I heard the 911 call on the news. This is unacceptable and the staff member should be charged! Period!

if the woman was breathing....even if it was "troubled breathing" she is not in cardiac arrest and CPR is not warrented. thats where I start.

When the woman and her family signed the contract stating that they would call 911 but not perform CPR for residents, she was accepting these terms and may have actually choosen the facility for that reason. About calling 911; it is the law for the facility to call 911 in many states, and for the medics to determine course of treatment for their patient. How unkind it would have been to bring this woman back to face the end again at a later date if her understanding was that she would be allowed to die naturally within the senior community.

There is a new development in the case. The daughter's comments that she was satisfied with the care received at the facility were taken out of context, she said. She went on to say that she was not satisfied with what happened and would not comment further. So we can retract the idea that her daughter was satisfied. The mother did not have a DNR order. This is starting to look pretty bad for the care facility.

911 put it out. It wasn't gossip. The media hasn't done anything. This woman maybe has died for a better cause, just so this could get on tape. The 911 operator was protecting herself, tg.
I prefer to put myself in one that will allow me to live because I am sick and 65 years old. I can think of a better place to be than Bakersfield. Truthfully, I don't want to die this way. It just makes me very, very sad. I deserve better as I believe this lady did to. How many people would walk by a petite dog on the street faintly breathing and just walk away? As a personal preference I would prefer to die in bed with out someone gawking over me. I'm sure alot of women my age feel the same way I do. This is something out of a horror movie and I really don't have anything else to say about the matter, either people get it or they don't and I prefer to stay away from the ones that think it's cool to gawk over a senior lying on the ground helpless, they should have at least bent down and prayed over her or would that be bad too? Just a silent prayer, maybe?.

I have read all the comments on this thread and I think many are over reacting to what the media has put out there to sell and bad mouth senior living communities. We don't know the whole truth of the situation and saying that because the family is happy with how things were handled is murder, is just wrong. We have no right to judge and the truth is, we will never get the whole truth because the media will put out bits and pieces of info to stir a public outcry so they can make money. Let the family family grieve in peace!!!

When I told my dad's emeregency room dr. not to treat, he had to be very careful because it is against the law in North Carolina as in any state. He did give him the three pints of blood. He was bleeding from the stomach. It would have gone on and on. It was very sad. I guess if her family is okay with it, murder, then it's okay.
Legally it's against the law to not treat an emergency. This was an emergency.
Even with a DNR. Legally you have to treat.
The medical examiner knows this woman's condition I bet. You're right, we don't know her condition as no one knows My father was lingering, this woman was eating. My dad was on a gastric feeding tube for 8/9 years, had pneumonia and the antibioticis caused bleeding in the gut. The physician withdrew antibiotics and my dad died from pneumonia because the medicine was killing him anyway. It was his time.
This woman was not even given a running start. I will never go to this nursing home. It was run like a prison.

For those of you who want to read an interesting article on this topic do a search for When CPR for the Elderly Becomes Morally Gray

I find the debate about the value of CPR in the frail elderly interesting and I would like to hear from those in the field, emergency rooms, 911 responders as to whether or not they would want CPR performed on their family members of xx age with xx conditions. However for those of you who are sure you don't want CPR for yourselves or know your family members don't want it (and you might be surprised at the answer) , what about other life saving measures, such as stopping bleeding or performing the heimlich manuever if choking? Because it appears the issue in this situation is not whether this woman had a DNR but did this facility have a policy that staff is not to come to the aid of residents in an emergency other than calling 911, no matter what the medical emergency might be and if they have such a policy would an employee who would want to try to help, be punished if they did?
On the subject of DNR, I'm the first to admit I find it very confusing when a dr asks if my elderly family member, who is not in a nursing home or on hospice wants a DNR. Because DNR to me is for those who are terminal or have no quality of life, which is, unless age is considered a terminal condition, not the immediate case. Yes, she needs assistance round the clock but still has quality of life. Now if the medical community comes forward and says they no longer recommend CPR for a person of xx age because in most cases it does more harm than good, then I would take that into consideration and try to explain it to my family member. But I'm not sure I want to be surrounded by people who fear being fired if they try to help me or my loved one in a medical emergency, unless I fully made it clear I or they don't want to be saved. And the other issue is, for anyone who has experienced death in a person or an animal is death is not often quick. With an animal is dying or suffering, it can be euthanized. So I guess I will continue to call 911 whenever I'm around an emergency and take it step by step. Obviously every day people have medical emergencies and passerbys don't often rush in and I'm not sure we should always expect them to , but because this was a facility where the aged lived, one might expect there would be either equipment or trained staff to handle some medical emergencies or at least follow the instructions of the 911 operator unitl help from 911 arrived. Or at least they should offer ongoing counseling to residents explaining the facility policies clearly and offering information about about DNRs or as the above article mentions, a Physician Orders for Life-Sustaining Treatment (POLST), which states what kind of medical treatment patients would like to receive. I've never heard or a POLST until I read this article. I guess my fear having a DNR would be if I was choking or some other recoverable emergency made me unconscious and I was in a facility such as this one and no effort would be made to try to determine why I am unconscious because of a policy. Another concern is what if the facililty caused the neglect. I've been a visitor in hospitals and nursing homes where food if left for a person who obviously can't chew or is too low to eat properly. If they choked, would the facility activitate the DNR and do nothing b/c, after all the person is old and in the hospital w/o trying to check for lodged food. I guess that's my main worry about DNR.

