Family says the 87 yr old woman denied CPR wanted a natural death

[pnwmom]

http://abcnews.go.com/Health/family-woman-denied-cpr-wanted-natural-death/story?id=18666182

The family of the elderly woman who died after she was denied CPR at her retirement home released a statement Tuesday saying that 87-year-old Lorraine Bayless received adequate care at the Bakersfield, Calif., facility, and that she had wanted to die naturally.

(SNIP)

"It was our beloved mother and grandmother's wish to die naturally and without any kind of life prolonging intervention," the family said. "We understand that the 911 tape of this event has caused concern, but our family knows that mom had full knowledge of the limitations of Glenwood Gardens and is at peace."

The family also said it was surprised by the amount of attention the incident received.
"We regret that this private and most personal time has been escalated by the media," the statement said.

[zbdent]

2. I didn't want to give the "news" site any hits because

nobody said whether or not the woman had a DNR form signed.

When my grandmother passed away, she had a DNR ... after several years of heart trouble, and I don't know how many attacks, she had put all her affairs in order, and had a DNR order. (Lost too young at 65, and before she could see me & MaidenZBD become husband and wife).

[pnwmom]

4. You mean you didn't read the article at the link because you didn't know what it said?

According to the article, fire officials said she didn't have a DNR but neither the family nor the living facility would confirm that.

In any case, the family said she was informed of the policies of the facility and knowingly chose to live there.

[zbdent]

5. Not this one ...

the multitude of people expressing outrage showing the link ... like CNN only had the video ...

as it is, you did confirm that she was aware of the policies and chose to stay ...

[HiPointDem]

32. She didn't have a DNR. If she did, they would have said so (it would have exonerated them

immediately) -- and they wouldn't have called 911 & the EMTs wouldn't have done CPR on her.

[AnotherMcIntosh]

72. At most, it can be said that she didn't have a DNR with the facility (not a health care facility).

There was no need for her to have a DNR with the facility. It was not a health care facility. She was living independently in the assisted-living portion.

One of my nephews is an EMT. How do you know that the EMTs wouldn't have done CPR on her if she had made a DNR request? In some jurisdictions, and perhaps all, EMTs do not make any determination as to whether a DNR request is valid but administer CPR as part of their standard operating proceedure when they think that a person is viable.

[HiPointDem]

78. she wasn't living in the assisted living facility (which has medical care, btw). she was living in

the independent living facility, which doesn't -- but actually, brookdale touts the availability of medical services on their campus as part of their independent living pitch.

so bullshit on that.

Orange county california (& presumably the same rule applies statewide):

Paramedics and ambulance personnel will comply with several types of Do-Not-Resuscitate requests:

- A family member tells the paramedics or EMTs that the patient does not want resuscitation attempted.

- There is an Advance Health Care Directive completed with instructions not to attempt resuscitation.

- A prehospital Do-Not-Resuscitate order has been completed and signed by the patient.

- A substitute decision-maker with Power of Attorney for health care decides that you would not want resuscitation.

http://healthdisasteroc.org/ems/issues/dnr

[riverwalker]

93. Minnesota POLST

(when my Dad was independant in assisted living, these were taped to every refridgerator)

What Is a POLST Form?

A POLST form is a doctor’s order that helps you keep control over medical care at the end of life. Like a Do Not Resuscitate (DNR) order, the form tells emergency medical personnel and other health care providers whether or not to administer cardiopulmonary resuscitation (CPR) in the event of a medical emergency. A POLST form may be used in addition to -- or instead of -- a DNR order. The POLST form may also provide other information about your wishes for end-of-life health care, as explained just below.
How Does a POLST Form Differ From Other Health Care Directives?

A POLST form differs from a DNR order in one important way: A POLST form also includes directions about life-sustaining measures in addition to CPR, such as intubation, antibiotic use, and feeding tubes. The POLST form helps medical providers understand your wishes at a glance, but it is not a substitute for a properly prepared Minnesota Health Care Directive.

A Health Care Directive provides more information than a POLST form, including details about your health care agent, more complete health care wishes, and your preference for organ donation. Therefore, if you have a POLST form, you do not need a DNR order, but you should still complete a Health Care Directive to provide a full set of wishes about your care.

http://www.nolo.com/legal-encyclopedia/minnesotas-provider-orders-life-sustaining-treatment-polst-form.html

[Cali_Democrat]

3. Very interesting

I can certainly picture myself wanting to kick the bucket without any intervention when the time comes.

I can respect that decision.

[Hekate]

6. It's amazing how much reflexive hatred was stirred up by the first report

Thanks for keeping on this, pnwmom.

