By Sue Botos
The death of a resident in a California senior living facility, after a staff member refused to administer CPR, has left those with family members in similar communities questioning the care their loved ones would receive in a comparable situation.
West Life contacted several area senior residences, and those willing to comment stated that unless it’s against the resident’s wishes, CPR can be provided until the arrival of emergency personnel. However, there are some variations depending upon the level of medical care provided, which can include independent, assisted living and skilled nursing.
Westlake Village offers all three care levels and is part of Brookdale Communities. Brookdale also owns Glenwood Gardens in Bakersfield, Calif., where a resident of the independent living facility, 87-year-old Lorraine Bayless, died after suffering a heart attack and a staff member refused to perform CPR. News reports were unclear about whether or not she signed a DNR (Do Not Resuscitate) order.
Patrick Payne, executive director of Westlake Gardens, stated, “We do everything possible to best serve our residents,” but added that he was advised not to directly comment on the residence’s CPR policy.
He did send a statement, via e-mail, which gave an overview of Brookdale’s CPR policy. “At our Independent Living community, the practice regarding a health emergency is to immediately call 911 for medical assistance. If a resident is experiencing respiratory or cardiac arrest, any Brookdale associate who is appropriately trained may choose to initiate CPR unless the associate knows the resident has a ‘Do Not Resuscitate Order.’ Any associate who is not trained in CPR may follow any instructions provided by the 911 operator until paramedics arrive to assume medical care,” the statement read.
While the CPR procedure for assisted living is the same as that for independent living, the statement noted, “At our Assisted Living Community, we follow prescribed regulations for the state.” The statement did not elaborate on these regulations.
The Ohio Department of Health website details regulations for skilled nursing facilities, but nothing was found to directly address emergency procedures for assisted living services.
The Brookdale statement concluded that a companywide review of emergency medical care practices is under way.
Tracey Mancuso, marketing director for Normandy Independent Living in Rocky River, said that optional care plans are offered to residents through a home health care company. “We do require all of staff to have CPR certification and offer training sessions throughout the year,” she said.
Elaborating in an e-mail, Mancuso stated, “Because we are not a licensed assisted living facility, we do not keep charts on our residents nor do we require having a Living Will on file. We do offer … a File of Life. It’s a magnetic folder that goes on the fridge and inside contains a paper with emergency contact information, allergies, hospital info, etc. This is not a requirement of the Normandy and it is completely up to the resident to keep it current. Out of a moral obligation, any employee of the Normandy would administer CPR if a resident was in distress.”
Matt Shula of Normandy Manor, a skilled nursing facility, said DNR forms are kept in residents’ charts. “If one of our residents is a full code (all measures are to be taken to treat cardiac or respiratory arrest) and then would require CPR, we would initiate CPR until paramedics arrive. We continually educate families and residents regarding DNR versus full code.”
The procedure is the same at The Welsh Home, which offers assisted and skilled care. “Our policy is patient choice. All of our employees have gone through CPR training,” stated administrator Marilyn Davis.
All staff at The Harbor Court Assisted Living and Memory Care, from aides to dining room servers, are trained in CPR. Marketing Director Kathy Greco commented, “We do honor a DNR; other than that, we automatically resuscitate someone in arrest.” She added that there are two types of DNR, one covering any situation, the other only for cardiac arrest.
When considering a senior living facility, experts generally recommend that families ask questions regarding emergency procedures and whether or not a nurse or other medical personnel is always available.