End-of-Life Care Forms Cause Confusion Among Providers

Senior living providers often rely on forms that communicate residents’ end-of-life choices, but once a resident leaves the community for medical care, those forms don’t appear to be doing their job. 

In fact, there is “significant confusion” among emergency physicians and prehospital care providers in interpreting the universal end-of-life care documents, called Physicians Orders for Life Sustaining Treatment (POLST), new research shows. 

These POLST documents detail patients’ choices regarding resuscitation — either “do not resuscitate” (DNR) or full cardiopulmonary resuscitation (CPR) — and other treatments, with options for full treatment, limited treatment or “comfort measures” only.


But according to a pair of studies in the March edition of the Journal of Patient Safety, POLST documents are commonly misinterpreted by emergency doctors and paramedics. 

The studies surveyed members of the Pennsylvania chapter of the American College of Emergency Physicians, asking respondents to determine code status and treatment decisions in scenarios of critically ill patients with POLST documents who unexpectedly arrest.

In some situations, respondents indicated that they would resuscitate when they would be expected to withhold life-saving treatment. Conversely, some respondents would withhold treatment when they would be expected to provide life-saving care.


“Our data suggest that POLST orders can be confusing for Pennsylvania emergency physicians, and likely for physicians nationwide,” wrote Dr. Ferdinando L. Mirarchi and colleagues.

To access the study, click here

Written by Emily Study