I assume most of us have already heard the news story over the weekend of the 87-year old woman who collapsed at an "independent living facility" and the 911 dispatcher pleaded with the nurse (LVN? RN?) to do CPR but per company policy, she refused. A DNR was not the issue. Just a no-CPR, let EMS respond to any medical situations policy.

From a common sense perspective, it sounds outrageous. But I didn't really want to scream and shout about that aspect of the story, otherwise I would've posted this in the Campfire.

I was wondering if there are other situations out there where a no CPR policy like this exists? My mom is getting up in years and eventually may end up in a situation like this. I just wanted to find out about other situations like this.

Apparently, the residents at this facility are all told of this policy up front when they sign up. But what about guests? Are there other places we go where we definitely will NOT be getting CPR or maybe even basic first aid per company policy? I'd just like be aware of this in places I or my mom frequent.

Tough situation. My 92 year old MIL is in an independent living facility, and she has a DNR already. I can also understand the policy too -with nearby FD / EMTs to assist and assess I would prefer their response to my 87 year old mother. CPR on the aged can be wicked brutal. Not how I want to go, frankly. Tough call Arney. My perspective on life saving measures changed once I passed 50 and watched parents and friend age and die in different circumstances. I saw my dad die in assisted living, and I'm watching my wife go very slowly of brain cancer. So I can envision this policy, but can't tell you if its the right one. Possibly start with a deep breath, and the old adage, judge not lest ye be judged.

I'm not necessarily saying it is a bad policy. But I'm saying that we should be aware if such a policy exists because it runs counter to what a normal person would expect. I'm still middle aged and still have (knock on wood) many, many years ahead of me, but heaven forbid, if I went into cardiac arrest visiting someone at such a facility and was falsely comforted thinking that there are nurses around, that would be a bad situation because of some blanket policy. At least at McDonald's, I have a chance that a concientious employee or employees will do CPR and hook me up to an AED in case EMS is delayed.

Death is a part of everyone's life but we in the US are terrible about talking about it. Technology and science has gotten way ahead of our ability to deal with death. DNR's, assisted suicide, palliative care, etc. are all important subjets to talk about, but these topics too often get turned into political hand grenades to score election points, unfortunately, and no one really takes the time to actually listen to other viewpoints.

And the consequences of doing CPR on a frail, osteoperotic 87-year old woman is certainly something I sympathize with, DNR or no DNR. But this policy, apparently would also apply to me or my very healthy 67-year mother, too, even if we happened to be visiting and something happened. Just saying we should know when such policies are in place.

I'm sorry to hear about your wife, Lono. That's a tough thing to have to go through.

The thing is that you need a policy on this kind of stuff.

Logically, it makes sense for an assisted living facility not to provide medical care to its residents as they are not licensed to do so.

As I understand it, they will pickup your drugs at the drug store for you but they are not allowed to take them out of the bottle for you as that would be considered dispensing.

It is one thing to have a clear policy of "We are not a hospital or emergency room and are not required to provide any emergency medical care." so that people don't have false expectations. However, this company's policy, or its interpetation, has gone to the extreem.

In an excerpt from the 911 tape, the desperate dispatcher pleads with the nurse to hand the phone to a passerby. The nurse flaty refuses. To the OP's point, one must wonder that if a good samaritan tried to help, would the nurse have interpeted the policy to mean she must prevent him from doing so?

Would a security guard at a shopping mall with a similar policy, for instance, hinder a passerby who tried to help?

Keep in mind that an independent living facility provides zero medical care as its services- most often it offers a living space for a monthly rent, until you move and/or die. Folks I am familiar with in that situation pray to someday *die* there rather than face the relative unknown of assisted living or a nursing facility, where you can receive CPR, if you want it.

The most typical FD response at my MIL's place is a lift after a fall, happens almost daily. The facility is among the most humane places for the elderly I am familiar with, but no way are they going to assess and lift a person on their premises. I don't mean to load the discussion with the L word, but there are plenty of residents and families of residents who are too quick to hold any facility liable for a bad assessment of their parent, or for pain and suffering afterwards. Risk managers will tell you that there are words for facilities that go beyond policy for their residents, and those are 'out of business.' I suspect the same level of care calculus extends to life saving measures, but I have no specific experience with that.

Is this perhaps a liability issue? If the nurse had performed CPR or enlisted a third party to perform CPR, would a liability issue arise?

A nursing home is licensed to provide medical care. An assisted living facility is not. It is that simple.

I don't know why the "nurse" on the phone refused to give the phone to a bystander. We are kind of assuming it was a real nurse, but for all we know it might well have been the receptionist or the bus driver that called. Why would an assisted living place have a nurse anyway? Most that I am aware of don't.

naval officers have a responsibility under both law and naval regulations to take care of those they are in charge of. An assisted living facility is generally banned from providing any medical care to its residents.

Update: She was the "resident services director"

All kinds of businesses and facilities have AEDs and even a team of employees designated to provide first aid and none of them are "licensed to provide medical care".

It appears like a peculiar policy when viewed from a distance without knowing the specifics.

Businesses are often required by OSHA to have first aid trained employees available.