Printable Do Not Resuscitate Order Document for the State of Michigan

Michigan Do Not Resuscitate Order - Usage Guidelines

When a person decides not to undergo cardiopulmonary resuscitation (CPR) in the event of cardiac or respiratory arrest, they can make their wishes known through a Do Not Resuscitate (DNR) order. In Michigan, filling out a DNR order form requires careful attention to details to ensure that the individual's wishes are legally recognized. Follow these steps to fill out the form accurately.

1. Begin with personal information by entering the full name of the individual the DNR order is for. This ensures that the document is correctly associated with the right person.
2. Provide the date of birth of the individual to avoid any confusion with someone else who might have a similar name.
3. Include the address of the individual. This helps in identifying the person's residence for health care providers or emergency responders.
4. List any known allergies. This information is critical in preventing adverse reactions from medications or treatments that might be administered in other circumstances.
5. State the primary physician's name and contact information. This ensures that the physician is reachable for consultation or verification of the DNR order.
6. Describe the specific medical conditions that have led to the decision to have a DNR order. This provides context for the order and helps health care providers understand the underlying health considerations.
7. The individual or their legal guardian must sign and date the form, indicating their understanding and agreement with the DNR order's terms. This step legally validates the document.
8. Obtain a witness signature. This additional step is necessary for the document to be considered legally binding in Michigan. The witness confirms that the individual signing the form is doing so voluntarily and without coercion.
9. Finally, the attending physician must sign and date the form. The physician's signature certifies that the individual has been fully informed about the nature and consequences of a DNR order, and that the decision aligns with the individual's health status and medical advice.

Once the form is completed and properly signed, it's important to keep it in an easily accessible location at home and to inform family members, caregivers, and possibly close friends of its existence and location. Additionally, consider carrying a wallet card indicating that a DNR order is in place, to ensure that the individual's wishes are respected even when away from home.

What is a Michigan Do Not Resuscitate Order?

A Michigan Do Not Resuscitate (DNR) Order is a legal document that allows individuals to express their wish not to receive cardiopulmonary resuscitation (CPR) in the event their heart stops or they stop breathing. This document is used by individuals with serious illnesses or at the end of life to ensure that their medical treatment aligns with their preferences.

Who can request a Do Not Resuscitate Order in Michigan?

Adults of sound mind, who are 18 years or older, can request a DNR order in Michigan. This includes patients or their legally authorized representatives, such as durable power of attorney holders for healthcare, who are capable of making healthcare decisions on the patient's behalf.

How can one obtain a Do Not Resuscitate Order in Michigan?

To obtain a DNR order, an individual must complete the DNR form, which requires information about the patient and their wishes regarding resuscitation. The form must be signed by the patient or their authorized representative, and by a licensed physician, who confirms the patient's serious or terminal condition and the appropriateness of a DNR order. The form is then kept by the patient and can be registered with healthcare providers.

Where should Michigan residents keep their Do Not Resuscitate Order?

It is crucial that the DNR order be easily accessible in an emergency. Therefore, Michigan residents are advised to keep the original document in a prominent location at home, and also to carry a copy with them. Additionally, copies should be given to the person's physician, hospital, and any healthcare facilities or home health agencies involved in the person's care.

Is the Michigan Do Not Resuscitate Order recognized outside of home settings?

In Michigan, DNR orders are recognized in various settings outside of the home, including hospitals and nursing homes. However, the applicability may vary in settings outside of Michigan, and it is advisable to consult with health facilities or providers in other locations to confirm recognition and understand the procedures for transferring the orders to other states' jurisdictions.

Can a Do Not Resuscitate Order in Michigan be revoked?

Yes, a DNR order in Michigan can be revoked at any time by the patient or their authorized representative. Revocation can be done in any manner that clearly expresses the intention to revoke, including physically destroying the DNR order form, verbally communicating the revocation to a healthcare provider, or by creating a new advance directive or DNR order that contradicts the previous wishes. It is important to notify healthcare providers and remove all copies of the outdated DNR order to ensure that medical treatment aligns with the current wishes.

