Do Not Resuscitate Order Document for Michigan

What is a Do Not Resuscitate (DNR) Order in Michigan?

A Do Not Resuscitate (DNR) Order in Michigan is a legal document that tells health care providers not to perform cardiopulmonary resuscitation (CPR) if a person's breathing stops or if their heart stops beating. The document is used by individuals who want to avoid life-extending procedures when their conditions are terminal or if they wish to die naturally and peacefully without aggressive interventions.

Who can have a DNR Order in Michigan?

In Michigan, DNR Orders are available for any individual who wishes to decline CPR in the event of a medical emergency. This includes adults, emancipated minors, and parents or guardians who can request a DNR Order for their minor children or wards in certain situations. The individual must be competent to make this decision or have a designated patient advocate or guardian to make such decisions on their behalf.

How do you obtain a DNR Order in Michigan?

To obtain a DNR Order in Michigan, you must follow these steps:

1. Consult with a healthcare provider to discuss the implications and your desires regarding resuscitation.
2. Complete the DNR Order form, which must be signed by the individual (or their legal representative) and a witness.
3. The form must also be signed by the attending physician, indicating their knowledge of the patient's wishes.
4. Once completed, the form should be kept in an easily accessible location and shared with family members and healthcare providers as necessary.

Is a DNR Order permanent?

No, a DNR Order in Michigan is not permanent. The individual who has established the DNR can revoke it at any time, either verbally or in writing. Similarly, they can also update their DNR Order as their health condition or preferences change. It's important to communicate any changes to the DNR Order to all relevant parties, including healthcare providers and family members.

What happens if emergency medical personnel are called?

If emergency medical personnel are called, and there is a valid DNR Order, they are legally required to respect the wishes outlined in the document. However, for emergency personnel to refrain from CPR, the DNR Order needs to be presented to them upon their arrival. If the DNR Order cannot be immediately located or if there is any uncertainty, EMS personnel may proceed with life-saving measures until the document is provided.

Can a DNR Order be used in all settings?

Yes, in Michigan, a DNR Order can be used in all settings, including at home, in assisted living facilities, hospices, and hospitals. However, it's crucial to ensure that the DNR Order is properly filed and communicated in each setting. Health facilities may have additional forms or procedures to ensure the DNR Order is recognized and respected across all care settings.

What should be done with the DNR Order once it is completed?

Once the DNR Order is completed, it should be:

• Kept in an easily accessible location at home.
• Filed with your primary healthcare provider and the hospital you frequent.
• Discussed with and a copy provided to family members, close friends, or anyone who may be involved in your healthcare decisions.
• Consider also carrying a DNR identification, such as a bracelet or a card, especially when traveling outside the home.

Filling out the Michigan Do Not Resuscitate (DNR) order form requires attention to detail to ensure that one’s medical wishes are communicated accurately. A frequent mistake occurs when individuals do not provide the full legal name, leading to identity confusion, especially in emergency situations. It’s vital to ensure the name matches exactly with other identification documents.

Another common error is the omission of the date of birth. This specific information is crucial not only for identity verification but also for ensuring that medical personnel can quickly access pertinent health information, which can be critical in an emergency scenario.

The importance of a witness's signature is often underestimated. A valid Michigan DNR order must be witnessed by someone who can verify the identity of the person filling out the form. Failing to include a witness’s signature may result in an unenforceable DNR order. Ideally, this witness should not be a beneficiary of the individual’s estate to avoid potential conflicts of interest.

Individuals frequently neglect to discuss their DNR orders with their healthcare provider. While not a requirement for the form itself, a conversation with a healthcare provider ensures that the DNR order is consistent with other elements of the individual’s healthcare plan. This oversight can lead to discrepancies in care in critical moments.

Incorrectly identifying the healthcare proxy or patient advocate is another error. The person appointed should not only be trustworthy but also fully informed about the individual's healthcare wishes, including the decision not to be resuscitated. Ensuring this person's name and contact information are accurately recorded on the form is essential.

Many people fail to update their DNR order. Regular review and, if necessary, revision of the DNR order ensure that it reflects current healthcare wishes. Changes in health status, personal relationships, or medical technology might make updates to the DNR order appropriate.

There's also a common neglect in making adequate copies of the DNR order. It should be readily accessible, not tucked away in a safety deposit box. Copies should be given to family members, healthcare proxies, and primary care physicians to ensure that the individual's wishes are respected across all settings.

Lastly, a significant oversight is the failure to register the DNR order with emergency services, if such a registry exists. While not all areas have this option, where available, it provides an added layer of assurance that one’s DNR wishes will be honored by first responders.

