Advance Directives, DNR & POLST (Part I)

Power of Attorney for Health Care, Living Will, DNR, POLST, POST, advance directives… these terms can be confusing, but it is important that everyone understands them. Below are some simple definitions of advance directives terminology.

Advance Directives
An umbrella term for many types of documents that relate to providing future health care decisions for patients. Advance directives include Power of Attorney for Health Care forms, Do-Not-Resuscitate (DNR): Physician Orders for Life-Sustaining Treatment (POLST) forms, and Living Wills.

Filling Out Forms (Informed Consent)Power of Attorney for Health Care Form
The most common and far-reaching advance directive. It allows the patient to appoint an agent to make health care decisions for them when they are unable to do so, in any circumstance. Completing this form should be preceded by advance care planning.

Advance Care Planning
A facilitated discussion that encourages the patient to express what health care decisions they would make in the future based on their own personal goals, values, and beliefs in a variety of circumstances; and then the sharing of these decisions with the agent they have chosen, as well as their family and health providers.

Sometimes referred to as POST in other states. This form converts patient decisions to physician orders. It is intended for use in the late stages of a patient’s life-limiting illness, the frail elderly, and for the person who the physician expects could die in one year. It gives explicit guidance to health care professionals about how to care for the patient when the POA-HC is not immediately present.

Living Will
This form tells health caregivers what life-sustaining treatments a patient does not want when they have an incurable and irreversible injury, disease, or illness judged to be a terminal condition by their attending physician, who has determined their death is imminent. It is not as far reaching as the POA-HC or POLST/POST forms.

About Linda Fehr, RN, BC, BSN, CPHQ

Linda Fehr is a registered nurse, nationally certified in geriatric nursing and health care quality. She has served as Director of OSF Supportive Care since 2008.

Her career history at OSF includes managing a Medicare Advantage population, the Institute on Aging, the Adult Diabetes Center, and the Central Illinois Pain Management Center where she developed multiple programs and coordinated a number of research and quality improvement projects. She has had first-hand personal experience in caring for patients and family with chronic disease at end of life.

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