I think that, perhaps, was the "tone" the staff member had when responding to the 911 operators questions. While one can not suppose to know what this individual was actually feeling, she comes across as very uncaring and uninterested. Perhaps she was deeply upset by the fact she could not administer any assistance, however that is not the impression she gives.
Maybe if she sounded more concerned when speaking to the 911 operator she wouldn't be the subject of such personal critism.

I'm afraid that the news just gave people enough information to incite an angry response, but not enough to form any logical conclusion. That is what the news has come to. It is all about the emotional response now instead of investigation. That comes later, but few people do a follow-up in their reading. I'm sure we'll hear even more about this on down the line, but we'll have to look for it.

I think everyone needs to know the facts before accusing anyone of any wrong doing. My mother is in an AL/independent living facility. they are required to call 911 if the resident in unresponsive and that is it. My mom is 94, has a dnr and yes the facility knows that and she carries a copy in her wallet also. She does not want CPR.

So, I guess what you're all (except for mikki3est8s) saying is DNR, etc. just let the elderly, infirm, etc. die no matter what it takes? Don't let them linger, don't call for help, just push them over to the side and move on with your business (life, etc.), and they'll go on into the great beyond as if they were never here??!! Yes folks, this now what our world has come to, but those here saying the facility was right, and so on, the day is coming for you as well, and in your cases it just might end up being even worse than this. Come quickly Lord Jesus.

Doing CPR on an old person is not as simple as doing it on someone young. Chances are great that the ribs will be broken and perhaps puncture internal organs. Old bones can be very fragile. If they had had a defib machine, then maybe they could have given it a try.

When we were told the story, we got the feeling that the lady was going through a lunch line and had happily consumed a meal. We aren't told her history. Had she had other strokes? Did she have a disease? Was there a DNR? We don't know enough to decide if this was wrong or right. All we know is her daughter did not find fault and say she was not going to sue. Her daughter knows better than I do.

Did they actually have time to look for a DNR while she was there dying? They couldn't possibly know if everyone in the community does or does not have a DNR on file. No Excuses. Help while you can and by the way... what took the EMT's so long to get there? They should have been dispatched as soon as the call came in.

Many people have been trained in CPR, nurses especially, but it's imperative that the nurses in the facility know about a patient's DNR wishes before they even begin working with them. Do we know this patient had a DNR? Is the facility trying to avoid lawsuits (i.e., so that the owners of this facility can maintain a profit margin)? Irrespective of the previous comments, I can't imagine anyone not performing CPR on someone who obviously needs it; it's unethical according to the Hippocratic Oath, as well as showing no compassion. Of course people should read all the interminable legalese involved before signing any facility's documents, but so many people who 'trust' these facilities to wholly take care of them without having an advocate to slog through all the paperwork. I guess my bottom line is that so many are reacting to this case as more of a clinical or legalistic standpoint rather than a compassionate one. I just hate these facilities that are run by limited partnerships who obviously expect a profit from their investments; I often wonder if they truly care about the residents in their facilities, or are more interested in making (or saving) money.

To be clear, there is nothing in the article suggesting the lady had a signed DNR order or an advanced directive. Either way if she was well enough to eat in a dining room and the nurse did call 911, why did she call 911 if the plan was not to help. Once the call went in to 911 to stand by with a medical license can't be correct. Since she may have passed even with assistance --what is the justification for not assisting?

Many people, my self included, have advanced directives. If I start chocking on a piece of meat at a diner, I don't expect to be ignored . A DNR and advanced directives commonly are under consideration when the person is very ill, and does not want their painful road extended.


