How to Get a California Do Not Resuscitate Form

In California, a Do Not Resuscitate (DNR) directive is commonly implemented through a Physician Orders for Life-Sustaining Treatment (POLST) form. This document translates a patient’s care preferences into clearly actionable medical orders that accompany the patient across all care settings, including hospitals, clinics, and emergency services. Understanding how to obtain and properly complete a POLST form helps ensure a patient’s wishes are respected during a medical crisis.

Understanding California POLST And DNR

The California POLST program is designed to capture a patient’s preferences regarding resuscitation and other life-sustaining treatments in a portable medical order. Unlike a basic DNR preference noted in a medical chart, a POLST form contains specific orders about resuscitation, intubation, mechanical ventilation, feeding tubes, and palliative care. In California, POLST forms are legally recognized and widely accepted by EMS, hospitals, hospice programs, and long-term care facilities when properly completed and signed.

Key differences to know include that a POLST is a medical order that travels with the patient, is physician-endorsed, and is intended for individuals with serious illness or frailty who may want or need a clear, concrete plan for emergencies. A standard Do Not Resuscitate designation on a hospital chart may not be portable or explicit enough for EMS in the field. For many patients, POLST offers a practical path to ensure that their wishes are followed regardless of where they receive care.

Who Should Consider A POLST In California

POLST is appropriate for adults with serious illness, advanced frailty, or those who have meaningful preferences about life-sustaining treatment. It is especially relevant for individuals who want specific medical orders beyond a general “no resuscitation” instruction. People who are in hospice or receiving palliative care often benefit from completing a POLST to guide care in a crisis. It is not limited to end-of-life scenarios; it can reflect preferences at various stages of a chronic condition.

How To Obtain A California POLST Form

The PROCESS begins with a conversation between the patient, and a clinician such as a physician, nurse practitioner, or physician assistant, often with input from family or a designated surrogate. The patient or their legally authorized representative must participate in the decision, ensuring the choices align with their values and medical prognosis.

Where to obtain the form:

• Directly from a treating clinician (physician, nurse practitioner, or physician assistant) who can assess medical condition and discuss goals of care.
• ThroughHospice providers, if the patient is receiving end-of-life care, as they commonly prepare POLST forms as part of the care plan.
• From hospital or clinic advance care planning resources, which frequently feature POLST forms and staff guidance.
• Via the California POLST program website or state health department resources, which provide the official form and instructions for completion.

Important: The form must be completed, signed by a clinician, and then witnessed or notarized if required by the local facility. Patients should request a copy for their records and ask about carrying a laminated copy or wallet card for easy access in emergencies.

Completing The POLST Form

The POLST form involves choosing from specific medical orders that reflect current preferences. Typical sections address:

• CPR (Resuscitation) Decision: Whether to initiate CPR in the event of cardiac or respiratory arrest.
• Medical Interventions: Preferences regarding intubation, mechanical ventilation, and other life-sustaining measures.
• Artificial Nutrition: Whether to continue or avoid feeding tubes and intravenous nutrition when recovery is unlikely.
• Symptom Management: Priorities for comfort-focused care, including analgesia and palliative measures.

All selections should consider the patient’s medical condition, prognosis, and personal values. The clinician signs and dates the form, and ideally a patient or surrogate signature confirms understanding and consent. In California, the POLST form is designed to be inter-operable across care settings, so the objective is to maintain consistent guidance no matter where care occurs.

How To Ensure The POLST Is Honored

To maximize adherence to the POLST, patients and families should:

• Keep the original POLST in a readily accessible location, and distribute copies to primary care, specialists, hospice, and designated caregivers.
• Provide a laminated copy or wallet card to EMS services and facilities, so responders can quickly identify the patient’s wishes.
• Inform family members and designated healthcare surrogate about the POLST choices to prevent confusion during emergencies.
• Review and update the form if medical conditions worsen, prognosis changes, or personal preferences shift.
• Coordinate with the patient’s primary care physician to ensure the POLST aligns with ongoing treatment plans and other advance care documents.

EMS agencies and hospitals in California are trained to recognize POLST forms. If a patient presents with a POLST, responders should follow the medical orders contained within, unless a physician provides a higher-priority directive or a more recent medical order supersedes it. Always clarify the form’s validity and date to avoid outdated decisions being acted upon.

Common Questions About The California POLST

What if I don’t have a POLST but want one? Start a conversation with your clinician about your goals and prognosis. They can guide you through the process and help you complete the form.

Can a POLST be changed or revoked? Yes. A new POLST form or a clearly documented change in medical orders can supersede prior instructions. It is essential to ensure all parties have access to the latest version.

Is a POLST the same as a DNR order? A POLST includes a DNR option, but it is broader in scope. It translates patient preferences into specific orders that are actionable across settings, whereas a standalone DNR is an instruction to withhold resuscitation only.

Maintaining Clarity And Accessibility

Because emergencies require swift action, clarity is critical. Patients should:

• Use plain language in conversations with clinicians to avoid misinterpretation.
• Request translations or assistance if language barriers exist to ensure informed decisions.
• Keep contact information for surrogates up to date within medical records.
• Ask about any facility-specific requirements for processing POLST forms upon admission or transfer.

Practical Steps At A Glance

For those seeking additional guidance, patient advocacy groups, state health departments, and hospital social workers can provide support and resources to navigate the POLST process and ensure compliance with California law.

Putting It All Together

Securing a California POLST form is a proactive step in aligning medical care with personal values. By engaging with a clinician, understanding the scope of the form, and properly distributing copies, individuals can ensure that their wishes for resuscitation and other life-sustaining treatments are honored across all care settings. The POLST framework offers a portable, action-oriented approach to advance care planning that is specifically tailored to the complexities of medical decision-making in California.