When filling out the Michigan Do Not Resuscitate (DNR) Order form, it's crucial to approach the task with diligence and understanding. A DNR, a document that instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) in the event of a cardiac or respiratory arrest, ensures an individual's wishes regarding life-saving treatment are respected. Nevertheless, errors can occur during this process, potentially leading to unintended outcomes. Below are nine common mistakes to avoid:

1. Failing to discuss the decision with a healthcare provider. A DNR form is a significant medical decision, and consulting with a healthcare provider ensures that the individual fully understands the implications of their choices.
2. Not having the form properly signed by the required parties. In Michigan, the DNR form must be signed by the patient (or their legal representative) and their physician to be legally valid.
3. Overlooking the necessity for witness signatures. Depending on specific regulations, having a witness to the signing of the document may be required to further attest to its authenticity.
4. Leaving sections of the form incomplete. Every part of the DNR form serves a purpose, whether it's specifying the individual's wishes or identifying the healthcare proxy. Omissions could lead to misunderstandings or delays in care.
5. Using incorrect or outdated forms. Laws and forms can change. Utilizing an outdated or incorrect form might render the DNR order invalid or lead to unexpected legal complications.
6. Misunderstanding the scope of the DNR. Some individuals mistakenly believe a DNR restricts all forms of medical treatment. However, it specifically applies to CPR in the event of cardiac or respiratory failure.
7. Not communicating the DNR order to family members or caregivers. Lack of communication can result in family members being unaware of the individual’s wishes, possibly leading to conflicts or challenges at critical moments.
8. Failing to review and update the DNR order. As circumstances and preferences change, it's vital to ensure the DNR reflects current wishes. Regular reviews and updates are necessary.
9. Not storing the DNR in an easily accessible location. In an emergency, healthcare providers need immediate access to the DNR document. If it's not readily accessible, its instructions may not be followed.

By paying careful attention to these details, individuals can ensure that their health care preferences are clearly documented and respected, potentially easing the burden on themselves and their families during difficult times.

When discussing end-of-life care, the Michigan Do Not Resuscitate (DNR) Order form represents just one crucial piece in a broader constellation of legal documents designed to respect the wishes and rights of individuals during their most vulnerable moments. This DNR form is a medical order that instructs healthcare professionals not to perform cardiopulmonary resuscitation (CPR) if a patient's breathing stops or if the patient's heart stops beating. However, to ensure a comprehensive approach to end-of-life planning, several other forms and documents often accompany the DNR form. Each plays a vital role in ensuring a person's healthcare preferences are well-documented and respected.

• Advance Directive - This document combines a Living Will and a Durable Power of Attorney for Health Care. It outlines a person's health care preferences in detail and appoints someone to make decisions on their behalf if they become unable to do so themselves.
• Living Will - It details the types of medical treatments and life-sustaining measures an individual prefers or wishes to avoid, especially in situations where recovery is unlikely.
• Medical Power of Attorney (POA) - This legal document designates an agent to make healthcare decisions on behalf of the individual, should they become incapacitated and unable to communicate their wishes directly.
• Last Will and Testament - This vital document dictates how an individual's property and personal affairs should be handled after their death.
• Physician Orders for Life-Sustaining Treatment (POLST) - Similar to a DNR, this form documents a patient's preferences for other types of life-sustaining treatments, such as intubation or feeding tubes, in addition to CPR.
• Hospital Discharge Form - While not directly related to end-of-life planning, this form can include critical information about a patient's DNR status upon discharge from a hospital.
• Organ and Tissue Donation Form - Individuals can specify their intentions regarding organ and tissue donation on this form, potentially helping others even after their own death.
• Portable Medical Order Form - In some states, this form accompanies the individual across different care settings, ensuring their treatment preferences are consistently honored.
• Funeral Planning Declaration - This document allows individuals to specify their wishes regarding funeral arrangements, burial or cremation, and memorial services.
• Financial Power of Attorney (POA) - Though primarily concerned with financial matters, this document can play a role in end-of-life planning by designating someone to manage an individual's financial affairs, potentially freeing up resources for healthcare needs.