At the age of 65 I am now the oldest generation in my immediate family. Both parents, both in-laws, are now gone. The differences in how they achieved their deaths are striking, especially my mom and mom-in-law. All I can say about DNR for those who do not want it is this: if, given her explicit directions to let her die in peace, someone covering their own ass had successfully CPR'd my mom, she would have sued them blind.

Dying of old age is normal; get used to it. Dying quickly is by far not the worst thing that can befall a person in extreme old age. My poor MIL, in the absence of any directives at all, had a massive stroke and was given a feeding tube rather than being allowed to pass peacefully. Instead she lived on for almost another year, unable to move or communicate at all, food poured into the tube, the results going out into a diaper. It's the kind of prolonged dying my mother feared above all, which is why she put everything into writing.

[pnwmom]

7. I'm sorry your MIL had the kind of death so many of us dread.

My MIL had a pretty good experience in hospice, but I can see how those other situations happen. After my 95+ MIL had been in the stage of "active dying" from cancer for three weeks, we realized that two of the rotating nurses were feeding her! They were coaxing her to swallow food and MIL was complying -- and then throwing up and being miserable for hours. Feeding is NOT what's supposed to happen once the actively dying person in hospice starts to refuse food. I think the problem was that these caregivers were nurses who were attached to her. For six months, it had been a good thing that they could feed my MIL, and it was very hard for them to shift gears and let her die.

Also, the caregiving nurses tried to give her a lot less pain meds than the hospice nurse had ordered, thinking it was better that she be conscious more of the time -- but she was suffering! My husband finally had to explicitly instruct the caregivers that we were not trying to prolong her death, (and that's exactly what was happening), and then she died within a couple days.

Luckily, we were in there with her every day so we had a chance to see what was going on. But this was all so new to us we feel bad that we didn't catch on sooner than we did.

[REP]

11. The hospice nurse treating my terminal father were afraid he'd become addicted to painkillers

He had bone cancer of the spinal column, which had metastasized from his bladder. He didn't want any more needles, so he was on pills and patches. Even when his life expectancy was weeks, the stupid nurse was worried about him becoming addicted to morphine.

Seriously.

[Mariana]

13. With my grandfather, they were worried about tolerance

rather than addiction. He was taking various pain meds daily for months. The last thing anyone wanted was for the drugs NOT to be working at full strength toward the end, because his body had got used to taking them.

[pnwmom]

16. Couldn't they just increase the dose as tolerance developed?

I think many cancer patients die when the dose they need for pain ends up killing them.

[Mariana]

94. Up to a point, yes.

But his quality of life was pretty good right up until the last couple of weeks. He was fully conscious and alert and enjoyed reading, watching TV, playing cards and talking with people. It might not have been so if he'd had to take big doses of narcotics to make up for a high tolerance level. Toward the end, when it got really bad, they gave him enough to keep him unconscious all the time, and indeed the meds may have killed him.

[pnwmom]

98. I'm glad the meds were working when he needed it.

It sounds like what finally happened to my MIL at the end; she finally needed enough pain meds so she was sleeping all the time, and then she was gone in a couple days.

[Hekate]

14. That happened to my grandmother, too, only it was her sister who was shorting the meds

Granny died about 1970, of cancer, and her sister had moved in and cared for her devotedly during her illness. My Mom discovered that auntie was holding back on the pain meds for fear of addiction. Aaagh. But it ran in the family -- Mom always under-medicated her own pain, so powerful was her fear of addiction.

[pnwmom]

15. This is a real problem -- way too common.

Hospice people are supposed to know better, but not all the people caring for a dying patient have this training.

[tavernier]

45. I'm a Hospice nurse

I've never run into this. Our main concern is to keep the patient pain free. I've had situations when the family or the patient is concerned about addiction. Teaching is a big part of hospice nursing, in order to help the family and patient understand our role. In some of these cases we must reassess the patient's placement in hospice.

The hospice team works together (nurses, docs, social workers) to provide the most pain free and comfortable end-of-life care for the patient and family. If there are questions or problems, any member of the team can be approached to reach a solution.

[pnwmom]

51. We did find a solution when we talked to the hospice nurse.

But, since we were inexperienced, we didn't realize what was happening till it had been going on for a couple weeks. The caregiver-nurses (who were not employees of hospice but were supposed to be taking direction from hospice) weren't telling us that they were under-dosing her in order to keep her awake more. (Instead of giving her the prescribed x dose every x hours, they were giving her lower doses "as needed" -- which wasn't controlling the pain.) And they kept urging her to take food even though the hospice nurse told us she was actively dying and her feet had started to turn blue. It got so bad that my MIL was begging for assisted suicide -- but she couldn't find two doctors to agree to that (couldn't even find one). She stopped asking for suicide help, though, as soon as we figured out the medication problem and got the pain under control.

