If you are caring for a loved one with a serious illness or advanced frailty, you may have heard the term POLST. It stands for Provider Orders for Life-Sustaining Treatment. While it sounds clinical, it is actually one of the most powerful tools you have to ensure your loved one’s dignity is protected during a medical emergency.
Here is a simple, step-by-step breakdown to help you navigate this essential document.
Step 1: Understand What a POLST Actually Is
A POLST is not the same as a Living Will.
While a Living Will shares what someone might want in the future, the Understanding the POLST Guide clarifies that a POLST is a medical order for right now.
- It is actionable: First responders (like EMTs) are legally required to follow it immediately.
- It is portable: It stays with the patient—at home, in a care facility, or in the hospital.
- It is bright: Usually printed on high-visibility paper so it can be found quickly in an emergency.
Step 2: Determine if a POLST is Right for Your Situation
Not everyone needs a POLST. According to our Understanding the POLST Guide, it is specifically designed for:
- People with a serious, chronic, or progressive illness.
- Those with advanced frailty.
- Individuals whose healthcare provider would not be surprised if they passed away within the next year.
If your loved one is generally healthy, stick with an Advance Directive (Living Will) instead.
Step 3: Learn the Name Used in Your State
The “POLST” goes by different names depending on where you live. You might see it called:
- POST (Physician Orders for Scope of Treatment) — Common in Tennessee.
- MOLST (Medical Orders for Life-Sustaining Treatment)
- MOST (Medical Orders for Scope of Treatment)
Step 4: Have “The Conversation”
Before filling out the form, sit down with your loved one. Use this Understanding the POLST Guide to discuss their current values:
- Do they want to be resuscitated if their heart stops?
- Do they prefer “comfort-focused” care (staying at home rather than the ICU)?
- What are their goals for the quality of life they have now?
- Download Your State’s Template: Because these are state-specific, ensure you have the correct version. You can find your state’s form through the National POLST Map & Directory.
Step 5: Schedule a Consultation with a Clinician
A POLST is a medical order, so it must be filled out and signed by a healthcare professional (Doctor, Nurse Practitioner, or Physician Assistant) along with the patient or their legal surrogate.
Step 6: Keep it Visible and Update Regularly
Once signed, keep the original bright-colored form in a prominent place—many families keep it on the refrigerator or the back of the front door.
- Update it: Review the form at least once a year or whenever there is a significant change in health
POLST Appointment Checklist for Caregivers
Part 1: Preparation (Before the Visit)
- Review Current Health: Note any recent changes in your loved one’s condition or hospitalizations.
- Locate Existing Documents: Bring copies of any current Living Wills or Medical Power of Attorney forms.
- Identify the State Form: Ensure you know if your state uses POLST, POST, or MOLST.
Part 2: Essential Discussion Points
- The “Surprise” Question: Ask the doctor: “Would you be surprised if my loved one passed away in the next 12 months?” (If the answer is ‘No,’ a POLST is highly recommended).
- Resuscitation (CPR): Discuss if the patient wants chest compressions and electrical shocks if their heart stops.
- Medical Interventions:
- Full Treatment: Includes intubation/ventilators and ICU care.
- Selective Treatment: Hospital care but avoiding invasive machines.
- Comfort-Focused Care: Focusing on pain relief and dignity, often avoiding hospital transfers.
- Artificially Administered Nutrition: Discuss preferences regarding feeding tubes (long-term vs. short-term trial).
Part 3: Finalizing the Document
- Confirm Signatures: Ensure the clinician signs the form AND the patient (or legal surrogate) signs it. An unsigned form is not a valid medical order.
- Check the Color: Confirm if your state requires the form to be printed on a specific color of heavy paper (like neon pink or green).
- Clarify Portability: Ask how to ensure this order follows the patient if they move from home to a hospital or a skilled nursing facility.
Part 4: After the Visit
- The Refrigerator Rule: Place the original form in a high-visibility spot (like the fridge or near the front door).
- Notify the Team: Give copies to the home health agency, hospice team, or any specialists involved in care.
A Final Note for the Caregiver
Talking about life-sustaining treatment is never easy. It can feel heavy to sit down and have these “what-if” conversations.
Please remember that following the steps in this Understanding the POLST Guide isn’t about giving up; it’s about giving a gift. It’s the gift of certainty for you and the gift of dignity for your loved one. You are doing the hard work of honoring their life and their legacy, one conversation at a time.
Helpful Resources
- Download Your State’s Template: National POLST Map & Directory
- Learn More About Conversations: Pathways to Effective Communication
- Legal Tools for Caregivers: Texas Guardianship & Legal Tools
Explore the Full Series of Estate and Healthcare Planning Explained
This post is part of our series. Each one serves a unique purpose in protecting your loved one’s wishes and your peace of mind. Catch up on the rest of the series here:
POLST (You are here)
Resources for Caregivers
- Call 2-1-1 throughout Texas for information and access to health and human service information for all ages.
- Call 800-252-9240 to find local Texas Area Agency on Aging.
- Call 800-677-1116 – Elder Care Locator service to find help throughout the U.S.
Use resources such as Area Agency on Aging (AAA). Types of assistance provided by AAAs:
- Information and referral
- Caregiver education and training
- Caregiver respite
- Caregiver support coordination
- Case management
- Transportation assistance
Assistance available through AAAs for persons age 60 and older may include:
- Benefits counseling
- Ombudsman – advocacy for those who live in nursing homes and assisted living facilities
- Home-delivered meals
- Congregate meals
- Light housekeeping
Be sure to check out our Resource Directory, FAQ, and Educational Events Calendar for more great information! Permission is granted to duplicate any and all parts of this page to use in education programs supporting family members caring for elders.
Audited: April 2026
We hope this information is helpful to you in the important work you do as a family caregiver.
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