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Physician Orders for Life-Sustaining Treatment in Rural Virginia
Pamela B Teaster1, E Carlisle Shealy1
1Virginia Tech, Blacksburg, USA.
Sage Open Aging
|July 4, 2025
Summary
Physician Orders for Life-Sustaining Treatment (POLST) implementation in rural areas faces challenges. Improving POLST requires consistent funding, clear goals, staff training, and strong institutional support for better end-of-life care.
Area of Science:
- Medical Ethics
- Health Services Research
- Gerontology
Background:
- Physician Orders for Life-Sustaining Treatment (POLST) were developed in 1991 to enhance end-of-life care for patients with advanced, chronic, and progressive illnesses.
- POLST aimed to overcome limitations of traditional advance directives, such as low completion rates and communication issues.
Purpose of the Study:
- To investigate current Physician Orders for Life-Sustaining Treatment (POLST) practices.
- To identify barriers to POLST implementation in a rural healthcare setting.
Main Methods:
- An online survey was distributed to 101 healthcare practitioners.
- Semi-structured interviews were conducted with 20 practitioners.
Main Results:
- Key findings indicate a need for consistent funding and clearer treatment goal articulation.
- Enhanced staff training opportunities and robust institutional support for POLST are crucial.
- Physician and community engagement, along with identifying POLST champions, are vital for successful adoption.
Conclusions:
- Addressing barriers to Physician Orders for Life-Sustaining Treatment (POLST) is essential for improving end-of-life care in rural communities.
- Consistent support, training, and clear communication are necessary for effective POLST implementation and patient outcomes.
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