A Portable Order for Life-Sustaining Treatment (POLST) ensures your medical preferences are honored during emergencies and end-of-life care. Unlike living wills, POLST forms provide specific instructions that healthcare providers must follow.

For those with serious illnesses or at risk of life-threatening events, a POLST form ensures their current medical wishes align with the care they receive. Keep reading to learn if, when, why, and how you can update your POLST form.

Key Takeaways 

• POLST forms can be revised at any time or after changes in health status, personal values, or treatment adjustments and changes in healthcare providers. 

• Patients cannot revise the POLST form on their own. A new form must be filled out and signed by a healthcare provider. 

• Always notify the relevant people about changes to your POLST form, distribute copies, and ensure old forms are marked as void. 

Can You Change Your POLST Form?

A key benefit of a POLST form is its flexibility. It can be updated or revoked anytime to reflect changes in your health, values, or treatment preferences.

Other documents like living wills don’t provide this level of flexibility with the instructions provided. For example, your living will can include instructions that no artificial life support must be used, whereas POLST forms provide more specific instructions. For example, you can state whether you want cardiopulmonary resuscitation (CPR), artificial nutrition, or to go onto a ventilator. 

Since you can revise and revoke your preferences, your POLST will always remain aligned with your current needs. 

Kathleen Cameron, former Senior Director of the National Council on Aging, thinks of a POLST as “a mirror that reflects your highly personal goals and definition of ‘quality of life.” 

Being able to change your POLST is a legal right and ensures patients have complete control over their medical care.  

Who can initiate changes on a POLST form? 

• Patient: The patient is the primary decision-maker and can make changes whenever their preferences or circumstances change.

• Legal representative: If the patient is unable to make decisions, their designated healthcare proxy or medical power of attorney can request revisions on their behalf.

• Healthcare providers: While your doctor or other medical team members can suggest revisions based on new treatment options or medical information, these changes must reflect your preferences.   

When Should You Consider Revising Your POLST Form?

There are no hard or fast rules on when you should change your POLST form, but the following scenarios are times you should consider making revisions. 

Changes in Health Status

The purpose of a POLST form is to reflect your healthcare preferences, so it makes sense to change your POLST when there are changes in your health status. Common examples of when you should make changes include: 

• Being diagnosed with a serious, chronic, or terminal illness

• Recovering from a critical condition that will alter your overall prognosis

• Transition to or from curative treatments to hospice or palliative care 

Even the smallest changes in your health status can prompt revisions.  

Adjustments to Personal Values or Treatment Preferences

Our values and beliefs will evolve, especially when dealing with terminal illnesses that put things into perspective or shift our priorities. Over time, you may no longer want aggressive treatments and prefer to focus on quality over quantity.  

Changes in Healthcare Providers 

Switching healthcare providers or moving to a new state may mean you will need to revise and update your POLST to make sure it complies with laws and that your new care team legally recognizes it. 

Steps to Change or Revoke Your POLST Form

Before you make changes, you should be aware that you cannot modify a POLST form yourself. You need to have a medical professional do it. Follow these steps:

Notify Your Healthcare Provider

First, you’ll need to notify your healthcare provider about the changes you want to make. You’ll meet with your primary doctor and explain your reasoning for doing this. Clearly explain the specific aspects of your POLST you want to change or remove. 

During this process, your doctor might make suggestions or explain the possible outcomes of your decisions so that you are 100% aware of them. 

Complete a New POLST Form

When making changes or revisions to your POLST form, you must create a new one from scratch. Your healthcare provider will help you complete the form correctly to ensure it reflects your wishes.  

Your healthcare provider will sign the new form to validate your POLST form. 

Mark the Old Form as Void 

Your healthcare provider will mark your old POLST form as void to avoid confusion. Make sure your records are updated at the relevant healthcare facilities and that you distribute copies of your new POLST form to everyone who needs them.   

Communicating Your Changes

It is crucial to communicate any changes to your POLST form with the relevant people to avoid confusion and ensure your medical preferences are respected. 

Discuss Updates with Your Healthcare Proxy

If you have assigned a healthcare proxy or medical power of attorney, they must be aware of changes to your POLST form. This is so they can advocate for you when you’re not in the position to do so. 

