Advanced Directives

First & Last Name *
1A Durable Power of Attorney for Health Care may also be known as a health care proxy, a patient advocate designation or a DPA for health care *
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2An individual who is named in a patient advocate designation to exercise powers concerning care, custody, and medical or mental health treatment decisions is known as a plenary guardian. *
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3The Patient Advocate makes the determination that an individual is no longer able to participate in making their health care decisions. *
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4In Michigan, all individuals 18 years of age or older may designate in writing another individual who is 18 years of age or older to exercise powers concerning care, custody, and medical or mental health treatment decisions for the individual making the patient advocate designation. *
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5The patient advocate will not have general power to handle all the patient's property and finances - this would require a lawyer's assistance to draft a durable power of attorney for finances or a living trust. *
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6A patient has the right to voluntarily have their durable power or attorney for health care placed on a statewide registry, operated by the Auto Club of America, under contract from Michigan Department of Community Health. Health care providers will then have immediate access to the patient's information. The registry is free to the patient and to the health care providers. *
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7The focus of a DPA for health care is on who makes the health care decision, while the focus of a living will is on what the health care decision should be. The DPA for health care may be more flexible than a Living Will because the patient advocate can respond to unexpected circumstances. *
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8A do-not-resuscitate order (DNR Order) is a written document in which an individual (declarant) expresses their wish that if their breathing and heartbeat ceases, they do not want anyone to attempt to resuscitate them. Examples of individuals who may wish to prepare a DNR include a hospice patient who is home to die as peacefully as possible or a nursing home resident who has deteriorating health conditions. *
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9Consumers of SCCMHA are required to prepare Advance Directives and have them placed in the SCCMHA records. *
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10Unlike the DPA for health care, Michigan provides a standard form for a DNR. The form requires signatures from the declarant's attending physician, the declarant, and two witnesses who are 18 years of age or older (at least 1 of whom is not the declarant's spouse, parent, child, grandchild, sibling or presumptive heir). There is also an alternate form available for individuals who have religious beliefs against using doctors. *
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11At any time after an DNR order is signed and witnessed, the declarant, the declarant's patient advocate, the guardian, the attending physician or delegatee, may apply a Do-not-resuscitate identification bracelet to the declarant's wrist. *
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12An individual shall not apply a do-not-resuscitate identification bracelet to another individual unless he or she knows that the patient is a do-not-resuscitate declarant. An individual who wrongly puts a DNR identification bracelet on an individual may be punished by up to five years imprisonment and/or a fine of not more than $500. *
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13If the court determines that some form of guardianship is necessary, the court will appoint a patient advocate for six months before they appoint a plenary guardian. *
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14A plenary guardian is a guardian who has only those powers set forth in the order of appointment and the letters of guardianship. The plenary guardian possesses less than all of the legal rights and powers of a full guardian. The plenary guardian has special powers that are clearly specified and conferred by a court order. In a case of plenary guardianship, the ward continues to possess some legal control over themselves. *
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15If the court finds by clear and convincing evidence that an individual is developmentally disabled or incapacitated and lacks the capacity to do some, but not all, of the tasks necessary to care for himself or herself or their estate, the court may appoint a partial, or limited, guardian to provide guardianship services to the individual - but the court may not appoint a plenary, or full, guardian. The court order shall define the powers and duties of the partial guardian. *
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16An individual with a developmental disability for whom a partial guardian has been appointed retains all legal and civil rights except those that have by court order been designated as legal disabilities or that have been specifically granted to the partial guardian by the court. *
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17A partial guardian shall not be appointed for a term greater than 10 years. *
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18If the court finds by clear and convincing evidence that an individual is developmentally disabled, or incapacitated, and is totally without capacity to care for himself or herself or their estate, the court shall specify that finding of fact in any order and may appoint a plenary, or full, guardian of the person or of the estate or both for the individual. *
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19A standby guardian is an individual designated by the court whose appointment shall become effective without further proceedings immediately upon the death, incapacity, or resignation of the initially appointed guardian. The powers and duties of the standby guardian shall be the same as those of the initially guardian. In an emergency situation and in the absence and unavailability of the initially appointed guardian, the standby guardian may temporarily assume the powers and duties of the initially appointed guardian. *
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20By a properly executed power of attorney, a parent or guardian of a minor or a guardian of a legally incapacitated individual may delegate to another person, for a period not exceeding 180 days, any of the parent's or guardian's powers regarding care, custody, or property of the minor child or ward, except the power to consent to marriage or adoption of a minor ward or to release of a minor ward for adoption. *
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21SCCMHA consumers must be informed about their right to create an advance directive, and if the consumer has medical health diagnosis, the consumer is obligated to create a do-not-resuscitate order. *
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22If an SCCMHA consumer has a guardian, the consumer's SCCMHA record is automatically updated by the Probate Court. *
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23When or if you have any questions related to advance directives, contact the SCCMHA Compliance Officer at 797-3539. *
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