Florida POLST Form: How It Differs from a Living Will and Who Needs One

Florida participates in the national POLST (Physician Orders for Life-Sustaining Treatment) framework, though the state's implementation has its own quirks. Unlike a living will — which is a personal legal document — a POLST is a medical order signed by a physician that translates your treatment preferences into actionable clinical instructions.

The distinction matters because medical staff follow physician orders; they may not have time or training to interpret a living will during an acute care event.

What a POLST Covers

A POLST form addresses specific medical interventions across several treatment categories:

• Resuscitation preferences — full CPR, limited interventions, or comfort measures only
• Medical interventions — full treatment, selective treatment, or comfort-focused treatment
• Antibiotics — full course, limited use for comfort, or none
• Artificially administered nutrition — tube feeding decisions, including nasogastric and PEG tubes

These orders apply across all healthcare settings: hospital, nursing home, assisted living, home, and during transport between facilities. A POLST travels with you in a way that a hospital chart order does not.

POLST vs. Living Will vs. DNRO

Three documents, three different jobs:

A living will states your wishes. A POLST translates those wishes into orders that medical staff can execute without interpretation. A DNRO specifically addresses the narrow question of CPR by paramedics before you reach a hospital.

In practice, a person with a serious illness benefits from having all three: the living will establishes their values and broad preferences, the POLST converts those into portable orders, and the DNRO ensures EMS honors their resuscitation decision at home.

Who Should Have a POLST

POLST forms are designed for people with serious advanced illness — not for healthy adults doing general advance planning. The Florida Medical Directors Association (FMDA) recommends POLST for patients who:

• Have a life expectancy of one year or less
• Are living in a skilled nursing facility or receiving hospice care
• Have a progressive condition like advanced dementia, metastatic cancer, or end-stage organ failure
• Are frequently hospitalized and want consistent treatment orders across admissions

Healthy adults should rely on a living will and surrogate designation for advance planning. The POLST conversation typically happens between a patient and their physician when the illness trajectory is clear.

How to Get One in Florida

1. Initiate the conversation with your physician, hospice medical director, or facility medical director
2. Discuss treatment preferences across each category on the form
3. Both you and the physician sign the completed form
4. The original stays with you — in your medical chart at a facility, or in a visible location at home
5. Copies go to your healthcare surrogate, your primary care physician, and any facility where you receive care

The form should be reviewed and updated whenever your medical condition changes significantly, when you transfer between care settings, or when your treatment preferences evolve.

The Portability Advantage

The practical problem POLST solves: when a patient moves from a hospital to a skilled nursing facility to home hospice, each transition point requires new admission orders. Without a POLST, the patient's treatment preferences may not transfer cleanly. The nursing home might default to full treatment, the home hospice team might not know about the patient's antibiotic preferences, and a hospital readmission might restart aggressive interventions.

A POLST is designed to be the single portable document that bridges every handoff.

Limitations

A POLST does not replace a healthcare surrogate designation or a durable power of attorney. It covers medical treatment orders, not decision-making authority. If your POLST does not address a specific clinical scenario, your surrogate makes the call. If you do not have a surrogate designation, the hospital falls back to Florida's statutory priority list.

The Florida Advance Directive & Living Will Kit explains how POLST fits into the broader advance directive system alongside your living will, surrogate designation, and DNRO.

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