POLST vs Living Wills: How the Paperwork Differs

Living Wills and POLST documents are two commonly used forms of advance planning. They both provide information about the type of care a person wishes to receive and may seem interchangeable. Yet, there are notable differences between them as well.

What is a Living Will?

A Living Will is a legal document that highlights the medical treatments that an individual does and does not want. This includes wishes regarding pain management, life-saving measures, medications, tube feeding, dialysis, CPR, and more.

Such decisions are influenced by what matters most to the individual. For example, some people wish to be kept alive at any cost, while others may want only limited interventions.

Arizona has no required form for Living Wills – allowing people to write their own. However, there are some details that must be included, so it’s often better to use a form that’s already been prepared to meet Arizona’s standards, like Five Wishes.

Why a Living Will is Important

Living Wills provide crucial details about the patient’s wishes and their values. The information helps family members and healthcare staff know the type of care to provide.

Living Wills are most relevant when the person is no longer able to speak for themselves. This could be because they’re unconscious or in a coma. Or, they may still be conscious but cannot make decisions for themselves, like in the late stages of dementia.

What is POLST?

POLST stands for Physician’s Orders for Life Sustaining Treatment and covers some of the same ideas as a Living Will. However, POLST is much more specific, as it translates the person’s wishes into specific medical directives that can then be followed by healthcare professionals.

POLST forms are generally created by physicians in consultation with their patients, and the paperwork should then follow the patient as they move through the healthcare system.

Why POLST Forms are Important

POLST forms increase the odds that the senior’s wishes are followed.

This is partly because the forms focus on specific medical treatments. As such, little interpretation is needed and healthcare staff can quickly follow the directions. Additionally, healthcare facilities often have systems in place to track the POLST documents and ensure these move with the patient.

POLST vs Living Wills – What are the Differences?

Specificity

Living Wills are often broad, with a focus on the outcomes that the person wants. In contrast, POLST documents are more specific, providing precise information about individual medical interventions.

For example, the Living Will might say that the person “doesn’t want to be kept alive by machines”, while the POLST might include orders not to resuscitate and not to intubate.

Similarly, a Living Will might say that the person wishes to be comfortable, while the POLST provides specific medical orders about what medical interventions can be provided for comfort and which interventions should be avoided.

Their Role

Living Wills provide guidance about the principal’s wishes and values, allowing healthcare proxies and surrogates to make decisions about desired treatment. They’re especially powerful as a reference for cases where the proxy or surrogate does not know or remember all the principal’s wishes.

POLST documents are primarily for medical staff. They allow the staff members to act quickly in the case of an emergency, especially if the healthcare proxy isn’t present, the Living Will isn’t immediately available, or there isn’t time to interpret the Living Will.

POLST appears to be commonly used in Arizona, and many hospitals have systems to ensure that medical orders are efficiently found and followed.

Who They’re Relevant For

Living Wills are helpful in most situations, regardless of whether a person is seriously ill. Creating one means that there’s at least a reference document for what the person wishes, although the Living Will should still be updated regularly.

In contrast, POLSTs are most relevant when people have a serious medical condition or they are likely to face a medical emergency in the near future.

Format

There is no consistent required format for Living Wills in Arizona. The information can be as broad and specific as the creator wishes. Arizona’s laws simply require a Living Will to be in writing, with clear intent, dated, signed by an adult and witnessed by at least one adult or a notary public.

That said, there are state forms that people can use, along with the Five Wishes paperwork and any forms produced by other groups. POLST forms tend to be more consistent and more concise than a Living Will, as they are designed to be actionable and easy to use.

Which is Better?

POLST forms and Living Wills are not mutually exclusive. Instead, the Living Will is often used to create the specific instructions in the POLST form. Using both types of documentation increases the chance the principal’s wishes are followed, especially in the case of an emergency.

If you’re trying to limit your paperwork, begin with a Living Will and a PoA form (or Five Wishes, which includes both). Your agent from the PoA form can then use the information in your Living Will to make healthcare decisions. Their authority should also allow them to work with your physician to develop a POLST.

Final Thoughts

While POLST forms aren’t as well-known as Living Wills, they’re still a particularly important part of advance planning. They’re significant for people with severe health conditions, where medical emergencies and rapid decisions are likely.