Brookdale Senior Living, which operates 42 senior living facilities in Ohio, has promised a thorough review of its emergency medical care policies following the death last week of an elderly woman who was denied CPR at one of its independent care communities in California.
Brookdale, which has 18 senior housing facilities in southwest Ohio — including three in Dayton, three in Cincinnati and two in Springfield — said the female employee who refused to administer CPR despite the pleas of the 911 operator she called for help “misunderstood” the company’s policy for providing emergency aid and has since taken a voluntary leave of absence.
“This incident resulted from a complete misunderstanding of our practice with regards to emergency medical care for our residents,” the Brentwood, Tenn.-based company said in a statement. “We are conducting a company-wide review of our policies involving emergency medical care across all of our communities.”
Brookdale has launched an internal investigation, and law enforcement officials in Bakersfield, Calif., are also reviewing the death of 87-year-old Lorraine Bayless, who collapsed in a dining room from an apparent heart attack and was later pronounced dead at a local hospital on Feb. 26. The tragic incident has garnered international attention.
It is unclear whether the female staffer at Glenwood Gardens, who identified herself as a nurse to the 911 operator, was prohibited from performing CPR. Bayless did not have a “do not resuscitate” order on file at the home that would have prevented the nurse from administering CPR. Her family said Bayless had chosen to live in a facility without medical staff and wanted to die without life-prolonging intervention.
But elsewhere, including in Ohio, independent living facilities are not required by law to provide medical care. By contrast, nursing homes and assisted living facilities are subject to a broad array of federal and state regulations.
The extent to which employees are trained and facilities regulated depends in large part on the level of care provided in different types of retirement communities, said Suzanne Kunkel, director of the Miami University’s Scripps Gerontology Center.
“The underlying principle is that we more heavily regulate situations where we think people need more protection like nursing homes,” Kunkel said. “But most of us still want choice; we want autonomy; we want to stay as independent as we possibly can.”
Senior care operators continue to diversify into different types of facilities to offer consumers more choice when it comes to the level of intrusion they want in their private lives, Kunkel said. But she also acknowledged that dividing into different entities also allows operators to avoid costly regulations that could potentially save lives.
“Of course, following and complying with regulations costs time and money, so I think that’s part of the issue,” Kunkel said. “But I also think these senior care organizations are truly trying to acknowledge the fact that we need different things at different stages of our lives. So, they’re trying to diversify the services they provide.”
Kathy Keller, a spokeswoman for Columbus-based AARP Ohio, said the names and definitions of the different types of senior housing options are often confusing, making it imperative to ask questions about level of care you can expect to receive in different facilities.
“What we’re trying to do is put out information through the AARP publications and through our website to get people to ask questions and not to be uncomfortable asking questions,” Keller said. “That’s the big hurdle. There’s so much paperwork, and so much else to do that people feel intimidated. They feel like they can’t stop the process long enough to get answers, and that can be dangerous.”
But the responsibility rests with the facilities operators as well to be as transparent as possible, Keller said: “They need to make sure that people understand exactly what they’re signing up for and what they’re not signing up for.”