Each of these documents serves a distinct function in safeguarding a person's autonomy and ensuring that their healthcare and personal preferences are respected. When utilized together with a Michigan DNR order, they create a comprehensive legal and medical framework that promotes dignity and respect for individuals at the end of their life. Such preparedness not only brings peace of mind to the individuals themselves but provides clear guidance to families and healthcare providers during often challenging times.

• Advance Directive

  An Advance Directive is a legal document that outlines preferences for medical care if a person becomes unable to communicate or make decisions. This can include wishes about end-of-life treatment, such as mechanical ventilation or feeding tubes, resembling a Do Not Resuscitate (DNR) Order in its function to guide healthcare providers based on the patient's wishes.

• Living Will

  A Living Will specifically addresses a person's wishes for medical treatment in end-of-life situations. It is similar to a DNR order because it may include instructions not to use life-sustaining treatments in certain situations. A Living Will is more comprehensive, providing detailed guidance beyond resuscitation preferences.

• Medical Power of Attorney (POA)

  The Medical Power of Attorney document designates a person to make healthcare decisions on someone's behalf when they are incapacitated. Although its primary focus is not on the specific treatment choices like a DNR, it shares a common purpose in preparing for situations where direct consent cannot be obtained, ensuring respect for the individual's healthcare preferences.

• Physician Orders for Life-Sustaining Treatment (POLST)

  Similar to a DNR, a POLST form offers instructions regarding end-of-life care, but it covers a broader range of medical interventions. POLST forms are meant for seriously ill or frail individuals and provide specific medical orders – such as the use of antibiotics, feeding tubes, and, notably, resuscitation.

• Out-of-Hospital Do Not Resuscitate Order

  This variation of a DNR is specifically intended to be respected outside of hospital settings, including private homes and hospices. Like a standard DNR, it expresses a wish not to undergo CPR or advanced cardiac life support, but it applies across various non-hospital settings where emergency services may be called to respond.

• Five Wishes Document

  Five Wishes is a type of Advance Directive that goes beyond typical healthcare decisions, incorporating personal, emotional, and spiritual wishes alongside medical and legal preferences. Similar to a DNR, it includes instructions for care in circumstances where a person cannot speak for themselves, but it addresses a wider range of considerations, such as comfort care and the desires around communicating love to family members.

Filling out a Do Not Resuscitate (DNR) order in Michigan is an important process that requires clear understanding and careful attention. Here are some essential do's and don'ts to help guide you through this sensitive process:

• Read the form carefully. Make sure you understand every part of the document before filling it out.
• Consult with your healthcare provider. Discussing your health condition and end-of-life wishes with a medical professional can provide valuable insight.
• Discuss with family members or loved ones. Sharing your decision with those close to you can help ensure your wishes are understood and respected.
• Fill out the form completely. Ensure all required sections are filled out to avoid any confusion or issues later on.
• Use ink. Fill out the form in ink to ensure that it is durable and legible over time.
• Sign and date the form. Your signature and the date are crucial for the document to be legally binding.
• Keep it accessible. Once completed, keep the document in a place where it can be easily found in an emergency.
• Make copies. Give copies to your healthcare proxy, family members, close friends, and your primary healthcare provider.
• Review and update as necessary. As situations change, it's important to review and possibly update your DNR order.
• Respect the laws and regulations of Michigan. Ensure your DNR order complies with Michigan state laws to guarantee its validity.

