Patient Referral


There is a growing awareness about the need for primary care providers, patients and families to discuss the range of options that are available when it becomes clear a patient is not going to recover from an illness or condition.

One approach quickly gaining recognition is called a POLST form. POLST stands for Physician Orders for Life-Sustaining Treatment. A POLST form is an agreement worked out between the patient, the patient’s family, and his or her physician which specifies the types of medical treatment that a patient wishes to receive towards the end of life.

Unlike a more general Advance Directive, the POLST form details a physician’s specific directions regarding treatments such as breathing machines, chest compressions and cardiac electroshocks. It is not open to deliberation or negotiation. Rather, it is a clear, specific instruction meant to guide first-responding EMTs and any care-givers further down the line. A POLST form:


  • IS a medical order that gives patients more control over their end-of- life care.

  • IS designed to guide the actions of emergency medical personnel (e.g., whether or not to administer CPR)

  • MUST be signed by a doctor or other medical professional

  • Is NOT intended to be used by people who are healthy

  • IS for persons with a serious illness at any age

  • Provides medical direction for current treatment as well as future decisions regarding medical interventions, such as intubation, antibiotic use, and feeding tubes.



Currently 45 states either have in place or are moving forward with some form of POLST initiatives.

Crossroads Hospice works with health care practitioners as well as families to help them understand how these nuances can affect the scope of treatment and to help them ensure that a patient’s feelings and expressed wishes are respected. If you would like more information, please feel free to email me at: . If I can’t answer your question, I’ll be happy to refer you to someone who can.

Sherri Bickley, LMSW, M.Th.
Emotional Support Consultant at Carrefour Associates, LLC