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Family: Woman denied CPR did not want resuscitation

By Tracie Cone

Associated Press

LAST UPDATED: 12:43 a.m. HST, Mar 06, 2013

SACRAMENTO, Calif. >> A woman who died after a nurse at her elder home refused to provide CPR had chosen to live in a facility without medical staff and wanted to pass away without life-prolonging intervention, her family said.

Lorraine Bayless' family said in a statement to The Associated Press that it does not plan to sue the independent living facility where the 87-year-old woman died last week.

A 911 tape recounts a dramatic conversation between a dispatcher and a nurse who refused to cooperate with pleas for someone to start CPR as firefighters sped to the scene. In the 7-minute, 16-second exchange, the dispatcher insisted the nurse perform CPR or find someone willing to do it.

The home's parent company said in a statement that the employee wrongly interpreted company policy when she declined to offer aide.

"This incident resulted from a complete misunderstanding of our practice with regards to emergency medical care for our residents. Glenwood Gardens is conducting a full internal investigation," Brookdale Senior Living said, adding that the employee was on voluntary leave during the process.

City fire officials say Bayless did not have a "do not resuscitate" order on file at the home. Her family said, however, "it was our beloved mother and grandmother's wish to die naturally and without any kind of life-prolonging intervention."

Glenwood Gardens is an independent living facility, and company officials say no medical staff is employed there. The woman who identified herself as a nurse to the dispatcher was employed at the facility as a resident services director, the company said.

The nurse's decision has prompted multiple state and local investigations at Glenwood Gardens in Bakersfield.

The California attorney general was "aware" of the incident, said a spokeswoman, Lynda Gledhill. Bakersfield police were trying to determine whether a crime was committed when the nurse refused to assist the 911 dispatcher looking for someone to start CPR.

The nation's largest trade group for senior living facilities has called for its members to review policies that employees might interpret as edicts to not cooperate with emergency responders.

"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."

Bayless collapsed in the Glenwood Gardens dining hall on Feb. 26. Someone called 911 on a cellphone asking for an ambulance to be sent and eventually a woman who identified herself as a nurse got on the line.

Brookdale Senior Living said in a statement that the woman on the 911 call was "serving in the capacity of a resident services director, not a nurse."

The Tennessee-based parent company also said that by law, the independent living facility is "not licensed to provide medical care to any of its residents." But it added later that it was reviewing company policies "involving emergency medical care across all of our communities."

Bayless' family said she was aware that Glenwood Gardens did not offer trained medical staff, yet opted to live there anyway.

"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's statement said.

The death shines a light on the varying medical care that different types of elderly housing provide — differences that consumers may not be aware of, advocates say.

Even if independent living homes lack trained medical staff, some say they should be ready to perform basic services such as CPR if needed.

The California Board of Registered Nursing is concerned that the woman who spoke to the 911 dispatcher did not respond to requests to provide aid or to find someone who might want to help.

"If she's not engaged in the practice of nursing, there's no obligation (to help)," agency spokesman Russ Heimerich said. "What complicates this further is the idea that she wouldn't hand the phone over either. So that's why we want to look into it."

"I would certainly hope someone would choose human life over a facility policy, said Robyn Grant, director of public policy and advocacy at the National Consumer Voice for Quality Long-Term Care. "That's pretty rotten."

The family said it would not sue or try to profit from the death, and called it "a lesson we can all learn from."

"We regret that this private and most personal time has been escalated by the media," the statement said.


AP Science Writer Alicia Chang contributed to this report from Los Angeles.

