What Is the Difference Between an Advanced Directive and a Portable Orders for Life Sustaining-Treat
Updated: Jun 17, 2019
It is a very good idea to communicate medical wishes in order to plan for the possibility that you may one day be unable to make your own medical decisions. In doing so, there can be confusion about the difference between an advanced directive and a POLST (sometimes called a "do-not-resuscitate") order. While both these documents are advance medical directives, they serve different purposes.
An advanced directive is a document that you can use to give instructions regarding treatment if you become terminally ill or are in a persistent vegetative state and unable to communicate your instructions. The advanced directive states under what conditions life-sustaining treatment should be terminated. If you would like to avoid life-sustaining treatment when it would be hopeless, you need a living will. An advanced directive takes effect only when you are incapacitated and is not set in stone -- you can always revoke it at a later date if you wish to do so.
When drawing up an advanced directive, you need to consider the various care options and what you would like done. You need to think about whether you want care to extend your life no matter what or only in certain circumstances. An advanced directive can dictate when you want a ventilator, dialysis, tube feeding, blood transfusions, and other life- saving or life-prolonging options.
A POLST (Portable Orders for Life Sustaining Treatment) is a different document. A POLST says that if your heart stops or you stop breathing, medical professionals should not attempt to revive you. This is very different from a living will, which only goes into effect if you are unable to communicate your wishes for care. Everyone can benefit from an advanced directive, while POLST's are generally only for very elderly and/or frail patients for whom it wouldn't make sense to administer CPR. Typically, you will create a POLST with your physician.