A nurse at Glenwood Gardens in Bakersfield, Calif., refused to give Lorraine Bayless CPR after she collapsed last Tuesday in the dining room and was barely breathing. The nurse called 911 for help, saying it was against the facility's policy for staff to give CPR.
"It's a human being," dispatcher Tracey Halvorson says on a 911 tape released Sunday by the Bakersfield Fire Department. It was aired by many media outlets Monday.
"Is there anybody that's willing to help this lady and not let her die?"
"Um, not at this time,'' the nurse said. Bayless was declared dead at Mercy Southwest Hospital later Tuesday.
"I was appalled to hear of a policy at a facility that will not give CPR,'' says Robyn Grant, director of public relations and advocacy for The National Consumer Voice for Quality Longterm Care. "Who knew? I guess this has never come up before, but it will from now on. It's an incredible tragedy."
Bayless' daughter told KGET-TV she is a nurse and was pleased with her mother's care. The station also reported Bayless did not have a "do not resuscitate" order on file.
The executive director of Glenwood Gardens, Jeffrey Toomer, defended the nurse's actions, saying she did indeed follow policy.
"In the event of a health emergency at this independent living community our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives," Toomer said in a written statement. "That is the protocol we followed."
Toomer said a "thorough internal review" of the incident would be conducted. Bakersfield police are also conducting an investigation.
Toomer told KGET that residents of the home's independent living community are informed of the "no-CPR" policy and agree to it when they move in.
The policy does not apply at the adjacent assisted living and skilled nursing facilities. Those residents would have received CPR in identical circumstances.
Calls by USA TODAY to Toomer and parent company Brookdale Senior Living, which operates long-term care facilities in 36 states, were not returned. Glenwood Gardens' website says Brookdale facilities are listed among the top 2012 choices for senior living and nursing homes, on lists by CNN and U.S. News & World Report.
"This speaks to the fact that consumers have to be extremely vigilant when selecting independent living and assisted living care,'' Grant says. "It's really hard when you're looking for care and reading these contracts to understand every word. We suggest people take them to an attorney to understand the responsibilities of the facilities."
At many of the nation's retirement communities, the cost of the care is based on how much medical assistance is required. Both assisted living and skilled nursing care are more expensive than independent living.
"There's already a level of stress when you're looking for care because of costs involved and for many other reasons,'' Grant says. "I think it puts a harsh burden on seniors and needs to be more clear."
"The nursing home industry is the Wild West of health care, the most poorly regulated, with typically the most vulnerable of patients, and a high concentration of for-profit operators,'' says Chuck Idelson, spokesman for the California Nurses Association. "It's an area ripe for abuse, and greater public oversight is surely needed."
Not all facilities have the same policy, however. At Erickson Living, an effort would have been made to save Bayless, says Dan Dunne, director of communications for the company, which has retirement facilities in nine states.
"All of our communities have first responders who are trained to provide emergency care, including CPR whenever and wherever necessary," he says.
Grant questions the facility's response when the dispatcher is heard on the tape pleading with the nurse to find someone to do CPR.
"I hate to judge anyone who might be worried about losing a job in this economy,'' Grant says, "but you'd really hope human decency would stand above policy."
In the tape, the nurse could be heard talking to someone else at the facility.
"She's yelling at me," she said of dispatcher Halvorson, "and saying we have to have one of our residents perform CPR. I'm feeling stressed, and I'm not going to do that, make that call."
When Halvorson asked the nurse if she was going to let the woman die, the nurse said, "That's why we called 911."
When people are selecting longterm care, they need to read the fine print "and separate reality from the advertising pitch saying 'we'll take care of you','' says David Dosa, an associate professor of medicine at Brown University.
http://www.usatoday.com/story/news/nation/2013/03/04/cpr-refusal-woman-dies/1961407/
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