Lorraine was found barely breathing by a woman employee of the facility who immediately called 911 to report the medical emergency. The 911 dispatcher, following protocol, asked the woman to give Lorraine CPR while waiting for the ambulance to arrive. The woman employee, who said she was a nurse, refused saying it was against the facility’s policy. An independent living facility, unlike an assisted living facility or a personal care home, is not authorized to provide medical care to its residents. And as it turned out, the woman caller, although a nurse by training, was working at Glenwood Gardens as a resident services coordinator. In any event, Lorraine was finally taken by the ambulance to the Mercy Southwest Hospital where she died. Understandably, following Lorraine’s death, many where quick to condemn the woman caller’s refusal to do CPR on Lorraine as “unfeeling,” “immoral,” “unethical” or “unconscionable.”
Notwithstanding the facility’s policy and notwithstanding her actual job at Glenwood Gardens, many maintain that the woman caller could have given CPR to Lorraine, not as an employee, but as a mere bystander, and she could have done this without fear of suit because of the state’s Good Samaritan laws. Being a trained nurse, they maintain, she knows how to administer proper CPR and should have at least tried resuscitating Lorraine. But should she?
Perhaps because she is a trained nurse, the woman caller knows that she cannot perform CPR, if it is to be done right, on Loraine’s frail 87-year old frame without possibly crushing the rib cage. If you want blood to circulate, you really have to push as hard as you can to compress the chest by two inches inward, and you have to do this at the rate of 100 compressions per minute, and you have to keep on doing this until the professional rescuers arrive. Where already rendered brittle by age, the ribs and possibly even the sternum would have likely cracked. Bone fragments would have likely punctured the lungs. Lorraine would have suffered terribly. For an elderly person, getting CPR can be brutal. An English doctor specializing in adult and elderly health care named Nick Edwards likened it to “going ten rounds with the boxer Mike Tyson.”
Going back to our earlier question: Should you provide CPR intervention to an elderly person who suddenly collapsed and seemed unable to breathe? Whether you give CPR or not, you are legally protected. But are you morally bound? It helps if the elderly person himself has made advance directives for such eventuality like a Do Not Resuscitate (DNR) statement or a Physician’s Orders for Life Sustaining Treatment (POLST). Here you do what the elderly person asks. But what if there were no advance directive, like in Lorraine’s case? Currently, the default option is still to give CPR.
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