Inform Family Members

Updating your family on changes to your POLST form can help prevent confusion or conflict during emergencies, as well as prevent any delays in treatment. 

Keep your family members updated on your POLST changes with Trustworthy. Trustworthy’s Family Operating System® has AI-powered Autopilot features that simplify getting and staying organized. Use the collaboration features to share your important documents securely by creating a network of trusted collaborators and setting what kind of access is provided. 

The SecureLinks™ feature allows you to share important documents, like POLST forms, with people outside your network. It allows you to create unique, view-only links with limited access, giving you complete control over your medical information.   

How State Laws May Impact POLST Revisions

POLST regulations will vary by state, including the form’s format, the procedures for making changes, and the types of people authorized to sign it. 

For example, in states like Alabama, Alaska, and Maine, patients do not need to sign a POLST form, although it is strongly recommended. Other states, like New Jersey, do not allow signatures from healthcare proxies, only physicians and registered nurses. So, being aware of your state's signature requirements is important. What might be valid in one state does not necessarily mean it’s valid in another. 

Ensuring Compliance by State 

When switching states, you’ll need to comply with revision rules according to the state, which usually involve a medical review and the creation of a new POLST form. Under the official National POLST Legislative Guide, it reads: “When a patient moves from a hospital to a nursing home, or across state lines – from one jurisdiction to another, typically the physician assuming care will review the patient's history and existing orders and update those orders as appropriate.”  

Where to Store and Share Your Updated POLST Form

To avoid confusion, conflict, or treatment delays, store your POLST form somewhere accessible to you, your family members, healthcare providers, and medical proxies. We recommend keeping copies of your POLST forms with your other medical documents or on your refrigerator, as first responders will look for medical instructions there. 

Make sure that your healthcare providers, specialists, and other medical facilities have copies of your POLST form so your medical preferences are readily available. 

Storing your digital copies with secure digital vaults like Trustworthy is recommended. This family document management platform has bank-level security features like AES 256-bit encryption, multi-factor authentication, biometric authentication, physical security keys, on-screen redaction, tokenization, and advanced threat detection to keep your information safe. 

The predefined categories allow you to scan and upload your documents, such as a POLST form, without creating a filing system from scratch. Use the collaboration features to safely and instantly share your essential medical documents with those needing them.  

Common Mistakes to Avoid When Revising a POLST Form

Failing to Notify The Relevant People 

A common mistake people often make is not informing relevant people like healthcare providers, family members, and healthcare proxies about changes to your POLST form. 

Keeping everyone informed is the best way to guarantee your wishes are respected and conflict is avoided. 

Keeping Outdated Copies

Multiple outdated POLST forms in circulation can lead to confusion during emergencies, treatment delays, or the administration of care that you didn’t want in the first place. 

You can use Trustworthy’s automated reminders to make sure outdated POLST forms are marked void. 

Misunderstanding Emergency Treatment Implications

During emergencies, not fully understanding how the changes to your POLST form will affect your current treatment plan can be detrimental. So, discussing all concerns and questions with your healthcare provider before making any changes is highly recommended. 

Resources for Revising Your POLST Form

The important thing to remember is that you never have to make any revisions on your own, as the following can assist you: 

• Primary care physicians: Your doctor can guide you through the entire process and answer all your questions and concerns.

• Palliative care specialists: These people can help with end-of-life planning and help you understand what to expect.

• Legal advisors: Attorneys specializing in healthcare law can help you navigate the process of revising your POLST form so that it is legally valid. 

There are also plenty of tools, patient advocates, and support groups to help you make revisions to your POLST form. For example, the National POLST website has a wealth of helpful resources and downloadable forms to use. Support groups can provide emotional support as you go through the process of revising your POLST form. 

Frequently Asked Questions 

Can I make changes to my POLST form without creating a new one?

No, any changes or revisions will need to be reflected in a new form signed by your doctor according to your state’s requirements. 

Can a POLST form override a living will or other advance directives?

POLST forms are medical orders that take preference in an emergency, but this form should be used alongside your living will as a POLST form provides more explicit instructions. 

Are there any costs associated with revising a POLST form?

No, there are no costs to filling out a new form. However, there may be costs associated with consultation with your healthcare provider or legal advisor.