[tavernier]

95. yes, as much as we wish that every patient

and hospice had the ideal situation, it does differ from city to city and state to state. I'm sorry she had to suffer. That makes me sad.

[pnwmom]

97. Thanks, tavernier.

I'm afraid we learned the hard way. If either of us are ever in this situation again, we'll be better advocates.

[pipi_k]

82. Same thing

with my second husband, whose oral cancer spread to his brain.

The doctors wouldn't give him opiates because they were afraid he'd become addicted.

Well, he was an alcoholic anyway, so he did the next best thing...he drank the pain away...as much as he could, anyway.

[pnwmom]

104. I'm so sorry. There's nothing harder than watching a loved one suffer.

[HiPointDem]

87. This woman had no advance directives on file and no DNR. And she got CPR from the med techs

because there was no paperwork.

After laying sprawled on the floor of a public dining room for seven minutes while a nurse argued with a 911 dispatcher next to her over whether to initiate cpr.

advance directives are great; this facility doesn't use them. It uses a blanket policy of refusing CPR and calling 911 to give CPR.

So if you want CPR, you get it too late.

If you don't want CPR, you get it anyway.

Great policy, the worst of all possible worlds.

[Gormy Cuss]

8. I'm happy for the family that they are at peace with this

but the attention was merited because not every person her age, let alone their families, would think the facility's response was appropriate or adequate.

[Honeycombe8]

9. It wasn't just the lack of action that caused the uproar..it was the TONE of

the caller on the phone....people have sounded more caring when calling in for a pizza delivery. The caller could not have cared less what happened to teh woman (who was lying on the floor, don't forget).

I doubt many people would want NO assistance whatsoever, after falling to the floor passed out and in the process of dying.

Regardless what the family says, the woman herself chose NOT to sign a do-not-rescuscitate order. She made her feelings clear in that regard, even if Mom had turned out to be a burden, perhaps, to the family.

[pnwmom]

17. We don't know that she failed to sign a DNR.

This information has not been confirmed by either her family or by the retirement residence. (You can read that in the linked article.)

The only thing her family has said is that she was fully aware of the residence's policies and that she wanted to die a natural death without measures taken to extend her life.

[HiPointDem]

31. Do you think they have a DNR on file and have just neglected to mention that fact?

They *don't* have a DNR on file, or they would have said so to the press.

Furthermore, they wouldn't have called 911 and allowed them to do CPR on the woman if they had a DNR.

[AnotherMcIntosh]

75. If she was living in the assisted living portion of the facitity and not the health-care portion,

she was living independently and didn't need to have a DNR request on file.

[HiPointDem]

81. "independent living," not "assisted living". if she didn't have a dnr on file, and got cpr from the

med techs, then why does this thread claim she got what she wanted, which was supposedly a peaceful death and no cpr?

Actually, what she got was to lay sprawled in a public dining room for ten minutes while a nurse argued with the 911 dispatcher about whether to give her cpr, waiting for EMIs to come -- and give her fucking CPR!!

The facility had no idea 'what she wanted,' and didn't care.

If you are living indendently and collapse in a restaurant, does the restaurant owner call 911 and refuse to let anyone at the restaurant give you CPR? To the point of refusing to give the phone to someone else so the dispatcher can instruct them?

Because that's what this facility does, on a blanket basis.

Does your apartment owner provide you with meals in a communal dining room?

Do you have gift shops and classes at your apartment?

Do you have an emergency call button in your apartment?

Does your apartment manager do your laundry?

Is there 24-hour staffing at your apartment?

[Honeycombe8]

107. She may not have needed one, but I would bet you a million jillion dollars they tried to get one

from her, to make sure they don't have liability.

We ALL need one, if we don't want to be rescuscitated. At 87, I can assure that this was discussed with her....more than once.

[AnotherMcIntosh]

110. "to make sure they don't have liability"

Are you a member of the bar?

What is your background to support that kind of speculation?

On what factual basis do you believe that they could have had liability and wanted to avoid the risk of so-called liability?

If you are an attorney, just cite the authority which supports your opinion that they could have had liability.

[Honeycombe8]

106. Yes, it's been stated there was no DNR. nt

[JVS]

99. Creating a dead end low-wage service class causes such things.

[Honeycombe8]

108. You're probably right in large part. Too large a work load, too long a shift, too low wages.

Some people get careless, uncaring, and just worn out. Also, the best people can't be hired.

But we don't know she was low paid. She was the services director of an assisted living facility. She wasn't a min. wage worker.

