published Monday, March 11th, 2013

Smith: All seniors need to have a living will

By Robin Smith
  • photo
    Robin Smith, former Chairman of the Tennessee Republican Party and congressional candidate.
    File Photo/Chattanooga Times Free Press

The death of 87-year-old Lorraine Bayless, a resident of an independent living facility in California, grabbed our attention last week.

Bayless was at the center of a 911 call placed by an individual who identified herself as a "nurse" but later was noted to be serving in the capacity of a resident services director at Glenwood Gardens, a facility owned by Brookdale Senior Living of Brentwood, Tenn.

For just over seven minutes, the recorded call captured a desperate dispatcher pleading with one who identified herself as a nurse, one qualified to administer care, yet refused to engage in cardio-pulmonary resuscitation (CPR) and refused to allow any other individual present to do the same.

The call was initiated from a cell phone at the independent living center after Bayless collapsed in the facility's dining room.

While independent living facilities are, indeed, not licensed to provide medical care, the only reason emergency care should have been denied this woman in need was a directive in writing, a "Do-Not-Resuscitate" order, prepared by the individual and/or the power of attorney acting on that individual's behalf. This "DNR" did not exist.

After the event, the family of the deceased's said that she wanted to die "naturally" -- but that statement held no authority as this emergency situation unfolded.

The spokesman on behalf of this particular facility later claimed the actions of the nurse/resident services director "resulted from a complete misunderstanding of our practice with regards to emergency medical care." The employee was placed on "voluntary leave" while the company "is conducting a full investigation."

Later, Bayless died. Be reminded, she was denied the most basic of emergency care, not major medical heroics.

The published photos of Bayless do not reflect a sickly, nor frail, individual. Instead, she was neatly dressed and groomed with a Facebook page touting 41 "friends" and acknowledging her high school alma mater in New York State.

Website photos of the Glenwood Gardens facility in Bakersfield, Calif., show a multistoried complex resembling an apartment village lined with palm trees. The website says residents get "specially tailored meals in our elegant dining room by one of our chefs" and are encouraged to "dip in the private community pool or spa" where "our residents receive the best there is to offer" for "an average" of $2,262 per month.

The facility's website goes on to declare the "premiere independent assisted living facility" features "emergency call systems" in "all units to provide access to assistance twenty-four hours a day" with "caring staff trained and equipped to give aid or assistance whenever needed or requested."

Really?

So, what are the lessons to be learned?

Regardless of age, you should have a living will that is legally prepared and available to all individuals who would have any role in your care. Spell it out to avoid your survival being in the hands of a misunderstood policy.

A second, sad lesson is that the value of life among our youngest and oldest is devalued in our culture. Despite the "luxurious features" of the surroundings, the decision to withhold aid to an individual was based on a personal opinion of their usefulness to society at 87 years of age.

Our calloused culture is driven by narcissism, pathological selfishness and an unquenchable thirst for personal comfort. A society is not "progressive" if it is amoral.

Robin Smith served as chairwoman of the Tennessee Republican Party from 2007 to 2009. She is a partner at the SmithWaterhouse Strategies business development and strategic planning firm.

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nucanuck said...

While it is good to see Robin Smith come out for a progressive society, it is hard to imagine that all our oldsters will now hire an attorney and flash their living will at all who may be called on to render elder care.

We will never know whether Ms Bayless would have lived or died, had CPR been administered, but what we do know is that our society spends untold Medicare billions in elderly end-of-life care. It seems that dying with dignity is only possible after the medical profession has wrung every last billable dollar out of our last days.

I was surprised when we moved to Canada where the life expectancy is higher than in the US, that the decision to make the patient comfortable comes sooner and with fewer extreme proceedures than in the US. My information is only anecdotal, but that seems to be the consensus here.

End-of-life care in the US is out of control, IMO.

March 11, 2013 at 1:22 a.m.
aae1049 said...

Having a living will and will readily accessible by loved ones is so very important. I am getting a full set redone, living and will with duplicates to all charged with executing the will and back up's for my family. I also recently pre planned my funeral. After handling the estates of family that had no plan,I wish to make things very easy for my son. So,he can not be riddled whit decisions and be able to focus on saying, 'see ya later." Hey, I don't have much, but I want to make sure the process goes well for my son.

March 11, 2013 at 6:43 a.m.
nucanuck said...

aae1049,

I agree that living wills are a good thing, but that does not mean that they will become universal or even wide-spread. Cost and capacity enter the picture for many.

Also, puting one's affairs in order to facilitate final passage makes complete sense for those who still have the mental capacity to do so. A living will may or may not be part of that process.

March 11, 2013 at 10:44 a.m.
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