Frequently Asked Questions
What does "POLST Paradigm" mean?POLST stands for Physician Orders for Life-Sustaining Treatment. We use the term "POLST Paradigm" to describe several programs, developed on a state or community-wide basis, having different program names, forms, and policies. What is a POLST Paradigm form?A POLST Paradigm form is a brightly colored, medical order form, used to write orders indicating life-sustaining treatment wishes for seriously ill patients. The form accomplishes two major purposes:
Why was POLST developed?POLST was developed initially in response to seriously ill patients receiving medical treatments that were not consistent with their wishes. The goal of a POLST Paradigm Program is to honor patient's end-of-life treatment preferences either to have or to limit treatment, even when transferred from one care setting to another. Who should have a POLST Paradigm form?A POLST Paradigm form is most appropriate for seriously ill persons with life-limiting, also called terminal, illnesses or advanced frailty characterized by significant weakness and extreme difficulty with personal care activities. How does a POLST Paradigm form work?The POLST Paradigm form remains with a patient if he/she is moved between care settings, regardless of whether the patient is in the hospital, at home, or in a nursing home. If you live at home, keep the original POLST Paradigm form where community emergency responders will look for it (most programs recommend the side or front of the refrigerator). If you live in a nursing or adult foster care home, the POLST Paradigm form will be kept in your chart. How does a patient get a POLST Paradigm form?POLST Paradigm Programs are not available in every state. A patient can start by clicking on their state from the national map or drop-down menu to learn if their state or community has a POLST Paradigm Program. Then, speak to your primary care professional about communicating your goals of care and whether POLST is right for you. 
Does a patient have to have a POLST Paradigm form?No. The use of a POLST Paradigm form is always voluntary. Does a POLST Paradigm form replace traditional Advance Directives?No. Traditional Advance Directives are recommended for all adults. Advance directives allow you to express your wishes and appoint someone you would like to make health care decisions if you are not able to do so. When available, an Advance Directive should accompany a POLST Paradigm form but is not required for the orders to be valid. Who completes the POLST Paradigm form?A health care professional (usually a physician, nurse practitioner, physician assistant or social worker) completes the form after understanding the patient's values and goals of care. Remember, a POLST Paradigm form is a medical order and is therefore not completed by the patient. Who signs a POLST Paradigm form?The form must be signed by a physician, and in some states it may also be signed by a nurse practitioner (NP) or physician assistant (PA), to be valid. Many states also require the patient or his/her chosen decision-maker's signature. What if the patient's POLST Paradigm form does not have the signature of his/her doctor (nurse practitioner, or physician assistant)?The form is not considered valid without the signature of a physician, or in some states a nurse practitioner (NP) or physician assistant (PA). What happens after the form is complete?The original POLST Paradigm form always remains with the patient. In a health care facility, the form will be in the medical record. In a home setting the form should be placed in a location recognized by emergency medical personnel (usually the side or front of the refrigerator). Health care facilities will make a copy of the form for your medical record before sending you home or to a different care setting. What if the patient's loved one can no longer communicate her/his wishes for care?Family members may be able to speak on behalf of a loved one. A health care professional can complete the POLST Paradigm form based on family members' understanding of their loved one's wishes. Some state laws have limitations on the power of a patient's chosen decision-maker so check with your health care professional. Do any POLST Paradigm Programs require POLST by law?No. The POLST Paradigm form is always voluntary and is intended to:
How do I find out if my state or community has a POLST Paradigm Program?Select your state from either the national map or state drop-down menu to learn if there is contact information. If so, the state or community contact representative will have more information about a POLST Paradigm Program in a state or community. If a state doesn't have a POLST Paradigm Program; can a form still be used?No. Unfortunately, a POLST Paradigm form would not be recognized by health care professionals in a state where there is not a POLST Paradigm Program. We recommend speaking with your primary care professional about goals of care. How can a POLST Paradigm Program get started?A POLST Paradigm Program requires collaboration and involvement from health care, ethics and legal professionals, hospitals, long term care, hospice, and emergency medical services. Without a program, we recommend speaking with your primary care professional about the POLST Paradigm and how to best communicate goals of care. How can I get more information about the POLST Paradigm Program?Ask your health care professional or contact: polst@ohsu.edu What are some of the medical terms used when talking about serious illness?
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