Families planning for the end of life often run into two similar-sounding forms and assume they are the same thing. They are not, and the difference matters in an emergency. A do-not-resuscitate order is a doctor-signed medical order about one thing, whether to attempt CPR, while a POLST is a broader one-page medical order covering a range of end-of-life treatments such as intubation, antibiotics, and feeding tubes; both are actionable orders that emergency and care staff must follow immediately, unlike a living will, which states wishes but is not itself an order.
This article explains what each form does, how they differ, how they compare to a living will, and which one a senior may need.
What a Do-Not-Resuscitate Order Is
A do-not-resuscitate order, or DNR, is narrow and specific. It addresses a single question: whether to attempt cardiopulmonary resuscitation if the heart or breathing stops.
It is a medical order signed by a doctor, and it does not affect any other care, so a person with a DNR still receives pain medication, other treatments, and comfort care. There are two main types: an in-hospital DNR that applies only within the hospital, and an out-of-hospital or prehospital DNR that tells emergency responders, care home staff, and others not to attempt resuscitation no matter where the person is. The out-of-hospital version is what protects a person's wishes at home or in a community.
What a POLST Is
A POLST, which stands for Physician Orders for Life-Sustaining Treatment and goes by other names like MOLST or POST in some states, is broader. It is a single page that turns a person's treatment wishes into medical orders across several areas.
Beyond CPR, a POLST addresses the overall level of medical intervention a person wants, from full treatment to comfort-focused care, along with specific measures like intubation, antibiotics, and feeding tubes. It must be signed by a health care provider and by the patient or their representative. Because it captures a fuller picture, it is generally recommended for people who are seriously or terminally ill or quite frail, not for healthy adults.
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The Key Differences
Seeing the two side by side makes the distinction clear. They differ in scope, who they are for, and how they are completed.
| DNR | POLST | |
|---|---|---|
| What it covers | CPR only | A range of treatments, including CPR, intubation, antibiotics, feeding tubes |
| Form | A single medical order | A one-page set of medical orders |
| Who signs | A doctor | A provider plus the patient or representative |
| Best suited for | Anyone who specifically declines CPR | Seriously ill or frail people with clear end-of-life wishes |
| Portability | The out-of-hospital version travels with the person | Travels with the person across settings |
Both are recognized medical orders that staff are bound to honor, which is what sets them apart from a statement of wishes.
How They Differ From a Living Will
People often confuse these orders with a living will or advance directive, but they play different roles. The difference is between wishes and orders.
A living will is a general statement of what a person would want, written by the person, and a health care power of attorney names someone to decide, but neither is a medical order, and in an emergency they may not be on hand or immediately actionable. A POLST or DNR, by contrast, is an order a provider signs that emergency staff act on right away. The forms complement an advance directive rather than replace it; the directive expresses the wishes, and the POLST or DNR makes them immediately actionable. Our guide to advance directives explains how these documents fit together.
Which One a Senior Needs
The right form depends on a person's health and their specific wishes. They are not one-size-fits-all.
A DNR fits anyone who has decided they do not want CPR attempted, regardless of overall health. A POLST suits a person who is seriously or terminally ill or very frail and wants their broader treatment preferences turned into orders that will be followed across settings. Both require a conversation with a doctor, both are voluntary, and both can be changed or revoked at any time. The National Institute on Aging recommends discussing these choices as part of advance care planning, ideally before a crisis.
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(385) 200-2175Practical Next Steps
- Clarify the person's wishes about CPR and broader life-sustaining treatment first.
- For a CPR-only decision, ask the doctor about an out-of-hospital DNR so it applies everywhere.
- For a seriously ill or frail person, discuss a POLST to capture broader treatment orders.
- Keep a living will and health care power of attorney in place alongside these orders.
- Store the forms where they are easy to find and give copies to the care community and family.
When to Talk to a Local Advisor
End-of-life paperwork often comes up alongside decisions about care settings and support. A local senior advisor can help with the housing and care side and connect families to senior living communities equipped for serious illness, while a doctor completes the medical orders. The advisor service is free to families.
For related reading, see our guides to advance directives and end-of-life care. Guidance on advance care planning is available from the National Institute on Aging.
This article is informational only and is not medical or legal advice. Form names and rules differ by state. Complete a DNR or POLST with a health care provider and confirm the requirements where you live.
