POLST vs. DNR: What's the Difference?
A DNR is about CPR. A POLST is a wider medical order for a person who is seriously ill or frail. A living will is not a medical order. This page shows how they differ, then lists each state.
Three different papers
DNR means do not resuscitate. It is a medical order about CPR if the heart stops or breathing stops. See what a DNR order covers.
POLST means portable medical orders. National POLST Opens in a new tab. says it is not an acronym anymore, though it used to be read as one. States still print their own names on the form. You may see MOLST, MOST, POST, COLST, or another name. Those are POLST-type forms. The provider forms page uses the name on that state's form.
A living will is part of an advance directive. Medicare Opens in a new tab. describes it as the document that says which treatments you would want if you cannot decide. A health care power of attorney, or proxy, names who speaks for you. Those papers are for adults in general. They are not the same as a signed medical order.
Side by side
| DNR | POLST-type form | Living will | |
|---|---|---|---|
| What it is | A medical order about CPR | A medical order about CPR and other emergency treatments | A legal document about wishes if you cannot speak |
| Who it is for | A person who does not want CPR, under that state's rules | A person who is seriously ill or has advanced frailty. Not for healthy adults. | Any adult who wants to write wishes down |
| What it covers | CPR if the heart stops or breathing stops. The form name can matter. Ask about your state. | Often CPR, hospital transfer, ICU care, and a breathing machine, plus overall goals | Treatments you would or would not want, which can include resuscitation, a breathing machine, and tube feeding |
| Who signs | A clinician. The provider forms page names who. | A clinician. National POLST says most states also need the patient or the surrogate to sign. | You, plus the witnesses or notary your state requires. See the forms page. |
A POLST is a medical order. A living will is not.
Emergency crews have a standard of care: try what is reasonably possible to save a life. A POLST is how a seriously ill or frail person says yes to that, or says what level of treatment they want instead. Because it is a medical order, a clinician signs it.
National POLST says patients should not be handed a blank POLST to fill out alone. The talk has to cover the illness, what is likely ahead, the treatment options, and the person's goals.
A living will still matters. It guides the person you named, and it helps a hospital team. It does not do the same job as the order on the refrigerator. The National POLST appropriate-use policy Opens in a new tab. says POLST is for people at risk of a life-threatening event because of a serious life-limiting condition, which may include advanced frailty. It says POLST is not for healthy older adults, and that an advance directive should be encouraged for all adults.
Only the form your state approves is valid there. National POLST Opens in a new tab. says the national form is a template. Using the generic form without your state's rules can put care at risk.
How to get a POLST
Ask your clinician if a POLST fits your health now. If it does, fill it out together. Ask who must sign. Ask where to keep the original.
National POLST tells people at home to post the form on the refrigerator or put it in the medicine cabinet, and to tell family it is there. Take it with you to a hospital or facility. Ask whether a copy is valid in your state. National POLST says copies are valid in almost all states. That is not a promise about a different state.
You can change your mind. Tell your clinician, and ask how to void the old form so crews do not follow it.
Your state
The POLST-type form for your state, and the out-of-hospital DNR when the state lists one separately. A clinician has to sign these.
All MOST, POLST, and DNR formsWatch a short video
Heart and CPR is the resuscitation choice. Living wills explains the legal document that is not a medical order.
Heart and CPR
What it means to try to restart a heart, in words you can share before you have to decide.
Living wills
A written way to say what care you would want, so the people you love are not left guessing.
These videos are educational. They are not medical or legal advice.
Get ready for the visit
A POLST starts with knowing your goals. Use LifeWishGuardian to get ready for that conversation with your clinician.
The recording is not a POLST. Your clinician still has to sign the state form.
Questions families ask
What is a POLST form used for?
A POLST is a portable medical order for a person who is seriously ill or who has advanced frailty. It tells emergency clinicians and other teams what treatments that person wants now, given the current illness. National POLST says it starts with a talk with a clinician. The form can cover CPR, whether to go to the hospital, and whether to use ICU care and a breathing machine.
Is a POLST the same as a DNR?
No. A DNR is about CPR if the heart stops or breathing stops. A POLST usually includes that CPR choice and other choices, such as hospital transfer, ICU care, and a breathing machine. Some states use one POLST-type form for all of this. Others also have a separate out-of-hospital DNR. The provider forms page shows which forms our state data includes.
POLST vs. advance directive: do I need both?
They do different jobs. An advance directive, such as a living will and a health care power of attorney, is for adults to complete before a crisis. A POLST is a medical order for a person who is seriously ill or frail. National POLST says a healthy person should have an advance directive, not a POLST. Many people who qualify for a POLST still keep the advance directive. Ask your clinician if you need a POLST.
What is a MOLST form?
MOLST means Medical Orders for Life-Sustaining Treatment. It is one name states use for a POLST-type form. MOST, POST, and other names are the same kind of order. National POLST says the letters now stand for portable medical orders, even though older names are still on many state forms. Your state's form name is in the box on this page when we know the state.
What color is a POLST form?
There is no single national color. Some states ask for bright paper so emergency crews can see the form. In a few states the color is part of the rule. In others it is only recommended. The notes on the provider forms page say when an official page mentions a color. Color alone does not make a form valid. A clinician still has to sign it.
Does a POLST work in another state?
Do not assume it does. National POLST says only a state-approved form is valid in that state, and using a generic national form without the state rules can put care at risk. If you move or spend time in another state, ask a clinician there whether you need a new form.
Sources
These pages use public pages from agencies and national programs. They do not invent statistics.