California’s Do-Not-Assist Living Communities

A couple facts about cardiac arrest..  #1- It only takes from four to six minutes from the time your heart stops till brain death occurs.. #2- The national average response time for an emergency call is over 10 minutes..   These two facts alone make me wonder why an “independent living facility” in Bakersfield California has on it’s books “In the event of a health emergency at this independent living community, our practice is to immediately call emergency personnel for assistance and to wait with the individual needing attention until such personnel arrives”  Why even make the call?  Friends of 87-year-old Lorraine Bayless

have to be asking themselves this very question after she died on Feb. 26th.   They could have asked Lorraine herself had a nurse, working for Glenwood Gardens,  listened to the emergency operator (Tracey Halvorson)  who begged her to start CPR on Lorraine.. this is a part of what was said on  on that emergency call..

Dispatcher: “We must start CPR”

Nurse:  “Yeah, we can’t do CPR at this facility.”

Dispatcher: “OK, then hand the phone to the passerby. If you can’t do it, I need, hand it to the passerby, I’ll have her do it. Or if you’ve got any citizens there, I’ll have them do it.”

“No, no, it’s not,” the nurse says.

Dispatcher: “Anybody there can do CPR. Give them the phone, please. … This woman’s not breathing enough. She’s going to die if we don’t get this started.”

Silence

Dispatcher””I don’t understand why you’re not willing to help this patient. Is there anybody that works there that’s willing to do it?”

“We can’t do that,” the nurse says. “That’s what I’m trying to say.”

Dispatcher: “Are we just going to let this lady die?”

“Well, that’s why we’re calling 911,” the nurse replies.

Dispatcher:  “We can’t wait. She can’t wait right now. She is stopping breathing. Is there anybody there that’s willing to help this lady and not let her die?”

Nurse: ‘Um, not at this time.”

Even reading this conversation really irks me, what harm would it have done the nurse to give CPR?  would she have been fired for saving the life of a resident?   I really feel bad for the Dispatcher who did everything she could, everything she was trained to do, to save the life but she wasn’t able to get past the “it’s our policy to call and let the emergency workers do what we ourselves refuse to do..”

And the family?  They seem to be okay with the actions of this nurse.. They have gone on record as saying “Mom had full knowledge of the limitations of the home and is at peace”.   Yet their Mom was not on file with a “do not resuscitate” order..  it would seem to me that the children are assuming their Mother was okay with no one attempting to keep her alive..  yet she wasn’t in a hospital or nursing home, so it would seem to me that Lorraine might not have been done living yet..

Perhaps the issue, the one no one is talking about, is the fact that the California’s Good Samaritan Law,  does not protect as many Good Samaritans as was widely believed.   In a 4 to 3 decision, the court determined that Good Samaritan protection from civil lawsuits extends only to one who renders emergency medical care at the scene of an accident.   Lorrainne had collapsed in the dining room.  However, the dispatcher had told the nurse on the phone that the home, Glenwood Gardens, could not be sued if anything went wrong in attempts to resuscitate the resident, saying the local emergency medical system “takes the liability for this call”.

I asked my co-blogger, Dr. Fogg, about this case (as he ran an assisted living home in England for years) and his reply was “When we ran our home we certainly would never refuse any treatment to save lives however old the person may be, and did do cpr on several clients.  except there does come a time when a person is clearly dying when it is obvious their death would be a happy and expected release.  In those cases we wouldnt have dialed 911 (999) in the first place.   A policy of NO cpr is very worrying.”

I couldn’t agree more..

As a last thought, I would like quote CBS News legal analyst Jack Ford, who said ” but then the real question is, is there a legal responsibility and legal liability.  is there a legal liability. That depends upon two things: first is, what’s the agreement that this woman and her family had with this home, and…it was a residential facility, not a nursing home, assisted living. Very different if it was that. So if their agreement they say specifically, ‘We do not provide emergency medical care. We will get somebody for you,’ then that could shield them from some problems. Then other question is, what are your reasonable expectations. When they sold this as a sales pitch, did they say, ‘Look, we have wonderful workout facilities, wonderful dining facilities and we have medical people on site here.’ Well, you know then, despite what might be in the agreement there, you have a reasonable expectation.”

To bad Lorraine Bayless herself can’t weigh in on this issue..  I wonder what her last thoughts were peaceful as her family claims or if they were, as mine would have been, scared to death that no one was going to help me..

~ Daniel