• Fill it out in haste. Take your time to consider your options and the implications of a DNR order.
• Use pencil or erasable ink. These can fade or be altered, which may cause issues in an emergency.
• Leave sections incomplete. Incomplete information can lead to confusion and might make the document legally invalid.
• Forget to inform your healthcare provider. Your doctor or healthcare provider should be aware of your DNR order and have a copy of it.
• Store it where it can't be found. A DNR order is only useful if it can be quickly and easily accessed in an emergency.
• Fail to discuss it with loved ones. This can lead to distress and confusion during critical moments.
• Assume a copy at home is enough. Copies should be easily accessible to emergency personnel, not just kept at home.
• Overlook reviewing it periodically. Life changes might necessitate adjustments to your DNR order.
• Sign without fully understanding. If there's any part of the form that's unclear, seek clarification before signing.
• Ignore state-specific requirements. Each state has its own laws pertaining to DNR orders; ensure yours complies with Michigan's laws.

Understanding the Michigan Do Not Resuscitate (DNR) Order is crucial for ensuring that your healthcare wishes are respected. However, several misconceptions can lead to confusion. Let's clear up some of the most common misunderstandings:

• It's only for the elderly. People often believe a DNR order is only for older adults, but it can apply to anyone with a serious health condition, regardless of age.
• You need a lawyer to complete it. While legal advice can be beneficial, especially in complex situations, you do not need a lawyer to complete a DNR order in Michigan. Your healthcare provider can help you with the process.
• It applies in all medical situations. A common misconception is that a DNR order is applicable in every medical scenario. In reality, it specifically instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing. It does not apply to other medical interventions.
• It's permanent and irrevocable. Some people think once a DNR order is in place, it cannot be changed. However, you can revoke or modify your DNR order at any time based on your changing health needs or preferences.
• It guarantees no hospitalization. There’s a belief that having a DNR order means you will not be hospitalized under any circumstances. This is not true; the order only covers CPR, not other treatments or interventions that could warrant hospital care.
• A DNR order means no pain relief. Another myth is that DNR orders mean end-of-life care does not include pain management. In fact, these orders have no impact on pain relief and other comfort measures, which are always considered based on the patient's needs.
• It’s only for terminally ill patients. While DNR orders are often associated with terminal illnesses, they can be appropriate for patients with various severe health issues who wish to avoid CPR.
• Family consent is required. Some believe that family members must consent to a DNR order for it to be valid. While discussing healthcare wishes with family is important, adults with decision-making capacity can make a DNR order without family consent.
• All doctors immediately honor it. Ideally, all healthcare providers should respect a valid DNR order, but sometimes, especially in emergency situations or when being treated by new healthcare providers, it might not be immediately recognized. Ensuring that the DNR order is easily accessible and discussing it with your healthcare providers can help mitigate this issue.

By understanding what a Michigan DNR order does and does not do, individuals can make informed decisions about their healthcare and ensure their wishes are followed.

Understanding and properly using the Michigan Do Not Resuscitate (DNR) Order form is crucial for those who wish to make informed decisions about their end-of-life care. Here are four key takeaways for anyone considering filling out this form:

• Clear Communication: The DNR form is a legal document that communicates your wish not to have cardiopulmonary resuscitation (CPR) in the event your heart stops or if you stop breathing. It's essential that this form is filled out clearly and correctly to ensure your healthcare preferences are understood and respected.
• Valid Signature Required: For a Michigan DNR Order to be valid, it must be signed by the individual seeking the order or their legally recognized health care proxy or guardian. This signature is a critical step in the process, affirming that the decision is made willingly and with a full understanding of its implications.
• Physician's Role: Apart from the individual's or representative's signature, a licensed physician must also sign the DNR Order. This attests to the fact that the physician has discussed the implications of a DNR order with the individual, ensuring that the decision is informed and consensual.
• Accessibility: Once completed and signed, the DNR Order should be kept in an easily accessible place. Emergency responders must be able to find it quickly in an emergency situation to honor the individual's wishes. Common practices include attaching it to the refrigerator, keeping it in a visible spot in the bedroom, or in close proximity to any medical equipment in the home.

These takeaways emphasize the importance of thoughtful consideration, clear communication, and proper documentation in the process of completing a Michigan Do Not Resuscitate Order form. Being well-informed and prepared can ensure that your healthcare preferences are respected during critical moments.