personal, emotional and spiritual wishes of seriously ill people. Available in 20 languages

California Medical Association Advance Health Care Directive Kit

Caring Connections - State-specific Advance Directive forms that can be downloaded

The "Coalition for Compassionate Care of California" is a statewide partnership of more than 95 regional and statewide organizations dedicated to the advancement of palliative medicine and end-of-life care in California.




Find out more about the “Physician Orders for Life-Sustaining Treatment” Program

Senior Programs
Palliative Care & Hospice Care Training
General End of Life Care Programs
The Terminally Ill & Their Pets
End of LIfe Documentaries

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