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cojef wrote:
The quote from a family member says a mouthful on how the media can inflame public sentiment into a frenzy. Many bloggers castigated the the person carrying on the conversation with 911 operator. Cool heads did not prevail. Sometimes we get carried away with information overload. Me included as I had misgivings about how ishould conduct myself given the same situation.
on March 5,2013 | 04:45PM
st1d wrote:
to witness DNR in action is difficult as you tell yourself that you are honoring the decision of the patient. for those who are not aware of the patient's decision, it must be harder to accept the inaction of witnesses and medical staff who are aware of the patient's decision. i hope with the DNR now revealed, that the 911 dispatcher, the press, the public and california state officials step back and reflect on respecting the patient's decision.

final passage is not easy to witness knowing that some assistance could extend the patient's life. but, extending the life of any DNR patient leaves the quality of that extended life in question.

the patient's decision to DNR should be honored.

on March 5,2013 | 08:28PM
Kate53 wrote:
Except the patient didn't file a DNR with the home, or with anyone else. There was no DNR. We have no idea what the woman wanted other than what the family said. It may be cynical of me, but given what we read and see in the news every day, my first question is: How much does the family inherit?
on March 6,2013 | 04:40AM
st1d wrote:
you don't need to "file a DNR" all you need to do is inform the medical facility that you wish to be DNR. the only thing a filed DNR does is to give family members a guide to your decision. if all family members are informed of your DNR decision and agree, that's all it takes.

your first question speaks more of yourself than it does of this woman's family.

on March 6,2013 | 08:36AM
marilynblee wrote:
Everyone should have a living will or a medical durable power of attorney, and apparently she did. The uproar was unnecessary!,M
on March 5,2013 | 09:43PM
Kate53 wrote:
"City fire officials say Bayless did not have a "do not resuscitate" order on file at the home." No, she did not have a DNR.
on March 6,2013 | 04:42AM
shee26 wrote:
Just a good example of how skewed the media is about reporting these kinds of stories. Yes, big bad nursing facility, always bad and evil. Thank goodness the family spoke up. The sad reality is that even if you have a DNR, it doesn't mean that it will be honored unfortunately. Care providers are so afraid of litigation that they will prolong and continue their life regardless of their last wishes spelled out legally. Glad this woman went in peace with her very last wish fulfilled. Shame on the media for demonizing the nurse who called in to the EMS.
on March 5,2013 | 09:54PM
BluesBreaker wrote:
CPR isn't what I think of us a typical "life-prolonging intervention," except in the most literal sense. What if the patient's bed caught on fire? Would putting it out be "life-prolonging intervention"? Strictly speaking, yes. But I'll bet most people would interpret that phrase to mean a person in a vegetative state begin put on a respirator, instead of letting them die naturally. It seems like an awful lot of latitude in interpretation. Did the family really interpret the patient's intentions correctly?
on March 5,2013 | 09:54PM
st1d wrote:
moving a patient out of a burning bed is appropriate for a Do Not Resuscitate patient.
on March 6,2013 | 02:11AM
Randz808 wrote:
Very good example!
on March 6,2013 | 02:34AM
agumakiki wrote:
Why bother to call 911 if it's against company policy ? ?
on March 5,2013 | 10:25PM
st1d wrote:
" Someone called 911 on a cellphone asking for an ambulance to be sent and eventually a woman who identified herself as a nurse got on the line."

it wasn't the company that called 911, but another person who eventually handed the call over to the company representative.

on March 6,2013 | 02:13AM
Skyler wrote:
I can understand the concerns the CBoRN has, and since the lady that died didn't have a DNR order on file with the company, it makes sense to look into it... especially because of the implications on current & future living facility occupants. Must have been horrible for the 911 operator who was so desperately trying to save the old lady's life, only to have the person on the other end of the line being totally uncooperative..
on March 5,2013 | 10:26PM
likewise wrote:
If I manage to live to the ripe old age of 87 with dignity and some measure of quality of life I would be royally p. o. 'd to wake up and find myself hooked up to machine's, wearing a diaper and no longer able to do anything for myself. This is why I too would look for a facility such as this one. At 87 this lady was not going to wake up, jump out of bed and join the shuffleboard game. What ever reason for her collapse, at 87 the chances of recovery to an extent that makes like tolerable was slim to none.
on March 6,2013 | 06:57AM
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