<p>KKmama, PA state law sounds crazy. It’s like they want people to die. Will they allow you to do things that any passerby would do? Such as pull someone out of a bathtub if they were drowning? Turn their head to the side if they were drowning in their own vomit? Do the heimlich maneuver? Apply pressure to an area if they were bleeding to death? Hand them their asthma inhaler if they couldn’t breathe?</p>
<p>Those are inhumane laws. They should allow for common sense allowances to help people with simple emergencies the way any human being would. Can you go off the clock, and then provide unpaid help?</p>
<p>No, and that’s a straw man argument. I asked, as you quoted, if residents were aware of that policy, about not performing CPR on collapsed residents and had to understand and sign off on it before they entered the facility. If that’s the case, then there really is no issue.</p>
<p>Several weeks ago, My mom, in assisted living, had stroke symptoms, very slurred speech, confusion, but the assisted living employees didn’t seem to respond. My aunt talked to mom on the phone and recognized that something was wrong, went to the facility to check on her, and asked the nurse to give mom an aspirin and to call an ambulance. The nurse could not give her the aspirin without a drs order. We are realizing more and more that in assisted living, they really are only equipped to do very specific things in the way of care, and they cannot or will not often step outside those specified boundaries.</p>
<p>My son did compressions for 15 minutes. He didn’t break any ribs, but they sure hurt for months afterwards!</p>
<p>This question of giving care would seem to be an appropriate question to ask of AL facilities and to ensure that one’s wishes and the policies of the facility are in synch.</p>
<p>The problem is that, if one place has that policy, it’s likely that every other place in the area has the same policy…either, as mentioned above, due to state law, or just what is customary…so even if one is not happy with the policy, there really isn’t much choice. I also suspect that, if that policy is noted, it probably isn’t worded in a way that makes the average person truly believe that employees wouldn’t react in a way that would seem to be common sense.</p>
<p>That is not a straw man argument, cortana. There is the “they were made aware” policy by being in fine print in a stack of papers that they signed. And there are things that are clearly written in bold print, and told to a resident. I am sure that certain things like no smoking policies are written in bold print and talked about extensively. There is a right and wrong way to do things, even if you can get away with something that is technically “legal”. Have you read all the fine print of every document that your elderly parents or grandparents may have signed?</p>
<p>Incredible that a nurse cannot give a resident something as trivial as aspirin when your mom, had stroke symptoms, shoboemom. You know, when my kids went to middle school, high school and camp, we always signed something that gave the school or camp permission to give them basic medications. There was a rather long list. It seems odd that elderly residents can’t sign something themselves that gives the nurses or workers permission to take care of basic medical needs.</p>
<p>Busdriver11, you would call that policy ‘fine print’? You really think that isn’t something residents and their family (if any) would keep in mind when checking into the facility, especially at their age and health? Seems like a pretty serious condition to me and something that residents didn’t find out only when someone actually dies perhaps due to that clause. </p>
<p>And yes it is a straw man argument. You said
in response to my query whether residents are aware that the nurses there can not give CPR even though I said or implied nothing about nurses’ inaction with any other injury, like falling or getting a paper cut. Pretty serious exaggeration, don’t you think? </p>
<p>And just to clarify, the woman passed out while eating.</p>
<p>Questioning whether the care facility had a protocol to withhold aid, if someone became unconcious, is not something that I would think to ask about when looking for care for myself or a parent.</p>
<p>Now it would be.</p>
<p>I am also very curious about a facility my mother was staying in, when she needed intermediate care after a hospitalization three years ago.
She had been complaining that they made her take all her pills- vitamins & medications at the same time, and rushed her through it so that she often gagged.
She was found unconscious.
She had just turned 75.</p>
<p>This case is sad, crazy making. Most working with kids, the elderly are trained in CPR, and first aid, to give care till the emergency responders arrive. Most bystanders would do the same. I’ll be interested to see what the investigation turns up. What a ridiculous gap in safety for any segment of the population. A homeless shelter would hopefully give CPR! </p>
<p>I work at a camp where parents sign off on a list of meds to give campers, and we’d certainly start CPR. But this for the most part, is a healthy population. </p>
<p>The aspirin is not necessarily trivial. Even in the hospital, as an RN, I don’t give aspirin without an order. But can get someone to order one, fast, if needed. In a facility that deals with the frail elderly, there can be so many other conditions that a laundry list of medications for the entire population can be fraught with too many factors to consider. Though there possibility would be a long list of ‘as needed’ medications for any given resident. </p>
<p>Many health care providers tend to urge very elderly parents to be ‘no compressions’ or no code, knowing that the outcome would be less than positive. Which does not mean that other health concerns or emergencies are not addressed. An AED does not break bones as CPR does.</p>
<p>Assisted Living does dispense meds, and for some residents, it can indeed be quite a laundry list. They can even do PRN meds, although they might balk at the order “give if patient is having a heart attack.” My dad’s PRNs are mostly to do with pain. But again, that has to be ordered by a doctor.</p>
<p>Adult children need to understand the limitations of senior care facilities. They do not purport to be nursing homes (and I noticed that the article used “senior living facility” and “nursing home” interchangeably – which is incorrect). Independent/Assisted Living are NOT medical facilities. They don’t have doctors on staff, or in many cases, RNs. In an emergency, the job of the staff is to respond immediately, assess the situation, call 911 if needed, keep the resident calm, and give information to the EMTs when they arrive. In my parents’ case, we felt this was far, far better than leaving them in their home, where they weren’t even managing their daily meds safely. But we knew from the get-go that they weren’t going to get life-saving medical care there. What they needed, and what they have, is someone to take charge in an emergency.</p>