In the state of Michigan, a Do Not Resuscitate (DNR) Order form is a critical document for those wishing to express their preferences about not receiving CPR (cardiopulmonary resuscitation) in the event their heart stops or if they stop breathing. While a DNR is a significant piece of an individual's emergency care plan, several other forms and documents often complement it to ensure comprehensive health care directives are in place. These documents serve varied purposes, from specifying broader health care wishes to ensuring financial decisions are handled according to an individual's preferences.

• Advance Directive: Outlines a person's health care preferences, including treatments they do or do not want, in the event they are unable to communicate their wishes. This typically includes a Living Will and a Durable Power of Attorney for Health Care.
• Durable Power of Attorney for Health Care: Designates a specific person to make health care decisions on behalf of the individual, should they become incapacitated and unable to make those decisions for themselves.
• Living Will: Specifies the types of medical treatment the individual wishes to receive or avoid, particularly concerning life-sustaining treatment, under certain medical conditions.
• POLST (Provider Orders for Life-Sustaining Treatment): A doctor's order that outlines a plan for end-of-life treatment, which can include the patient's preferences about resuscitation, intubation, and other medical interventions. This document is used alongside a DNR order.
• Financial Power of Attorney: Grants a trusted person authority to manage financial affairs, including property and finances, on behalf of the individual, should they become unable to do so.
• Will: A legal document that spells out how a person's possessions and assets are to be distributed after death. It can also designate guardians for any minor children.
• HIPAA Release Form: Authorizes the disclosure of an individual's health information to designated persons, typically family members or close friends, to facilitate informed discussions about the patient’s care among health care providers and loved ones.

Using these documents in conjunction with a Michigan DNR Order form enables individuals to prepare a comprehensive health and personal care plan. This proactive approach to planning allows individuals to state their medical preferences clearly, designate decision-makers on their behalf, and ensure their financial matters are well organized. It’s recommended to seek guidance from a health care professional or legal advisor when preparing these documents to ensure they accurately reflect the individual's wishes and comply with Michigan law.

• Advanced Healthcare Directive: This document, similar to a Do Not Resuscitate (DNR) order, outlines an individual's preferences regarding medical treatments and interventions in situations where they are unable to make decisions for themselves. It covers a broader range of medical directives than a DNR, including choices about life support, tube feeding, and more.

• Living Will: A living will shares similarities with a DNR order as it communicates a person’s preferences on life-sustaining treatments if they are terminally ill or permanently unconscious. While a DNR specifically addresses the wish not to have CPR or other resuscitative efforts, a living will encompasses a wider array of medical interventions.

• Medical Power of Attorney (Healthcare Proxy): This legal document designates another person to make healthcare decisions on behalf of the individual, should they become unable to do so themselves. It is akin to a DNR in that it affects medical treatment at critical moments. However, its scope extends beyond resuscitation to all medical decisions.

• POLST (Physician Orders for Life-Sustaining Treatment): Similar to a DNR, a POLST form provides specific instructions regarding a patient’s preferences for life-sustaining treatments, including resuscitation efforts. This form differs by being more comprehensive and intended for seriously ill or frail patients, guiding broader aspects of healthcare treatment.

• Five Wishes Document: This document goes beyond the typical DNR order by encompassing personal, spiritual, medical, and legal wishes at the end of life. Though similar to a DNR in addressing the desire for or against life-saving treatments, it also includes details on comfort care, the type of medical treatment desired, how the individual wants to be treated, and what they want their loved ones to know.

Michigan's Do Not Resuscitate (DNR) Order form is an important document used to inform medical personnel of an individual's wishes regarding resuscitation in the event of cardiac or respiratory arrest. Completing this form accurately ensures that these wishes are honored. Below are things to keep in mind when filling out the Michigan DNR Order form:

• Do ensure the patient's identity is correct. It's crucial to double-check the spelling of the patient's full name, date of birth, and address to avoid any confusion during an emergency.
• Do have the form signed by the required parties. This includes the signature of the patient or their legally authorized representative, as well as the witnessing health care professional or notary public, adhering to Michigan laws.
• Do clearly discuss the decision. Before signing, ensure that the patient or the patient’s representative fully understands the implications of a DNR order.
• Do keep the original form accessible. After completion, the original DNR Order form should be kept in an easily accessible place where emergency personnel can find it quickly during an emergency.
• Don't use the form without proper authorization. The form must be completed by the patient or their legal guardian/representative. Unauthorized use can lead to legal issues and the form being considered invalid.
• Don't fill out the form in haste. Take the time to ensure that each section is completed accurately to reflect the patient's wishes regarding resuscitation efforts.
• Don't forget to distribute copies appropriately. It is advisable to provide copies of the signed and completed DNR Order form to the patient’s primary care physician, family members, and keep copies in easily accessible places for emergency medical teams to access.
• Don't use correction fluid on the form. Any changes or errors should be addressed by completing a new form to maintain the document’s integrity and legibility.
• Don't hesitate to consult healthcare providers. If there are any questions or uncertainties regarding the DNR process or its implications, it’s important to consult with healthcare professionals for guidance.

