Nobody expects to wind up in a hospital bed, unable to communicate their wishes about treatment options. However, to avoid any mistakes, arguments between family members, and a whole lot of stress being dumped on loved ones, it pays to plan ahead.

That’s where medical documents like a Physician Orders for Life-Sustaining Treatment (POLST) or an advance directive can create some much-needed peace of mind. These documents enable you to communicate your wishes ahead of time so that if something bad happens to you, your family and medical team know your wishes for treatment.

If you’re new to this process, creating a POLST or advance directive from scratch might understandably feel a little bit daunting. That’s why we sat down for a Q&A session with estate planning expert Kalim Khan.

Khan is the founder and senior partner at the Toronto-based firm Affinity Law, where he’s spent the last decade helping to guide families through complex legal decisions and fulfill estate planning and documentation requirements.

Read on to get Khan’s take on the key differences between a POLST and an advance directive, how to create and update these documents, and get pro tips for storing and sharing your essential documents to ensure your medical wishes are honored.

What exactly Is a POLST and an Advance Directive?

Answer: A POLST (Physician Orders for Life-Sustaining Treatment) is a medical order signed by a physician outlining a patient’s preferences for emergency and end-of-life care. 

An advance directive is a broader legal document that includes a living will and a healthcare power of attorney. It guides long-term medical decisions when a person is incapacitated.

A POLST is intended for patients with serious illnesses or those nearing the end of life, ensuring emergency responders and medical personnel follow their treatment preferences. An advance directive, however, is useful for any adult, providing long-term guidance in case of future incapacitation.

If both exist, the POLST generally takes precedence in emergency settings.

Who Should Have an Advance Directive?

Answer: Every adult should have an advance directive, regardless of age or health status. 

It ensures that their medical wishes are followed if they become unable to communicate due to illness or injury.

When is the right time to consider a POLST?

Answer: A POLST should be considered when a person has a serious, life-limiting condition and wants to ensure their treatment preferences are respected in emergencies.

It is typically recommended by a healthcare provider when curative treatment is no longer the primary goal.

How Do You Create and Update These Documents?

Answer: An advance directive is completed by an individual and may require witnesses or notarization, depending on the state. A POLST, however, must be completed and signed by a healthcare provider, such as a physician, nurse practitioner, or physician assistant.

For an advance directive, individuals can complete state-approved forms, designate a healthcare proxy, and update the document as needed. An advance directive then guides long-term care decisions when a patient is unable to communicate.

Medical professionals use a POLST to guide immediate emergency care decisions, as it acts as a standing medical order. A POLST requires a conversation with a healthcare provider and can be updated whenever a patient’s medical condition or preferences change.

What Makes These Documents Legally Binding?

Answer: A POLST becomes legally binding once signed by both the patient (or their representative) and a healthcare provider. An advance directive is legally binding once it is completed according to state laws, which may include notarization or witnessing requirements.

Emergency responders follow a POLST as a medical order and will provide or withhold treatment based on its instructions. 

In contrast, an advance directive is not typically reviewed in an emergency setting but serves as a reference for later hospital care.

How Should These Documents Be Stored and Accessed?

Answer: A POLST should be kept in an easily accessible location, such as a refrigerator or with emergency contacts, as first responders need quick access.

Advance directives should also be shared with healthcare proxies, family members, and doctors and stored in a safe but accessible place.

How Can These Documents Be Modified?

Answer: A POLST can be updated at any time by discussing changes with a healthcare provider. 

An advance directive can also be revised as needed, typically requiring a new signature and distribution to relevant parties.

How Do Surrogate Decision-Makers Factor Into Each Document?

Answer: An advance directive allows an individual to designate a healthcare proxy, who can make medical decisions on their behalf. 

A POLST directly instructs medical personnel and may not require a surrogate unless changes are needed.

What happens in emergency situations with each document?

Answer: A POLST is followed by first responders immediately. 

An advance directive, however, is more likely to be used after a patient is stabilized or admitted to a hospital.

How do different states handle these documents?

Answer: POLST forms are recognized in many states but may have varying names and requirements. 

Advance directives are legal in all states, but specific witnessing, notarization, and format requirements can differ. 

It’s crucial to ensure compliance with state laws.

Ensure Your Medical Wishes Are Honored Using Trustworthy

When it comes to your advance directive or POLST, accessibility and communication are key. That’s why it makes sense to partner with a platform like Trustworthy.

Trustworthy’s advanced Family Operating System® takes all the stress out of organizing and maintaining your essential family documents. 

A quick onboarding process supported by AI tools lets you instantly upload and categorize digital versions of everything from your family IDs and insurance policies to your POLST, advance directive, or living will.

From there, everything is 100% searchable and easy to find, even when you’re on the go, thanks to Trustworthy’s mobile app.

Meanwhile, Trustworthy offers a range of collaborative features to ensure that family, trusted friends, and your medical team always have access to important documents like your POLST or advance directive.

You can add trusted individuals to your digital vault and give them access to particular documents or folders you’ve secured in your Trustworthy account. You can also share SecureLinks with others, granting granular access to anyone you want to see a particular document. 

You can also set time limits for access, get notifications when the recipient opens up the file, and revoke access at any time.

Finally, it’s important to ensure documents like your POLST and your advance directive are regularly reviewed and updated to reflect your current wishes. Trustworthy enables you to set up custom reminders so that you never forget to keep your documents up-to-date.

So, are you ready to start planning for the future? Join Trustworthy today.