One can’t assume that at all. There are plenty of people who live beyond the age of 87 with a reasonable quality of life and without significant health problems. According to a quote in the article from a rep of the facility, it’s an “independent living facility” which is quite different from a SNF or nursing home and implies that the person was able to live independently.</p>
<p>
Again, according to the article, this wasn’t the case at all. The worker didn’t perform CPR because it was against a policy of the facility even though the 911 operator was begging for someone to administer CPR. A second point is, it’s not up to some worker at a facility like this to make the decision as to what’s ‘in the best interests of the elderly woman’. They’re in no position to make a decision like that.</p>
<p>
Why do you say that - simply because of her age? Unless you know the woman personally or have more knowledge of her background that isn’t cited in the article, you don’t know enough to to say CPR ‘wouldn’t have been the best thing’.</p>
<p>^^^^
You are right; I don’t know the specifics so can’t say that for sure about this specific resident. I should have said that in general, performing CPR on a frail elderly person is not a good thing.</p>
<p>I had an elderly relative living in assisted living who was sent to the hospital one night and implanted with a pacemaker, even though he was 99 years old, severely demented, and had a DNR. Sometimes doing everything medically possible is actually not helpful or kind.</p>
<p>I’m skeptical that the person in question was actually a nurse. Healthcare “aides” are often referred to as nurses, but they are NOT nurses. One must be licensed as an LVN or RN to call oneself a nurse, but that doesn’t stop patients and family members from referring to them as nurses. I’ve even seen doctors refer to their “medical assistants” as nurses-this is also not legal in most states, yet it still happens.</p>
<p>I’ve only worked in Texas, but I’ve never had a job as a RN which did not require BLS for healthcare workers. I had to be certified while in nursing school too once I began actual patient care.</p>
<p>This one hits close to me…I listened and like most had very uncomfortable emotions on it. My 84YO mom is now in skilled nursing ctr. She moved in 3 months ago after 3 years in a assisted living ctr. During her 3 years, she had several 911 calls and ambulance rides on her behalf due to brittle diabetes. The staff was aware of how to help, but had limited abilities to react quickly and equally to EMT or ER staff. We understood this at move in. They would always call for professional help, regardless of their own qualifications. It was still better than living alone. ALS provides a level of support that was appropriate even with limitations. MEd help, meals, activities etc. Its a temporary arrangement in the best case. I saw many residents in ALS who were close to needing or past needing a higher care level. I dont want to be callous, but IMHO, a if the family was aware of this policy and is satisfied with the care. This womans exit may have been preferable to skilled nursing. No disrespect to the professionals at skilled nursing. But everyone has their own opinion of Life Quality</p>
<p>They would never give an aspirin to a patient displaying stroke symptoms because without a brain image, they wouldn’t know if she was having an ischemic stroke or hemorrhagic stroke. You don’t give anticoagulants to someone having a hemorrhagic stroke. Studies have shown that aspirin isn’t very effective anyway with an ischemic stroke. Heart attack symptoms-that’s a different story.</p>
<p>Confusing story. Glendale Gardens appears to be a step-up community, with independent living, assisted living, memory care, and skilled nursing options. [Glenwood</a> Gardens - Bakersfield, CA](<a href=“Assisted Living Facilities in California | SeniorHomes.com”>Brookdale Riverwalk Pricing, Reviews & Amenities - Bakersfield, California) It would be helpful if the reporter or someone could specify whether this happened at the independent living facility (where there would almost certainly be no actual nurses on duty) or somewhere else on their campus. It’s unthinkable to me that a facility like this would have a “no CPR” policy in effect and I wonder if the families could possibly be aware of that. As a family member, I wouldn’t think to ask, though now I would.</p>
<p>A little OT, but interesting about DNRs - our senior center recently did a program on this with input from our local paramedics. In New York state, a living will that directs no resuscitation attempts applies only in a hospital/hospice setting. That would mean a skilled nursing facility, but not an independent living facility. If 911 is called here, paramedics will attempt to resuscitate unless they are shown a MOLST, Out-of-Hospital DNR, or DNR medallion. This is a complicated issue.</p>
<p>Can’t make up my mind on this one. Hits way too close to home. My dad entered the hospital for a high risk surgery in November. Surgery was aborted (surgeon didn’t like response of Dad’s heart to anethesia). Still don’t know what happened after that, because they were not able to remove him from respirator…everytime they tried, his heart rate would drop, and he would black out. First they said he was fighting infection (of unknown origin), then they said he needed more rest (sedated him for 3 days), ultimately, while I was visiting him one evening, they attempted to dial down on the respirator, attempting to wean him off. While I watched, the numbers on all the monitors started to go crazy, next thing people were running into the room, my most vivid memory was of the bed virtually hitting the floor, and one of the nurses jumping on top of my fathers chest administering CPR. To say it was brutal is still an understatement. It didn’t save my Dad.</p>
<p>I just saw this story on GMA… the tape of the 911 call is unbelievably disturbing. I honestly don’t know who anyone with a shred of decency could have just stood by and watched that woman dying without offering assistance because of a company policy??? Boggles my mind.</p>
<p>The staff did not “withhold” CPR, as some posters have stated it. They were not permitted to do so. And that is a very big legal difference.</p>
<p>Say that they had done CPR, the woman recovered but had brain impairment due to lack of oxygen for a short time. Family then sues because mom/grandma/whatever is now brain damaged. The person who performed CPR, if s/he is limited by law like I am, then goes to jail for performing medical care without a license.</p>
<p>As for “fine print”: it is not very fine. One agency I am aware of even has magnetic forms right on people’s fridges, that the client fills out providing emergency contacts and stating that they are aware that caregivers may not perform CPR. It is in 14-font and pretty darn blunt and brief.</p>