[lonestarnot]

10. Good gawd. Of course she did! Why can't people let that poor woman go whereever she went as

she fucking wished. Nutfuckery. People make me sick sometimes. No nurse in his/her fucking correct mind would have let that happen otherwise.

[HiPointDem]

49. she didn't, or the medics wouldn't have done cpr on her and the facility wouldn't have called

the medics.

and the facility would have been waving it at the press.

she didn't have a dnr. the facility has a blanket policy that *they* won't give cpr.

[lonestarnot]

96. Well did she check in there not knowing this policy. I don't think so.

[TeeYiYi]

12. My understanding was that she collapsed in the dining room...

..., possibly from choking on food. If she did inhale some food, that is not a natural way to die. It was inhumane not to help her.

I understand DNR, (which she did not have btw,) but helping someone who is choking is a completely different thing.

TYY

[pnwmom]

18. The most recent articles do not say she died from choking.

And the non-existence of a DNR has not been confirmed by either the family or by the residence, according to the most recent reports.

From the link at the top of the thread:

"According to fire officials, Bayless did not have a 'do not resuscitate' order, but that was not confirmed by the family or Glendale Gardens."

[pinboy3niner]

19. No, choking wasn't mentioned

But the responding fire service reported that Lorraine Bayless did not have a DNR order (and their paramedics performed CPR when they arrived). Some reports also said that the daughter confirmed that her mother had no DNR order. (And it's not surprising that the facility would not comment about a resident's medical records.)

The family's characterization of what Ms. Bayless wanted is open to question, as whatever she may have expressed to them likely would not involve the kind of comprehensive and detailed, specific questioning about a wide range of circumstances that is normally posed in the patient questionnaire that is filled out before a doctor issues a DNR order.

The real question here is whether rendering assistance in a life-and-death emergency counts as "health care" or "medical care" in a facility whose policy is that it does not provide such care.

In this case, even the company operating the facility appears to be re-thinking its policy. After its statements that its employee was following its policy, it reversed itself and now says the employee did not understand its policy.

[pnwmom]

21. The family says she moved into the facility knowing they wouldn't be providing any medical care.

And if I were her, I wouldn't have expected CPR in this situation.

By the time most people are 87, they have lost so many friends and relatives to long, painful deaths that their most preferred death would be a massive heart attack -- over and done.

I know that's what my mother's hoping for, and I would be, too, if I were her age. Having seen enough relatives go through extended cancer treatment, I wouldn't wish that on anyone. (And when you're that age, those are the two most common situations.)

[pinboy3niner]

24. To many of us, "not providing medical care" does not mean withholding aid in an emergency

And it would be a travesty to simply write off the elderly and deny aid based on an assumption that they would prefer death. No one has the right to assume that for someone else.

Much is made of the fact that this is an independent living facility, not a hospital or nursing home providing medical care. But by the same token, living independently, Ms. Bayless was like any one of us who might collapse on the street in medical distress. How reasonable is it to withhold emergency aid from someone who is "living independently"--like us?

Unless a doctor has issued an order based on the individual's express wishes, the presumption must ALWAYS be on the side of preserving life.

How we value life in our society for anyone--including the elderly-- is extremely important and goes to the heart of many, many other social issues. It's also why we insist that the remains of the dead be treated with the utmost care, and dignity, and respect.

[pnwmom]

34. Ms. Bayless knew what the policy was, according to her family. Why can't we presume they are right?

According to one recent study, there is only a 3.3% chance that CPR will succeed on an 80+ year old, and this woman was closer to 90.

I think the value of preserving life has to be weighed against the likelihood of preserving life, and the quality of life that's preserved.

http://newoldage.blogs.nytimes.com/2013/03/06/amid-cpr-controversy-many-unanswered-questions/

In another study of 2,600 out-of-hospital cardiac arrests over four and a half years in Oakland County, Mich., only 3.3 percent of patients over age 80 who received CPR survived to discharge from the hospital.

Even when older people survive CPR, the consequences can be deleterious: broken ribs and fractured sternums, punctures of the lungs or liver, vomit in the lungs and significant pain. Those who argue for CPR in the elderly say these complications, while serious, are preferable to death. Others say quality of life can be, and often is, terribly degraded.

[pinboy3niner]

42. She knew the policy? Even the company can't make up its mind about what the policy is.

Choosing to live in a facility that does not provide health care is not the same as agreeing to never have any intervention in an emergency.

When I'm ready to forego any assistance, I'll get a DNR order. Until then, I hope I don't get stuck with you as my "Good Samaritan."