Elizabeth

I say take Liebermann and stick her in a nursing home for a decade or two strapped to a wheel chair and see if she wants to live that way another 10 years? Who is she to say that nurse should be fired and criminally charged? The lady was 87 years old. If I were 87, living in a nursing home and died/dying or natural causes and someone kept reviving me - I'd fire them. The dispatcher should be fired for being so emotionally involved and unrealistic! And how did this go on for 8 minutes? If the dispatcher wanted someone there, get someone there, don't suggest someone from the streets. And yeah, a person is going to come in off the streets and do CPR on a fragile 87 year old body.
My dad is in a very nice facility, he is 80, and he HATES it. He has friends there, good meals, great staff that rarely changes, and he still wants to die. Believe me, if he dies and they revive him,,,,,,, he is going to wake up MAD.

That nurse should have called 911 requested and ambulance and hung up.

I read a later statement that the woman had a stroke, so CPR would have not have helped. The daughter made a statement, as discussed already, that she was satisfied with the level of care. The mother didn't want unusual procedures designed to prolong her life. I was sorry to see that the facility is backing down from their original statement on their policy. The staff person was put on voluntary leave pending further investigation. In this case it seemed to be a good call if it is true that the woman had a stroke severe enough to stop her heart that quickly. I personally can't think of a better way to exit the world -- quickly and with little apparent pain. I am sorry that the papers got hold of the news and took the privacy away from the family at a difficult time in their lives.

One issue that has not been mentioned is our society's fear of death and desire to postpone it as long as possible, even when quality of life is or will be poor. In this instance, performing CPR on a 87 year old woman is vitrtually guaranteed to result in broken ribs, bruises, intensive care, and death fairly soon, but after huge medical bills and extreme stress have been generated to leave to the family. Even with young people, the survival rate for people who have had CPR performed on them is quite low, although trying everything possible on a younger person makes sense. For an older person at the end of their life, it does not.

Yes, 911 is always called in order for the paramedics to show up with their equipment. The way that I was taught is: CAll 911, give all important data. Hang up. Start CPR.

More importantly, the elderly need to know up front if they will get such help if needed. If these assisted living or elderly housing communities are not willing to help in such situations, then the elderly should refuse to enter them. If the owners of such places see a hit to their profit margin, you will see them having
both RNs and the correct legal backing to provide it.

Letting the lady die because of a heartless, legalistic policy is wrong headed. But change will come if it interfers with their all important profit margin. These are capitalist not caregivers.

Elizabeth

I wondered about DNR when I heard the story. I also wondered why they called 911 if they were not going to do what 911 told them to do .......should they have even called for help?

Rosewoods: What do you think that those people do all day, sitting at their desks when there are no calls for assistance......THEY CHECK THE CHARTS.
When a resident goes into distress, they already know who is who, and who gets what. No need to grab paperwork. Charts are also on the computers.

Whether this patient did or did not have a DNR on record, the facility itself has a policy in conformity with all Independent Living Facilities. The patient, at age 87, should have been moved to an Assisted Living Facility where CPR is performed. The life-saving procedure could have been performed by anyone who was trained to do so, whether or not the I.L. facility has a policy or not/ All of us are trained in CPR.

I share many of the same thoughts and questions raised here and until more is known - if we ever heard all of the facts - I am not sure what to think about the situation. I understand and appreciate DNR's as a caregiver who had one in place with my mother and father at their request and as someone who was a paramedic who has preformed CPR. I do question why EMS was called in the first place if the resident had a DNR in place. The paramedics have a obligation to treat if a DNR cannot be produced or there is any question. I did not hear the nurse tell the dispatcher the resident had a DNR in place. All I heard was the nurse continue to tell the dispatcher that their facility did not do CPR and that she or no one there could or would start CPR. Even if the facility is not a medical facility, I also still do not understand why the facility does not do CPR or how a nurse is not obligated - even if it is only a moral obligation and not a legal obligation on the part of the nurse - to begin it depending on if there is a DNR or not. Even if the resident's daughter was okay with the way it was handled, I would not be surprised if there is an outside investigation about how the facility acted.

My Mom lives in an Independant Living Community. She has often told me that she would NOT want CPR started on her. What does she need to do to insure that her wishes are followed? She has a living will and advance directive, but who is going to run and check documents should something suddenly happen?

If you have read what CPR does to an elderly, frail person, you wouldn't wish this on your mother. The stats are clear. Many in Canada are fighting for the right to die in dignity. The daughter is satisfied with the situation. That should be the bottom line. Good article! I wrote about this, too: Senior dies after nurse refuses to give CPR

"The strength and durabillity of a society can be judged by how it treats its elderly." John F. Kennedy

What kind of family is OK, with Mom collapsing on the floor, still breathing, and left to die?

Hopefully, the State of California will intervene in this "situation."