Have you completed an advance health care directive or living will? These
simple legal documents can provide you and your loved ones peace of mind
by identifying what types of medical treatment you want (and don’t
want) and who is empowered to make health care decisions on your behalf
in the event that you can’t articulate those decisions yourself.
Advance health care directives help plan for unforeseen medical emergencies,
and they’re recommended for just about everyone. But what about
individuals for whom medical emergencies are not unforeseen, but imminent
and likely… or individuals with serious or life-threatening conditions
that may require emergency medical treatment within a year? People in
such circumstances can “lock in” peace of mind with a Physician
Orders for Life-Sustaining Treatment, or POLST form. An advance health
care directive can address an individual’s general wishes for medical
treatment and name someone to act as a legal agent in making health care
decisions, but POLST goes further—addressing the patient’s
specific wishes for CPR, artificially-administered nutrition and medical
intervention. Once completed and signed by the patient and a physician,
physician’s assistant or nurse practitioner, the POLST form, as
its name implies, has the weight of doctors’ orders that medical
professionals are required to carry out.
Unlike an advance health care directive, POLST is not for everyone. It’s
for individuals facing situations that are “not
if but
when the next medical crisis occurs,” says Mary Hersh, PhD, RN, Torrance
Memorial Medical Center’s palliative care program manager. “We
understand that serious illness is not only an experience of the patient
but also an experience for the family,” Hersh says. Making health
care decisions for a loved one is difficult. A directive or POLST can help.
Attorney Eric J. Harris, a specialist in estate planning, trust and probate
law, and a member of Torrance Memorial’s professional advisory council,
adds that advance health care directives are not always immediately available
to emergency medical personnel. In contrast, POLST forms, typically printed
on bright pink paper, are designed to be placed so they’re easily
accessible to first responders—on a refrigerator, say, or in a purse
or glove box. If an advance health care directive or POLST is not available,
physicians try to find the patient’s closest legal agent or next
of kin, which may prolong unwanted medical treatment. Both are relatively
simple documents and do not require an attorney to complete. “There’s
no good reason not to have an AHCD and a POLST,” says Harris.
POLST forms are available from
Torrance Memorial’s Care Coordination Center, which provides post-discharge care to patients and families. Contact Sasha
Mejia, NP, at 310-784-8713. The form can also be downloaded from the Coalition
for Compassionate Care of California at
capolst.org.