[pnwmom]

44. Each procedure is different.

In an 87 year old, the chance of a Heimlich, for example, helping without doing much damage is much greater than the chance that CPR will succeed. A Heimlich is also often given to an otherwise healthy person, while CPR is intended for someone who's had a heart attack -- two very different situations.

[HiPointDem]

52. who gives a rip? the fact is, there was no dnr and the corporation has a blanket policy of no cpr.

and it's the largest such corporation in the county and the policy is national.

and not everyone in independent living is a wizened old lady with paper thin ribs whose friends are all dead, longingly waiting for death, as you keep on painting it.

[pnwmom]

54. You obviously don't care about this individual human being.

You're ignoring her diagnosis of a massive stroke and everything her family has said about her wishes. She's just a vehicle for your righteous indignation.

[atreides1]

62. Families have been known to lie,

They have also been known to believe something in order to deal with feelings of guilt.

The reality is we will never know the entire truth, will we?

[pnwmom]

65. And is the doctor lying on the death certificate about a massive stroke?

What would CPR have accomplished under these circumstances?

[Sunlei]

85. a stroke is caused by the brain getting no oxygen, cpr gets blood and oxygen to the brain.

of course she died of a stroke.

[LisaL]

88. No, she had atherosclerosis.

[HiPointDem]

92. so do most people who have a heart attack or stroke. so what?

[LisaL]

90. Well, none of us are sure as hell know what she wanted better than her family.

[snooper2]

102. and since we will never know the entire truth you can be outraged about it forever!

right!

[HiPointDem]

30. who gives a damn what *you* would expect? what gives *you* the right to speak for all

87 year olds?

you have no idea what you would want if you were 87, because you're not 87.

[pnwmom]

35. You have no idea what I would want if I were 87,

but I sure the hell do.

I've been through enough elderly relatives' long declines and suffering, thanks. I hope I die in my sleep, but failing that, dying in a few minutes at the age of 87 will be fine.

[HiPointDem]

56. you don't know what you'd want at 87 either, and regardless of what *you* want, everyone

is not you.

[pnwmom]

63. And everyone is not you. So what?

But I certainly do know what I would want at 87 -- not that I expect to reach that age.

[MADem]

26. +1 nt

[pinboy3niner]

28. Props to you for your many good, thoughtful posts on this issue

The presumption MUST be on the side of life. Else we are all lost.

I alluded to the importance of this in a post below, but feel free to expand and improve upon it.

[TeeYiYi]

20. From a story I read earlier...

...that was published on March 6:

"It was later revealed that Ms Bayless had no Do Not Resuscitate form on file. However, it is against the policy of the retirement home to give CPR to residents of the independent living complex."

http://www.dailymail.co.uk/news/article-2288883/Lorraine-Bayless-family-nurse-did-intervene-save-mothers-life.html

I can't vouch for the source but I have no reason to assume that they are mistaken.

TYY

[pnwmom]

22. Revealed by the fire department but not confirmed by her family or the residence.

I've seen enough facts wrong in the media not to draw any conclusions based on information from an uncited source and in the absence of confirmation.

[TeeYiYi]

23. At this point...

...I doubt so many media resources would be reporting it as fact if they weren't reasonably sure.

Regardless, do you believe someone should have helped her if she was aspirating while eating?

TYY

[pnwmom]

38. I haven't seen a report that says 911 was asking the home to do a Heimlich.

But I wouldn't have had a problem with that. It's a much simpler procedure that doesn't tend to break bones and isn't given in the face of a heart attack.

Giving CPR outside of a hospital to an 80 year old has only a 3.3% success rate, according to a recent study.


http://newoldage.blogs.nytimes.com/2013/03/06/amid-cpr-controversy-many-unanswered-questions/

In another study of 2,600 out-of-hospital cardiac arrests over four and a half years in Oakland County, Mich., only 3.3 percent of patients over age 80 who received CPR survived to discharge from the hospital.

Even when older people survive CPR, the consequences can be deleterious: broken ribs and fractured sternums, punctures of the lungs or liver, vomit in the lungs and significant pain. Those who argue for CPR in the elderly say these complications, while serious, are preferable to death. Others say quality of life can be, and often is, terribly degraded.

[HiPointDem]

57. doing a heimlich on the 'frail' 87 year old you keep talking about could break ribs too. better

than choking to death, though.

glad you'll allow it as a matter of corporate policy, though.

but it's as much 'medical care' as cpr is.

[pnwmom]

61. A person having a heart attack is in a much worse state of health

than the typical person having a Heimlich.

[HiPointDem]

67. even if it's a 'frail' 87-year-old? you just keep throwing out one rationalization after another.

what happened to your story about how california laws MANDATED that an independent living facility COULDN'T give CPR? hmm?

