Understanding the Differences between POLSTs and Health Care Powers of Attorney

An essential part of every estate plan is the Durable Power of Attorney for Health Care Decisions (the “DPOA”). A DPOA authorizes your designee (referred to as the “Healthcare Agent”) to make decisions regarding your medical care when you are no longer able to do so. The DPOA also includes an advance directive in which you are able to designate your desires regarding the continuation or cessation of life sustaining treatment.

The Nevada POLST (Provider Order for Life Sustaining Treatment) is not a substitute for the DPOA and is often confused for being the same document. A POLST is a form to be considered when you’re facing a life-threatening medical condition. A POLST form gives medical orders to emergency health care professionals to follow. Since the POLST form is completed when someone is seriously ill or frail, their diagnosis and prognosis is known and so more specific treatment decisions can be chosen and documented on a POLST form. An advance directive is a legal document, not a medical order, and does not provide treatment orders. Instead, it lets health care professionals know generally what types of treatment the patient may or may not want during some unknown medical crisis. Since a POLST form is a medical order, EMS/EMTs can follow the orders during an emergency. If you only have an advance directive, EMS/EMTs must do everything possible to attempt to save your life. Once you are stable, then health care professionals will review your advance directive with the person you named as your surrogate, and decide on a treatment plan based on the guidance you provided in your advance directive.

Previously, the POLST form could only be completed by a physician. However, AB 199,which was passed by the 2017 Nevada Legislature, revised the POLST statute to provides that the order may be signed by a physician, physician’s assistant or advanced practice registered nurse.

In order to complete the POLST, you must be 18 and have capacity to make decisions regarding your life-resuscitating treatment and life-sustaining treatment. The POLST addresses your desires regarding life sustaining treatment as well as life resuscitating treatment (for example, CPR). If there is a conflict between the POLST and DPOA, the instructions in the most recent document will control.

Any time you are contemplating a POLST, you should always discuss with your health care professional your diagnosis, prognosis, treatment options and goals of care.

For more than 30 years, Attorney Lee A. Drizin has practiced in the areas of estate planning, probate, trusts, guardianship and real estate matters representing clients throughout the state of Nevada.

Drizin Law is providing this information for educational purposes only. It should not be construed as legal advice or a legal opinion as to any specific facts or circumstances. This information is based on general principles of Nevada law at the time it was created and you should be aware laws frequently change. Moreover, the laws affecting you may differ depending on the circumstances. You should consult with a qualified attorney in your own state or jurisdiction concerning your particular situation. Review of this information does not create an attorney-client relationship.