The POLST decision-making process and resulting medical orders are intended for patients 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.
Examples of Appropriate Patients for Engagement in POLST
Patients with serious life-limiting medical condition or advanced frailty:
whose health care professional would not be surprised if they died within 1-2 years; or
who are at an increased risk of experiencing a medical emergency based on their current medical condition and who wish to make clear their treatment preferences, including about CPR, mechanical ventilation, ICU; or
who have had multiple unplanned hospital admissions in the last 12 months, typically coupled with increasing frailty, decreasing function, and/or progressive weight loss.
Examples of Medical Conditions (not an exhaustive list)
Severe Heart Disease
Metastatic Cancer or Malignant Brain Tumor
Advanced Lung Disease
Advanced Renal Disease
Advanced Liver Disease
Advanced Frailty, a combination of advanced chronic disease and /or advanced age with significant weight loss and functional decline
Advanced Neurodegenerative Disease (e.g., Dementia, Parkinson’s Disease, ALS)
Note: For patients with significant disabilities, health care professionals should consider approaching patient about a POLST conversation only if this patient’s level of functioning has become severely impaired as a result of a deteriorating health condition and when intervention will not significantly impact the process of decline.
