New Document Helps Patients Make Final Care Wishes Known

While many people may be familiar with an Advanced Directive, there is another form available now that clearly outlines a patient’s life-sustaining care wishes, according to Terrell VanAken, M.D., medical director for NorthBay Bridges. The form is called a POLST (Physician Orders for Life-Sustaining Treatment), and it gives seriously ill people—or those in very poor health, regardless of age—a way to ensure that their care wishes regarding CPR, aggressiveness of medical care and artificial nutrition, will be honored when it comes to end-of-life medical treatment.

The POLST was originally created in Oregon to address the challenges that occur when frail, elderly or chronically ill patients are transferred from medical facilities to home or skilled nursing facilities. California adopted the POLST after California State Sen. Lois Wolk wrote a bill that was signed into law in 2009.

Filling out a POLST form is entirely voluntary, Dr. VanAken says, but California law requires that the physician orders in a POLST be followed by healthcare providers, such as emergency medical personnel, nurses and doctors. The POLST is signed by both a doctor and the patient, and the original stays with the patient as he or she moves through care facilities. If the patient is in a hospital, nursing home, or assisted living facility, the form will be in the medical record or file. If the patient is at home, it should be displayed in a visible place, such as on a refrigerator or bedside table. It will be easy to see in either place, as the form is printed in pink.

For more information, contact Dr. VanAken at (707) 624-7500, or go to At this Web site you will be invited to view a 12-minute video that clearly explains the form and how it guides patients and their families toward making their care wishes known.

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