[pnwmom]

69. Yes. A frail 87 year old having a Heimlich isn't ALSO having a heart attack or a massive stroke. n/t

[TeeYiYi]

91. Why do you need to see a report...

...that states 911 begged them to do anything at all? Someone should have been assisting her. If not, then why call 911?

Occam's razor suggests that "when you hear hoof beats behind you, think horses, not zebras" This woman was in the dining room when she collapsed. The simplest explanation would seem to be aspiration. Something that she ate or drank perhaps went down the wrong pipe. If it had been my mother I would have expected them to try to help her.

DNR, in my mind, refers to heroics such as ventilators and feeding tubes. This ordeal was asking for neither. Instead, it was a dining situation where a little assistance might have gone a long way. Or not. But why not try?

You've stated that she ended up dying from a stroke. That's only mildly comforting in light of how she was treated. (Or not treated in this case.) Yes, a stroke is a more natural way to die than aspiration, but who's to say that one did not precipitate the other. Either way, I would not want my mom staying at a place with such overpaid, uncaring imbeciles at the helm.

TYY

[pnwmom]

105. Why cite Occam's razor when you know it didn't apply in this case?

She just happened to be in the dining area when she had a massive stroke and collapsed. Neither the Heimlich nor CPR would have saved her from the effects of her artery disease.

[TeeYiYi]

109. Because I don't know that it didn't apply in this case...

...and neither did the nurse on the phone with 911. That nurse had no idea why the woman had collapsed so my feeling is that she should have been offering minimal assistance re: attempting to clear the woman's airway or applying basic CPR techniques either of her own volition or at the direction of the professional on the other end of the 911 call. Especially in the absence of a DNR, which the nurse was fully aware did not exist.

I'd like to believe that the woman died peacefully from a massive stroke, but that's just not the case. She ultimately succumbed to a stroke after laying there for at least 10 minutes with no oxygen getting to her brain. My hope is that she didn't lay there wondering why nobody was coming to her aid... "Oh well, bummer. I guess they're not going to help me..."

TYY

[pnwmom]

113. Her doctor said that the stroke was the primary cause of her death, and nowhere on the 911 tape

does the medic talk to them about choking measures. That's just groundless speculation.

Did you know that this woman had serious preexisting artery disease and that's why her family wasn't surprised that this happened?

The Michigan study said that 80+ year olds with out-of-hospital CPR have only a 3.3% chance of surviving. Her odds would have been less, considering she was 87 and had artery disease. Her family has made it clear they are satisfied with the outcome. Why are you second-guessing them? If they're satisfied with her care, shouldn't that be the determining factor?

If this woman had had successful CPR, and her heart was restarted, the next probable step is that she would have suffered permanent brain damage from the stroke that caused her collapse -- and her family would have to decide when to take her off the respirators.

Would this be Terri Shiavo (sp?) all over again?

[TeeYiYi]

114. What respirators?...

... The family made it clear that would never happen.

My biggest issue with this whole story is the incompetence and lack of basic human compassion on the part of the employees where this woman was a resident.

TYY

[TeeYiYi]

25. And one more consideration...

... If there had really been a DNR on file, they wouldn't have called 911... They would have been calling the coroner.

TYY

[HiPointDem]

29. You think the EMTs don't know whether the facility showed them a DNR or not? You think they

would have done CPR if they'd been told she had a DNR?

[pnwmom]

36. I know that the media often gets things wrong and no one has confirmed this. n/t

[HiPointDem]

58. the fire personnel on the scene have confirmed it. i doubt they got it wrong.

it's in the incident report.

maybe you think the media got that wrong, too.

if so, why do you think they're reporting the family's statement correctly?

[LisaL]

37. No, her physican says she had a massive stroke.

[pnwmom]

41. Thanks, Lisa, for the info. If only CPR had been done,

she could have had a bunch of broken ribs to go along with the massive stroke.

[pnwmom]

48. It turns out she died from a massive stroke. n/t

[HiPointDem]

27. Do you have stock in Brookdale Senior Living Corp, or what?

[pnwmom]

40. No, but you better dump yours. n/t

[jberryhill]

33. Is a flame war on DU part of "natural" death?

[pnwmom]

43. It seems to be.

Someone here just posted that her physician said she died of a massive stroke. To me, she doesn't seem like the poster-person for the wonders of CPR.

[HiPointDem]

60. says the person who thought a special second thread was necessary to drive home the point

that old people are too frail to be given cpr and they want to die anyway.

[pnwmom]

68. This is a follow-up thread because new information came to light.

People have been spreading a lot of misinformation -- that she might have choked to death, or that CPR would have likely saved her life.

