Healthcare Decisions

If you were seriously ill or involved in an accident and could not communicate, who would make your healthcare decisions?


Physician Orders for Life-Sustaining Treatment

POLST is a physician’s order that documents and directs a patient’s medical treatment preferences when faced with life-limiting illnesses and irreversible conditions.




Making decisions about the end of your life can be a life-affirming experience. By completing an Advance Care, or Advance Directives Plan, you can rest assured that, in the event you are unable to communicate, you have taken control of how you believe major decisions should be handled. This will bring peace of mind for yourself, as well as for your family. There are several Health Care Decision Forms that were adopted by the Arkansas State Board of Health pursuant to the Health Care Decisions Act of 2013. A recent update is Act 504 of 2017, the Arkansas Physician Order for Life-Sustaining Treatment Act (POLST), which provides a standardized physician order form.

These documents enable anyone to plan for and express end-of-life wishes in the event that you are unable to communicate. They can also help free your family from the responsibility and stress of making difficult decisions without you. Keep your advance care plan in a safe and easily accessible place, and make an extra copy for yourself in case the original is lost or accidentally destroyed. Give copies to your doctor, family members and close friends, and consider taking your plan with you if you are admitted to the hospital. Remember that if no one knows about your wishes, the risk of not being treated as you wish increases significantly.

Following are links from the Arkansas Department of Health website to download each of the forms necessary to complete your advance care plan:

Download Form

Acceptance of Surrogate Form

Advance Care Plan Form

Download Form

Appointment of Health Care Agent

Download Form

Physician Orders for Life-Sustaining Treatment (POLST) Directions and Form

These guidelines are provided for your convenience. For a more thorough plan, you should consult with your attorney. Arkansas Hospice Inc. does not assume responsibility for legal advice.

The Arkansas Hospice Family of Care
14 Parkstone Circle | North Little Rock, AR 72116
(501) 748-3333 or Toll Free (877) 713-2348
contactus@arkansashospice.org
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