POLST vs. AHCD: Understanding the Difference Between These Important Healthcare Documents
Navigating the world of healthcare planning can feel overwhelming, especially when faced with terms like POLST and AHCD. While both documents play a crucial role in ensuring your healthcare wishes are respected, they serve different purposes and are used in different situations. This blog post will clarify the distinctions between a POLST (Physician Orders for Life-Sustaining Treatment) and an AHCD (Advanced Health Care Directive) to help you understand which document is right for you.
What is an Advanced Health Care Directive (AHCD)?
An AHCD, also known as a living will or durable power of attorney for healthcare, is a legal document that allows you to:
- Specify your healthcare wishes: You can outline the types of medical treatment you want to receive or refuse in various scenarios. This might include decisions about life support, artificial nutrition, pain management, and other medical interventions.
- Appoint a healthcare agent (also known as a proxy or representative): This is someone you trust to make medical decisions for you if you are unable to communicate your own wishes.
Key features of an AHCD:
- Focuses on future wishes: It expresses your preferences for care if you become incapacitated.
- More general in nature: It typically provides guidance on a range of potential medical situations.
- Appoints a decision-maker: A crucial part of the AHCD is naming your healthcare agent.
- Effective when you are unable to make decisions: It only comes into play when you are deemed incapable of making your own medical choices.
What is a POLST (Physician Orders for Life-Sustaining Treatment)?
A POLST is a medical order form, not just a document of wishes. It’s a bright pink form that translates your healthcare preferences into actionable orders that healthcare professionals must follow. It’s designed to be used by people with serious illnesses or frailty, at any age.
Key features of a POLST:
- Focuses on current treatment: It addresses your current medical condition and the specific treatments you do or do not want now.
- Highly specific: It outlines choices regarding specific medical interventions like CPR, intubation, artificial nutrition, and other life-sustaining treatments.
- Signed by both you (or your representative) and your physician (or other authorized healthcare professional): This makes it a medical order.
- Immediately actionable: It’s intended to be followed by all healthcare providers in all settings – hospitals, nursing homes, and even at home.
- Portable: The pink form stays with you, so your wishes are known wherever you receive care.
POLST vs. AHCD: What’s the Difference?
| Feature | AHCD | POLST |
|---|---|---|
| Type of Document | Legal document outlining wishes | Medical order form |
| Focus | Future care if incapacitated | Current treatment preferences |
| Specificity | General guidance | Highly specific orders |
| Signatures | You (and sometimes a witness) | You (or your representative) AND physician |
| Portability | Not typically a portable medical order | Portable pink form |
| Use | Planning for future incapacity | For serious illness or frailty, at any age |
| Actionable By | Healthcare Agent | All healthcare providers |
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Who Needs Which?
- Everyone should have an AHCD: It’s a fundamental part of responsible healthcare planning.
- A POLST is particularly important for individuals who:
- Have a serious illness
- Are frail or elderly
- Want to ensure their wishes regarding life-sustaining treatment are clearly documented and immediately followed.
Can You Have Both?
Yes, absolutely! In fact, it’s often recommended to have both. Your AHCD expresses your broader wishes and appoints your healthcare agent, while your POLST translates specific treatment preferences into actionable medical orders. The POLST complements the AHCD by providing clear, concise directions for healthcare professionals to follow now, based on your current health status.
In summary: Think of your AHCD as the overarching plan and your POLST as the specific orders for immediate action. Both are crucial tools for ensuring your voice is heard in your healthcare, even when you can’t speak for yourself. Discuss these options with your physician and an estate planning attorney to determine the best approach for your individual needs.