The truth is she died of a massive stroke.

You would prefer to suppress the facts, for reasons known only to you.

[Silent3]

39. The family wanting a natural death doesn't at all explain the way that 911 call went.

The retirement home employee never mentioned DNR, the patient's or family's wishes. In fact, she was clearly trying to get medical help for the woman from another source, just refusing to do the resuscitation herself, with sort of a lackadaisical, thoughtless, "gosh, gee, I hope the dying woman gets help but not if that means breaking protocol" attitude.

[Sunlei]

46. I don't see a natural death to watch a woman fade away-gasping for a tiny bit of O2 in lungs

The woman could have lived if not for the inaction of that angel of death.

[pnwmom]

47. The death certificate says she died of a massive stroke, not a "fade away."

If they'd gotten her heart going again, with her brain severely damaged, how exactly would she have been better off?

http://www.contracostatimes.com/breaking-news/ci_22734279/common-document-could-have-prevented-bakersfield-cpr-drama

A preliminary death certificate shows that Bayless died of a massive stroke, not a heart attack -- so it is unclear that CPR could have saved her.
"While many strokes will not lead to death, (strokes) in certain parts of the brain are deadly (and) despite the best medical efforts, the likelihood of recovery is very low," said cardiologist Dr. Cesar Molina, a spokesman for the American Heart Association. He did not know details of Bayless' case.
She had been diagnosed with a disease of the blood vessels supplying the brain, called atherosclerosis,
according to her doctor Dr. Jennifer Abraham.
Her family issued this statement: "It was our beloved mother and grandmother's wish to die naturally and without any kind of life-prolonging intervention."

[Sunlei]

50. plenty of people survive a stroke noone survives whole, 2-3 mins without O2.

I think it's horrible that nurse didn't assist a couple lungs full of air.

edit- a stroke is lack of O2!!

[pnwmom]

55. "Plenty" of 87 year olds DON'T survive massive strokes.

In fact, they almost never do. And if she'd had successful CPR, the next question would most likely have been when to take her off the respirator.

How was the nurse supposed to give her a couple lungs full of air? Mouth to mouth is no longer standard CPR.

[Sunlei]

73. that nurse insured a stroke would occur from the lack of O2.

A trained nurse knows stroke happens when a being gets no oxygen to their brain.

even dogs get better emergency care.

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?feature=player_detailpage" frameborder="0" allowfullscreen></iframe>

[pnwmom]

74. Except the death certificate listed the stroke as primary,

not secondary to a heart attack.

[Sunlei]

84. The Nurse was not responsive to the 911 operator.

"It was a complete tragedy," said Maribeth Bersani, senior vice president of the Assisted Living Federation of America.

"Our members are now looking at their policies to make sure they are clear. Whether they have one to initiate (CPR) or not, they should be responsive to what the 911 person tells them to do."

http://www.news.com.au/lifestyle/health-fitness/family-says-lorraine-bayless-who-died-after-nurse-refused-to-do-cpr-didnt-want-help/story-fneuzlbd-1226591972306#ixzz2Mrsg4FsG

what if the woman had fallen in the pool had lungs full of water, or was choking on food or cut herself and was bleeding out? The nurse would have done nothing again to get oxygen to her brain?

[LisaL]

86. It's not illegal to not be responsive to 911 operator.

[LisaL]

76. She had atherosclerosis, which caused her stoke.

[mainer]

101. She would have spent weeks or months on life support

and died anyway. Is that what she wanted? Is that where we should be spending 90 percent of our health care dollars, giving support to vegetative patients who will die no matter what we do?

[HockeyMom]

53. 55+ Community?

Adult Retirement Homes? They provide very few services in these places. Basically, they are just developments where older people can live among others their own age. Many have golf courses, tennis courts, etc. You have to be over 55 to buy or rent in them. Some of them will have a separate Assisted Living Section which does provide medical services. Most of them do have dining facilities which is totally optional if the owner/renter wishes to eat there.

If a person is renting in these communities, they would have to sign a lease agreement which would spell out all the amenities, or services, which are provided. This woman would have had to sign a contract to live there. Did the nurse just happen to be in this section of the development, and not working there?

I suppose you could say with her just being a nurse she had a duty to perform CPR on ANYONE simply by her occupation. How far do you take that? I am not a nurse, but I am certified to perform CPR through my job with special needs students. I also live in a development in Florida which has a lot of very old people. The vote failed to make it a 55+ community. We have a community dining room. If I am eating dinner in the dining room, would I be required to perform CPR too? I seriously doubt that the cooks or waitresses have been trained to do CPR. This is not an Assisted Living Facility. They would also have to call 911. My sister-in-law has a condo here in a 55+ community. There are no medical services provided for there either. She knows that, and didn't want to live in a place like that.

