• Gentle Passage Doula Collective

What is a POLST?

Learn about the updated 2021 Portable Order for Life Sustaining Treatment, previously known as Physician Order for Life Sustaining Treatment.



Read more to find out if you want extreme life saving support when you can't advocate for yourself.


Have you, or someone you know, been diagnosed with a life-limiting or life-ending disease? If death is likely to occur within one to two years, then a Portable Order for Life Sustaining Treatment form (POLST) should be completed.

A POLST, is a document where you can indicate what types of life-sustaining treatment you want or do not want at the end of life. The POLST document is not necessary for everyone. It is designed for seriously ill people who are in very poor health, regardless of their age, as well as individuals in later years of life. It can help give medical professionals specific guidelines about your wishes such as cardiopulmonary resuscitation (CPR) and heroic measures in accidents or in an event where you are unable to communicate. It is not an Advance Directive, which provides more details for your end of life wishes and it helps give your family and loved ones a road map to your medical treatment. The POLST compliments the Advanced Directive by outlining specific “heroic” measures. The POLST must be signed by the patient and the attending physician, nurse practitioner or Physician Assistant-Certified, as well as dated.

You need a POLST to ensure your wishes and values are honored especially if you cannot speak for yourself. In medical centers, it is a bright green form that is placed in the front of your medical chart and in a prominent location if you are at home or other non-institutionalized setting. The original form should transfer with you when you go from one setting to another. A copy of it can be kept by an institution as part of your medical record, given to your durable power of attorney as well as family, friends and neighbors. Make sure that the copy of your form is signed and dated. Some people even carry the form with them when they leave their home to help communicate these immediate actions in unexpected situations, like a car accident, or a sudden and unexpected stroke or heart attack.

If you are in the beginning stages of dementia or have received a terminal diagnosis, you may want to have a family meeting with your doctor about completing a POLST form while you are still able to sign the document yourself. Talking about what may happen as your disease progresses, understanding the risks and benefits of your options and choices, allows you and your family to plan for these “what if” situations. You or your designated decision maker can make changes to the form whenever you want and if you have a change in your medical condition. It is important to discuss your wishes and desires with your designated power of attorney, your family and loved ones, and your doctor for healthcare decisions.


How would you like to be cared for when you cannot speak for yourself? Would you like CPR? Who is your Durable Power of Attorney?

Gentle Passage Doula Collective has a POLST form you can download here. You can usually obtain a POLST form from your physician’s office or you can get one from the Washington State Medical Association (WSMA). If you decide to print and fill one out, some of the recommended guidelines are: printing on a green card stock (Astrobrights terra green, smooth finish, 65 lbs, #22781, or equivalent), per the WSMA. You can also refer to their website for details on how to do this here. Copies, digital images and faxes of your POLST are legal as long as they are signed and dated by you and your doctor, nurse practitioner or Physician Assistant-Certified.


In addition, if you do not have a POLST and are in a situation where the medical team has to make a decision for life sustaining treatment, the team will provide the necessary steps for full treatment. This includes and is not limited to CPR, intubation, tube feeding, IV hydration and antibiotics, to name a few.


Completing the POLST form is always voluntary, but having this legal document can better support your wishes, inform your medical team and have you prepared for the future. Gentle Passage Doula Collective can help educate you on the POLST form, provide you with scenarios as well as help guide you with questions for clarity for your medical team. We can also host family meetings, create additional documents such as Advance Directives and hold Advanced Care Planning meetings. These meetings may include those you want near you (such as your family, loved ones, medical durable power of attorney and medical team) to help compliment the POLST form and prepare you and your family for next steps allowing you to take full control of this path.


GPDC is ready to help you in ensuring you are prepared and confident in having this form as well as guiding you, your family and loved ones for a successful path. Please reach out to us if you have any questions or to book a meeting with us.


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Reference: Washington State Medical Association.




The tools, resources and information does not provide medical advice. It is intended for informational purposes only, not advice or guarantee of outcome. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the Gentle Passage Doula Collective Website, downloaded resources and/or educational material, or misinterpreted the information/context/educational sessions. If you think you may have a medical emergency, immediately call your doctor or dial 911. Gentle Passage Doula Collective and its members are not responsible for errors and omissions in reporting or explanation. No individuals, including those under our active care, should use the information, resources or tools contained within to self-diagnosis or self-treat any health-related condition. Gentle Passage Doula Collective gives no assurance or warranty regarding the accuracy, timeliness or applicability or the content.


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