There are several common misconceptions surrounding the Michigan Do Not Resuscitate (DNR) Order form. Understanding the reality of these misconceptions is important for anyone considering a DNR for themselves or a loved one. Here are seven key misconceptions clarified:

• Only the elderly can have a DNR Order: Contrary to this belief, a DNR Order is not exclusive to the elderly. Anyone, regardless of age, who meets certain medical criteria can have a DNR Order based on their health preferences and discussions with their healthcare provider.
• A DNR Order is permanent and cannot be revoked: This is false. A DNR Order can be revoked at any time by the individual for whom it was issued or their legal guardian, provided that they are capable of making informed healthcare decisions.
• DNR Orders only apply in a hospital setting: This misconception often leads to confusion. In Michigan, DNR Orders can be honored both in healthcare facilities and in non-hospital settings, allowing patients to make choices that align with their wishes across different environments.
• Families can overrule a DNR Order during an emergency: Legally, a valid DNR Order must be respected by healthcare professionals, even if family members disagree at the moment of emergency. It reflects the patient's autonomous decision regarding end-of-life care.
• Signing a DNR means refusing all forms of medical treatment: This statement is misleading. A DNR specifically refuses cardiopulmonary resuscitation (CPR) in the event of a cardiac or respiratory arrest, but does not prevent a patient from receiving other forms of medical treatment, including pain management, antibiotics, or nutrition.
• DNR Orders result in lower quality of care: There is a concern that healthcare providers may offer less aggressive treatment to patients with a DNR. However, the aim of a DNR is to respect the patient’s wishes regarding CPR, not to influence other aspects of care. Healthcare teams continue to provide the highest standard of care consistent with the patient's goals and conditions.
• A DNR Order is the same as a living will: Though they both address end-of-life care wishes, they serve different purposes. A living will documents a person's preferences about the use of medical treatments in various scenarios, while a DNR specifically addresses the use of CPR. They are complementary documents that together can help ensure a person’s healthcare wishes are fully understood and respected.

Clarifying these misconceptions is crucial for making informed decisions about end-of-life care preferences and ensuring that those choices are honored. Individuals are encouraged to discuss these considerations with their healthcare providers and family members to ensure their wishes are clearly understood and documented.

Filling out and using the Michigan Do Not Resuscitate (DNR) Order form is an essential step for those who wish to make their end-of-life care wishes known. By understanding the key takeaways regarding this legal document, individuals can make informed decisions aligned with their desires and Michigan laws. Here are some crucial insights to guide you:

• Understanding the Purpose: The Michigan DNR Order form is designed to communicate a person's wish not to have cardiopulmonary resuscitation (CPR) in the event their breathing stops or their heart ceases to beat.
• Eligibility: Any person can request a DNR Order, but it needs to be filled out correctly and signed by both the individual (or their legal representative) and a licensed physician, physician assistant, or nurse practitioner.
• Signature Requirements: The form requires signatures from the individual or their authorized legal representative and the attending physician, indicating agreement with the DNR Order's directives.
• Recertification: The DNR order should be reviewed periodically. Some forms have an expiration date, so it's important to check and recertify if necessary to ensure it remains valid.
• Emergency Situations: The DNR Order is specifically for emergency medical personnel and hospital emergency departments as instructions not to attempt CPR.
• Scope of Decision: A DNR Order does not affect other treatments. Patients will still receive appropriate care for other medical conditions and comfort measures unless specified otherwise in advance directives.
• Revocation: A DNR Order can be revoked at any time by the individual or their authorized representative, either verbally or in writing.
• Notifying Family and Caregivers: It's crucial to inform family members and caregivers of the existence and location of the DNR Order to ensure one's wishes are honored.
• Proper Storage: The original DNR Order form should be kept in a readily accessible location. Copies should be provided to the individual's physician, local hospital, and potentially family members.
• Impact on Quality of Care: Choosing to have a DNR Order should not affect the quality of care received. It is a personal decision about end-of-life care that respects the individual's wishes.

By thoughtfully considering these key takeaways when completing the Michigan DNR Order form, individuals can ensure their healthcare preferences are respected during critical moments. It’s important to consult healthcare providers for guidance tailored to individual circumstances.