Edit: Regardless whether or not someone can perform CPR, 911 still needs to be called.

[pnwmom]

59. I think the posters here divide along the lines

of which ones have had experiences with very elderly relatives and retirement homes vs. assisted living or skilled nursing -- and which have not.

My MIL, in her 90's, was so proud of living in the retirement section of her facility. And, like Mrs. Bayless, she didn't want her life extended by emergency medical treatment, surgery, or hospitalization (although she didn't mind taking pills).

The family says that Mrs. Bayless signed a contract and she knew what services she would and wouldn't be getting. I also read that the nurse wasn't hired as a nurse -- that wasn't part of her job function.

FWIW, it turns out that Mrs. Bayless died of a massive stroke; getting her heart restarted wouldn't have helped with that.

[AnotherMcIntosh]

77. You may be right. But I think that the posters divide between the know-it-alls and those who are

willing to consider facts and apply reasoning.

The know-it-alls readily want hangings first, trials afterwards (if at all).

[HiPointDem]

64. the woman died in the dining room of this community, which has a large staff where full meals are

provided. the 'community' is actually a single building with 24 hour staffing on a larger corporate campus which also has an assisted living facility and a full nursing facility. it's not a bunch of independent houses with a golf course.

[pnwmom]

66. So? The independent living facility has a separate section and separate staff. By law. n/t

[HiPointDem]

70. The same corporation writes all their paychecks. The same person is the director of all the sections

and I'll bet good money there's overlap on the staffing.

Again with the 'by law'. that's bullshit. There's no law saying they have to have completely different staff in every section.

You just make stuff up.

[AnotherMcIntosh]

79. "The same corporation writes all their paychecks." You don't know that. Some workers may be

independent contractors or workers employed by companies that have contracted with the facility.

[HiPointDem]

80. I *do* know that, actually. It's a single facility with multiple levels of care.

Glenwood Gardens located in Bakersfield, California offers Independent Living, Personalized Assisted Living, Alzheimer's and Dementia Care, and Skilled Nursing Care options for seniors.

http://www.brookdaleliving.com/glenwood-gardens.aspx

[HockeyMom]

83. That looks just like our Dining Room

even to what the people living here look like. There is also a game room, pool room, exercise room, library, pool with changing rooms/showers. They plan different holiday themes in the dining room during the year. There are also trips planned by bus to the opera and plays, shopping trips out of town, to gambling casinos and resorts, etc.

No wonder they wanted to vote it to become a "Retirement Community". I suppose it would have cost too much money to start hiring medical staff.

Maybe it is just a California, and Florida, "thing".

[HiPointDem]

89. There's a full medical staff at this facility.

[HockeyMom]

71. Many years ago I did cleaning for people

in a 55+ development. Yes they were houses and there was a golf course, but there was also another section which had assisted living which were condo type apartments. They had dining facilities for both sections. The 55+ people just had to pay for their meals because it was not included and this dining was more like a restaurant.

The women, who I cleaned for, were all well into their 70s and 80s. They wanted to live alone, but just needed some help with cleaning, errands run, etc. This was not provided for by the Management Company in the Independent Living section. The owners/renters had to find and pay for their own help. What they did get, though, was bus service to the supermarket, if they wanted it, to buy their own groceries and help was provided to carry groceries on and off the bus. Lawn maintenance, raking, snow shoveling were also part of the services they received. NONE of these women played golf or tennis. They would never have been able to. They just wanted their independence with being in their own homes to do what they wanted and when.

[mainer]

100. I want to know how this got to the media

Did the 911 operator decide she was going to make this an issue? Who told the news reporters?

The only time, in my experience in health care, that this became an issue with another patient was because some damned right-to-lifer decided to insert himself into a matter between the doctor and the family (who decided not to prolong the life of a 90 plus-year-old with severe dementia). He called the attorney general because the doctors decided not to insert a pacemaker. Raised all sorts of trouble, calling it "murder," and for what? To prolong the life of an elderly woman who didn't even know where she was?

[AnotherMcIntosh]

112. The phrase "damned right-to-lifer" seems to fit this situation exactly.

My money is on the 911 dispatcher.

[Warpy]

103. I wonder who blew the whistle

since the family isn't litigious. It might even have been the nurse who felt hampered by the no CPR policy.

I hope the media hullabaloo dies a quick and ignominious death and leaves this family at peace.

[AnotherMcIntosh]

111. It was a person who had access to the dispatcher's audio tape and the outrage of the dispatcher.

What are the odds that it was the dispatcher?