The initial outrage in response to a recent incident involving an 87-year-old denied CPR while a nurse spoke with a 911 operator has fizzled among conclusions that the long-term care facility’s no-CPR policy and its implementation in this situation were OK. (You can search Glenwood Gardens, 87 year old, CPR)
Before anything else, it’s important to know that 1) I’m using this instance as a jumping-off point for a consideration of what I view as global issues for each of us in the context of this incident , not as legal or medical advice 2) Considerations, including the money incentive are not attributed to this family, but rather as factor that should be considered within our own lives 3)All facts asserted are those gleaned from news sources, widely published at the time of the incident.
Money, money, money. Whether it’s fear of losing a job (the nurse), cost savings by denying skilled and competent care to residents in independent living (Glenwood Gardens), hopes of preserving the deceased’s assets (the family), in any situation dealing with the care of older people there is a tremendous money incentive. Keeping the business aspect of healthcare in the forefront of your mind can be a great tool in making your own decisions.
Your intentions. The family took the lead in this instance, indicating that the woman knew about the facility’s policies, and that she did not want, as reported in Forbes.com on 3/6/2013 “life-prolonging emergency care.” Yet the same article states that “It is not clear whether she had a living will or do not resuscitate order, or had a designated a family member as her healthcare proxy,” in other words, all the documents we’re assured will communicate our intentions.
Honestly, I don’t know if I believe that this woman’s “intentions” were honored. It seems curious that with all the planning she did that the woman wore no “DNR bracelet,” an option available in many states, including California, for people to wear if they don’t want emergency personnel to administer life-saving emergency care. (There is not a bracelet that says, “YES CPR”, as far as I know.)
It’s also odd that the woman would be in a continuing care center in the first place if she anticipated simply letting nature take its course in the event she had a stroke and collapsed on the floor because these centers charge enormous amounts of money by promising levels of needed care to aging individuals. Ultimately being in that facility provided her with no additional protection or options. (A stranger in the street could call 911)
It would also be of value to hear the facility’s pitch when the woman signed the “contract” with the facility, and if so, why bother having nurses there at all? Anyone could call 911. Was the nurse angle used as a fraudulent incentive by the facility to make paying customers confident that there was competent staff around, though there was no intention for that staff to operate as professionals in the event of emergencies for those living in independent living?
We also don’t know whether the woman had been at the hospital before that she ultimately died at. Was there a DNR document she’d signed during some other hospital visit to the same hospital? After all, DNR orders don’t expire, which means that once there the hospital could rely on an old DNR order.
Ageism: It’s a fact of life that older people are viewed differently than younger people in terms of medical care. As you age, it’s important to take additional steps to make your intentions known to more than a few individuals in order to maximize the likelihood that your wishes will be honored.
It’s not the outrage, but the short-lived outrage that makes this occurrence important as a mirror of our society’s concerns and priorities.
The next articles will consider the battle of the documents, and which document prevails when it comes to your medical care.
