“It’s Okay, Mom Wouldn’t Have Wanted That”: Understanding POLST, DNRs, and Advance Directives in California
When emergency crews arrived, Susan felt her heart race. Her mother, Evelyn, had collapsed at home. Paramedics were ready to start CPR.
“Wait,” Susan said through tears. “She didn’t want this. She made that clear.”
But when they asked for documentation—something official—Susan didn’t have anything to show. Just memories of conversations they’d had over coffee and long car rides. Moments that felt crystal clear in her mind but didn’t mean much in the back of an ambulance.
This situation—heartbreaking and stressful—is all too common. Families often know what their loved ones want, but when the moment comes, there’s no paperwork in place to back it up.
That’s where a POLST and a DNR come in.
What Is a POLST?
A POLST, or Physician Orders for Life-Sustaining Treatment, is a medical order in California that tells emergency medical providers exactly what a patient wants in a serious health situation.
It goes beyond the typical “yes or no” to CPR. A POLST includes options for:
- Resuscitation (CPR or no CPR)
- Medical interventions (like full treatment, limited treatment, or comfort-only care)
- Artificial nutrition and hydration
The form is filled out and signed by the patient (or their legal health care decisionmaker) and a physician, nurse practitioner, or physician assistant. It’s meant for people with serious illnesses, advanced age, or frailty—those who may need urgent care and want to make their preferences known clearly.
What About a DNR?
A DNR, or Do Not Resuscitate order, is more limited in scope. It tells emergency responders not to perform CPR if your heart stops or if you stop breathing. That’s it—just resuscitation.
In California, a DNR can even come in the form of a medallion that EMTs can see right away. It includes a toll-free number and an ID so responders know your wishes in seconds.
The DNR is often included in a POLST, but some patients might have one on its own, especially if CPR is the only treatment they wish to decline.
How Is a POLST Different from an Advance Health Care Directive?
While a POLST is a medical order used in emergency and clinical settings, an Advance Health Care Directive (AHCD) is a legal document that lays out your general health care wishes and names someone to make decisions for you if you’re unable.
The AHCD is something every adult should have. It’s great for planning ahead and expressing your values. But unlike a POLST, it doesn’t give immediate medical instructions for first responders.
Think of it this way:
- AHCD: Appoints someone to speak for you; covers general preferences.
- POLST: Tells EMTs and doctors what to do or not do right now.
- DNR: Says no to resuscitation only.
Back to Susan and Her Mom
After that hospital visit, Susan met with her mom’s doctor. Together, they completed a POLST form that reflected Evelyn’s wishes for comfort-focused care only. Evelyn even decided to wear a DNR medallion.
Six months later, Evelyn passed away peacefully in her sleep, surrounded by loved ones. This time, there were no frantic calls, no second-guessing, no uncertainty. Just peace.
Final Thoughts
Whether you’re planning for your own care or helping a loved one, having the right documents in place matters. Conversations are important—but documentation ensures those wishes are followed when it counts.
If you’re unsure where to start, consider this:
- Complete an Advance Health Care Directive if you haven’t already.
- Talk to your doctor about whether a POLST is appropriate for you or your loved one.
- If CPR is something you know you don’t want, consider a DNR.
You can learn more about the POLST form in California by visiting www.capolst.org or calling 916-489-2222.
Planning ahead is a gift—to yourself and the people who love you.
Kaminski Law Group APC
Helping families across California plan with purpose, protect their legacy, and find peace of mind.
(916) 540-7618
hello@californiatrusts.law
www.californiatrusts.law
