POLST and End-of-Life Preferences

As we age or as we experience others reaching the end of life, our thoughts turn to what we would do under those circumstances. Living wills, health care proxies and advanced directives may have some flexibility about end of life decisions and the documents may not be able to be located when needed. For this reason, New Jersey has created POLST also known as Practitioner Orders for Life-Sustaining Treatment which permits individuals to set forth their end of life decisions after reviewing the forms with their doctor or nurse practitioner.

Medical professionals assist individuals in understanding medical interventions, treatment options and comfort measures available. The goal of POLST orders is to prevent unwanted or medically ineffective treatment, lessen the individual’s pain and insure that the individual’s wishes are followed. The decisions are set forth on the POLST agreement which is signed by the individual and the doctor. The individuals kept one form and the doctor kept the other.

In order to make the POLST available when the end of life is near, the State Health Commissioner and the New Jersey Hospital Association have joined forces to create a secure electronic database to make the patient’s POLST available. The program is now a voluntary pilot program for individuals to make known their wishes for end-of-life treatment and to make those decisions available to their health care providers and caregivers. Initially, it was limited to four New Jersey hospitals and long-term care facilities, but it is anticipated that the program will expand as more hospitals join the database. This will allow hospitals and other providers to access the POLST form free of charge when needed. The program will also create an app to allow EMTs to access the database as their ambulances are rushing to the emergency room.

In short, the electronic delivery of the POLST will make end of life decisions certain and accessible.