TRAVERSE CITY — A recent amendment to a Michigan law will allow nursing homes staff to honor the wishes of patients who signed “do not resuscitate” orders.
“What this changes is we’ll no longer have the trauma of our staff doing CPR on someone they know doesn’t want to be revived,” said June Harmsen, who manages Orchard Creek Senior Living and Healthcare’s supportive care unit. “And we won’t be held legally accountable if we don’t.”
Currently, nursing home staff must administer cardiopulmonary resuscitation if they find a non-hospice patient with no pulse or respiration, even if that patient had signed a "do not resuscitate" order, witnessed by his or her family and signed by a physician, Harmsen said.
“This is an issue, more than you think,” Harmsen said. “If we don’t have hospice on board for a patient, and they pass away, we must do the CPR and call EMS. Then we have to call the sheriff’s department, they have to investigate, they call the coroner and he comes in, or not.”
The process can delay a family sitting with their loved one by one to four hours, she said.
Law enforcement still must be called for a patient who is not in hospice, even though the law means staff won't have to administer CPR, she said.
“But at least my staff doesn’t have to traumatized doing what the patient doesn’t want,” she said.
Of the 19 people who died last year at Leelanau County-based Orchard Creek Healthcare, only one was not in hospice. A failing patient is quickly signed into emergency hospice to avoid this situation, she said.
Harmsen said rules were written in 1979 when state hospitals for the mentally ill were closing and many patients went to group or adult foster care homes. Lawmakers believed that staff at these homes lacked medical expertise to know when someone had stopped breathing.
“They didn't know if they could tell if someone was really dead or not, especially someone on drugs with really shallow breathing," she said. "I understand where it all came from. It just doesn't work for an elderly population. All our paperwork we fill out, the care plans, is geared toward the mentally ill. Do they have a job? Can they move through the community? Obviously, all these things don't apply, but almost nothing has been revised in forever."
The amendment to the Do Not Resuscitate Procedure Act and the Estates and Protected Individuals Code was signed by Gov. Rick Snyder on Nov. 5 and takes effect on Feb. 5.