The firestorm controversy regarding the refusal of a retirement community nurse to administer CPR to an 87 year old resident of its independent living section has been fueled, in part, by faulty media coverage. On the morning of March 4, 2013, I heard a reporter on a local news radio station in Chicago refer to the Glenwood Retirement Community in Bakersfield, California as a “nursing home,” which is a mistake. Many national news announcers made the same mistake. The more accurate terms would have been “senior retirement community” and “independent living.”
The distinctions do make a difference — not necessarily for the moral and ethical implications of the case (which are gravely serious and merit solemn discussion in a nation founded on life-affirming Judeo Christian values), but for the majority of Americans who might not understand the wide range of senior living options.
Glenwood Gardens is a community that offers independent living. The independent living unit where the decedent lived does not require any sort of licensing. Glenwood’s licensed assisted living units and nursing home are located on adjacent property. The independent living facility is not unlike a regular apartment building. Its residents are supposed be able to function with very little assistance except, perhaps, for some meal preparation and housekeeping help. Therefore, during the widely reported incident, the Glenwood nursing staff member was following business protocol when she called 911. Her choice not to administer CPR to the resident who later died is something that she will have to live with for the rest of her life.
If the resident in question had been living at a licensed assisted living community in the State of Illinois, the circumstances would have been a little bit different. The assisted living communities provide 3 meals a day and help with activities of daily living such as bathing, dressing, transferring, toileting, eating, and walking. According to the Assisted Living and Shared Housing Establishment Code in the State of Illinois:
a) The establishment shall have staff sufficient in number with qualifications, adequate skills, education and experience to meet the 24 hour scheduled and unscheduled needs of residents and who participate in ongoing training to serve the resident population. (Section 35(a)(3) of the Act)
b) The establishment shall have on duty at all times at least one direct care staff person who has obtained cardiopulmonary resuscitation (CPR) training specific to adults, which includes a demonstration of the individual’s ability to perform CPR, and who has current certification in CPR.
c) At the starting date of employment, each direct care staff member shall be 16 years of age or older.
The residents of a nursing home usually require total assistance with all of their activities of daily living and have some sort of health complication like a feeding tube or tracheotomy. The staffing requirements for a nursing home dictate that a Registered Nurse or Licensed Practical Nurse be on staff for 24-hours every day of the week. The direct care staff or Certified Nurse Assistants are required to complete courses that include training in CPR.
As a senior living advisor, I always make certain my clients understand the differences between the varied levels of care. I also work to summarize for and explain to my clients some 400 evaluation metrics that help identify whether any given community or nursing home is right for them and their projected needs. These are measures of quality, service, and skill that I have personally researched and painstakingly reviewed.
Usually, making the right or wrong decision about senior living options is not a matter of imminent “life or death.” In some respects, the Glenwood case was exactly that.
ADSLA is here to help seniors and their families choose the best living in senior living options.