This
uncomfortable, ethically questionable, confusing scene over Ms. Bayliss’ end of
life did not have to happen the way it did.
If you don’t want to be in that kind of situation, you need to be
responsible for deciding what you want and communicating it to those who will
have to act on your behalf.
You may have heard about a
rather unfortunate story that came out in the news a little while ago. It’s the
story of Lorraine Bayless and the Glenwood Gardens nursing home.
Spoiler alert: Lorraine fell
into cardiac arrest and the facility was utterly unable to administer CPR,
despite the pleading 911 operator. Why? “Company policy.”
This matter has been taken up by
Forbes in two recent articles, by two
different authors. The first, by Howard Gleckman, is titled “The CPR Death At Glenwood Gardens: What
Really Happened And Five Lessons You Should Learn.” The second Forbes article is penned by Carolyn
Rosenblatt and is titled “Nurse Refuses To Give CPR, Senior Dies:
Ethical Problem Or Legal Issue?”
Here are four key facts
regarding this story. First, Lorraine was having a stroke and CPR was not
likely to help her. Second, the “nursing facility” was actually an independent
living facility without skilled nurses. Third, Lorraine herself had not wanted
a long drawn out passing; and fourth, Lorraine and her family already had
arranged for a Do Not Resuscitate (DNR) order.
Against this backdrop, each of
us needs to know two fundamental wishes when it comes to our loved ones:
1) What does your loved one want and need in a
facility? Since the facility in question was not an actual nursing home and
the “nurse” was not actually a skilled nurse, the staff was not allowed to
perform CPR, both by “company policy” and by law. There are many types of
facilities with varying degrees of medical or personal care. Truly, to be in
the “wrong” facility may mean not limiting the care your loved one may want.
2) Likewise,
what does your loved one want (or not
want) when it comes to end-of-life measures? What decisions has your loved
one made regarding emergency care, resuscitation, breathing or other
life-sustaining apparatuses? Lorraine purposefully had a DNR, had made her
decision, and her family clearly knew her wishes. Nevertheless, there are many
additional considerations when it comes to making and communicating your
wishes.
As you might imagine, it’s best
for your senior loved ones to commit their wishes and decisions to writing. The
most common form is known by many different names, but is simply a written
record of their healthcare directives made in advance. As with financial
matters, your senior loved ones also will want to sign a durable power of
attorney for medical matters and appoint the “agents” they know and trust to carry
out their wishes. Another document to evaluate is the Physician’s Orders for
Life Sustaining Treatment (POLST), often also called Medical Orders for Life
Sustaining Treatment (MOLST).
Regardless, the object of these
kinds of documents is to empower your senior loved ones to inform their loved ones, doctors and medical
facilities about their wishes now so those wishes can (and will) be carried out
later. Note: Once executed, copies of the health care directives should be
liberally distributed among agents, non-agent family members, doctors and
medical facilities. As these end-of-life wishes also are emotional decisions,
it is best if everyone concerned is informed rather than surprised.
This end-of-life planning isn’t
just for senior loved ones. Have you made your wishes known through proper
legal planning? The best way to encourage personal responsibility in others is
to lead by example.
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Reference: Forbes (March
8, 2013) “Nurse Refuses To Give CPR, Senior Dies:
Ethical Problem Or Legal Issue?”
Forbes (March 6, 2013) “The CPR Death At Glenwood Gardens: What
Really Happened And Five Lessons You Should Learn”