This checklist helps Alzheimer's caregivers decide if a POLST form fits, complete it with a clinician, and keep it ready for emergencies. POLST is a portable medical order made after discussion with a health provider that tells emergency and other providers what to do if the patient cannot speak. Plan early while the person with Alzheimer's still has capacity. Name a health-care proxy in an advance directive, then use POLST later for specific emergency orders when serious illness progresses.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- Who should consider POLST?
- What choices go on the form?
- How do POLST and advance directives fit together?
- Where do you keep and when do you review it?
Who should consider POLST?
POLST is intended only for people who are very sick or very frail with progressing serious illness. According to the National POLST Collaborative, healthy adults should use an advance directive instead, as explained in its Learn About POLST Forms page. For Alzheimer's, that timing matters.
Early dementia alone does not make POLST appropriate. Consider it when frailty, repeated hospital visits, weight loss, or another serious illness makes emergency decisions likely. Ask the clinician whether the person now qualifies. If not, keep the advance directive current and revisit POLST when health declines.
What choices go on the form?
A standard POLST form records CPR preference, whether to hospitalize or stay in place, whether to use intensive care and a breathing machine, and feeding-tube use when swallowing fails. These are medical orders, not general wishes. Talk through each choice in terms of daily life.
For example, attempting CPR means chest compressions and a breathing tube, while declining it allows natural death. Staying in place may mean treatment at home or in the care facility rather than transfer to the hospital. Write the decision the person would want now, not for every future stage. The clinician signs the form to make the orders active.
How do POLST and advance directives fit together?
Advance directives are legal documents naming a surrogate and stating general wishes, while POLST provides specific emergency orders that emergency personnel can follow. One states values and a decision-maker; the other gives orders for responders. POLST complements but does not replace advance directives.
According to the Alzheimer's Association, it must be completed and signed by a physician or other authorized clinician and is not available in every state, as noted in its Legal Planning guide. For Alzheimer's, caregivers should plan early while the person has capacity, name a health-care proxy, and later that surrogate can complete or affirm POLST choices with the clinician. Bring the advance directive to the POLST visit so orders match prior wishes.
Where do you keep and when do you review it?
Keep the original POLST visible at home, file a copy in the medical record, and share its location with family and paid caregivers. When leaving home, carry a copy plus a phone photo.
Review POLST at least yearly and whenever condition, goals, residence, or care setting changes. According to the National POLST Collaborative, it does not expire but cannot be edited, so void an old form by writing VOID or destroying it, notify the provider, and sign a new form, as explained in its Manage Your POLST Form guide.
- Post original where responders will see it, such as the refrigerator or bedside
- File one copy with the primary clinic, hospital record, and care facility
- Carry one copy and keep a clear phone photo for trips and visits
- Tell family, aides, and neighbors where the home copy stays
