What is Advance Care planning?
Advance care planning is thinking about what health care you might want in the future. The kinds of wishes you can consider are:
- Where you want to be cared for and where you want to die
- What matters the most to you near the end of your life
- Who you want to be with you near the end of your life
- Values and religious beliefs that are important to you near the end of your life
- What kind of specific life-prolonging treatments you would prefer to have or not have
Your advance care planning discussions and documents will guide your healthcare agent and healthcare team to make decisions that best reflect your wishes, even in situations you may not have thought of. It may not be possible to follow your wishes exactly in every situation, but advance care planning makes sure that your voice is at the center of your health care.
What is an Advance Directive?
An advance directive is a voluntary, legal way to write down your advance care planning decisions. It’s a form in which an individual: (1) appoints a person or persons to make health care decisions for the individual if and when the individual loses the capacity to make health care decision (typically called a “health care power of attorney”); and/or (2) provides guidance or instructions for making health care decisions, typically in end-of-life care situations (often called a “living will”). An advance directive is a direction from the patient, not a medical order.
What is a Portable Order for Life Sustaining Treatment (POLST)?
A POLST form is a portable medical order for specific medical treatments the patient would want tonight (based on their diagnosis, prognosis and goals of care). POLST forms are appropriate for individuals with a serious illness or frailty near the end-of-life.
The POLST form accomplishes two major purposes:
- It is portable from one care setting to another.
- It translates wishes of an individual into actual medical orders.
A POLST represents your wishes as clear medical orders. POLST improves your chances of getting what you want and avoiding what you do not want at the end of life. You and your medical provider can use the POLST to write clear and specific medical orders that indicate what types of life-sustaining treatment you want or do not want at the end of life. Both you and your provider must sign the bright green form in order for it to be honored by other health care professionals.
Who should have these documents?
Advanced Directives: All adults should have an advance directive but an advance directive does not give medical orders. Instead, it provides an idea of what treatments you would like to receive and identifies a surrogate who can help make treatment decisions on your behalf.
POLST: Individuals who are considered to be at risk for a life-threatening clinical event because they have a serious life-limiting medical condition, which may include advanced frailty. A POLST form complements the advance directive — it does not replace it.
Does Your Care Team know your plan?
Talking to your health care provider about advance directives can help you learn about your current health and make decisions about your future care.
Additional Resources:
- National Institute on Aging: Advance Care Planning: English Español
- National POLST
- Washington POLST from the Washington State Medical Association