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by: Shaina Case

“POLST” stands for “Provider Orders for Life Sustaining Treatment Program.” (Wyo. Stat. Ann. § 35-22-501 et seq.). POLST is not an acronym commonly known among households, attorneys, or medical providers, even though it became effective three years ago and may act as a supplement to the advanced health care directive/living will (collectively referred to as “AHCD”).

Below is a comparison of the differences between POLST and an AHCD:

POLST AHCD

 

  • (1) Medical directive/order to attending physicians regarding the person’s choices.

 

 

  • (2) Geared towards persons who are seriously ill, right now, transforming their wishes into a set of medical orders, allowing people to make end of life decisions at a time when it may be more relevant.

 

  • (3) Allows a person, in advance, to make three main choices affecting their care. Specifically, whether the person wants:
    • (A) to be resuscitated;
    • (B) medical intervention; and
    • (C) to be forced fed.

 

 

 

 

 

  • (4) Before the form is completed, at least one medical provider (the one who must sign the form) is made aware, in advance, of the patient’s medical wishes and has discussed, in theory, any concerns or questions.

 

  • (1) Not a medical directive/order. Serves to make a person’s wishes, in advance, known to their designated agents and attending physicians.

 

  • (2) Often executed by persons who are otherwise healthy years before end of life decisions must be made.

 

 

 

 

  • (3) Allows a person, while alive and able, to select in advance certain end of life decisions. Includes broader range of choices, including whether the person wants:
    • (A) to have their life prolonged in certain, narrow scenarios;
    • (B) receive pain medication; and
    • (C) to be forced fed and/or watered.

 

  • (4) Allows a person, while alive and able, to designate, in advance, agents to make health care decisions for them in the event of their incapacity or disability. Hirst Applegate encourages clients to discuss their AHCDs with their designated agents and to give copies to their medical provider.

 

What if both AHCDs and a POLST form is executed and there exists some inconsistencies between the two? The more recent of the documents signed controls. Of course, regardless of whether an AHCD or a POLST form has been completed by a patient, so long as the patient has the capacity, either of these can be verbally revoked.

The POLST form can be downloaded from the Department of Health’s (“Department”) website (https://health.wyo.gov/wp-content/uploads/2016/04/187-18432_WyoPOLSTFormFINAL.pdf) or picked up at the Department. Be aware, however, that if printing the form at home, it must be printed on gold paper to be easily identifiable for patients and caregivers, The patient (or the legal representative) and the patient’s primary health care provider must sign the form. After the form is completed and signed, it should be placed in a visible location at the patient’s home, such as the fridge or front door, so that if/when a provider must enter the home they can see the form and follow the wishes as stated on the form. Practical problems with this is that a person may not always receive medical attention at their home. What if the person is at a restaurant, a friend’s house, on vacation? Previously issued CPR bracelets and directive forms are still valid, and a POLST bracelet can be ordered off the Department’s website. Bracelets, over the form, seem like a clearer solution to ensuring that wherever the person is, so is their wishes.

Part of the estate planning process at Hirst Applegate includes the preparation of an AHCD. As more education and awareness are made about the POLST program, the estate planning department at Hirst Applegate will work together with clients in determining whether a POLST form is right for them, and whether there is a need to incorporate the form into their current estate plan.