The lead sentence in a California online news source read: “A nurse’s refusal to give CPR to a dying 87-year-old woman at a California independent-living home despite desperate pleas from a 911 dispatcher has prompted outrage and spawned a criminal investigation.”
This is a tragedy. We need to dig deeper, however, to understand how this can happen. Did the independent living community have a medical arrangement with her? What is their policy on administering CPR (cardiopulmonary resuscitation)? Some communities will automatically administer CPR, while others have a policy to call 911 and staff does not perform CPR. That’s the simplified explanation.
My goal is to make sure you’re as educated as possible. First off, make sure you understand some of the basic documents that inform health care decisions when one is unable to articulate for oneself:
- Health Care Directive: (Also called an Advance Directive or Living Will) This is a document you fill out indicating how you would like to be cared for at the end of your life. You choose a Health Care Agent within this document, who will speak for you and carry out your wishes in the event you can no longer speak for yourself. Everyone should have a directive on file with a health care provider and copies to loved ones. (Health Care information) (Example of Minnesota HC Directive)
- DNR: (Do Not Resuscitate). This order needs to be signed by a physician. If your loved one is in a senior housing setting, make sure the staff has the order on file. They often make some kind of a notation on your loved one’s chart/file and/or room/apartment or refrigerator. (DNR state forms) (MN Form)
- POLST: (Provider or Physician Orders for Life-Sustaining Treatment). POLST is for people with chronic illness and accompanies an Advance Directive. This is a standing medical order that communicates the patient’s end-of-life health care wishes to other health care providers during an emergency. (Example of MN POLST form)
Regardless of who you’re caring for, if that person lives in a senior housing community, make sure you review that community’s emergency response policies. What are their policies regarding communicating incidents to families? Do they have the correct contact information? Senior housing policies vary from state to state and depend on the type of community, so make sure you check with your state–each is different.
Learn from this tragedy and ask questions. Understand what care your loved one will or will not receive. Contact me if you have further questions and don’t know where to turn. I’m here to help you become a smarter caregiver.