Many in Aged Care Allowed to Die Peacefully without CPR

[grandmoon]

Most nursing home managers and staff do not support giving cardio-pulmonary resuscitation to elderly residents who suffer heart attacks, and the technique has been found to be ineffective in reviving most.

While the policy of most nursing homes is to administer CPR, a survey of managers of the homes by Dr Bill Silvester, who heads the Respecting Patient Choices program based at the Austin Hospital, found fewer than one in five thought heart attack patients should be revived.

The reality was that in three-quarters of the homes no CPR was used in the past year, and in the few where it was, it was used only once, Dr Silvester said. ''It would appear that frequently residents were found deceased or were known to be dying and were allowed to die peacefully"

The results of the study prompted calls for new national guidelines on when CPR should be used.

Dr Silvester said in his analysis of the study findings: ''We would also recommend that guidance be provided on when and how to discuss this with residents and their families. NSW Health state that it is reasonable to withhold

CPR without explicit discussion with the patient or family if a) the resident or family do not wish to discuss it, b) the resident is aware that they are dying and has expressed a desire for comfort care or c) the facility does not provide CPR as a matter of course, consistent with the values and practices relevant to its population.''

Of more than 400 managers surveyed, fewer than 20 per cent thought CPR should be used in cases of ''witnessed cardiac arrest'', despite four out of five homes surveyed having a policy of providing CPR if the need arose.

''This revealed a significant difference between what the staff thought would be appropriate for their residents and what they were expected to do,'' Dr Silvester wrote in the report.

He cited international studies showing that on average fewer than 1 per cent of residents who had heart attacks and were given CPR survived and returned to the aged-care ho me.

He said the use of CPR on aged-care patients appeared to be driven by an expectation of what medical staff needed to do, rather than its effectiveness. ''The reason we did this study was we were appalled at the number of elderly people being resuscitated in aged-care homes and being brought into hospital and ending up in the intensive care unit.

''So we asked the ambulance people why this was, and they said they had no choice. And then we asked the nursing homes and they said it was because of expectation.''

The findings come on the eve of a conference in Melbourne on planning end-of-life medical care.

Read more: http://www.theage.com.au/national/many-in-aged-care-allowed-to-die-peacefully-without-cpr-study-sugg...

[*crikey*mate*]

Polksaladallie, do you know if they would have had to pay to have a spot there? or was it a free thing by the government or something?

[*crikey*mate*]

and a garden. My grandma would have liked to be able to go outside and potter around in the garden.

[azureline**]

The place that we prefer is beautiful, they have their own rooms with ensuite, the only 2 things they must have in the room are the hospital bed and the armchair,( specially designed for safety etc) and they are huge. One lady has a china cabinet with all her lovely tea sets that she uses. She has a piano and her own furnishings, just beautiful.

Another has glass cabinets with the most beautiful porcelain dolls in it. They were all very well dressed and groomed and all occupied with activities when we went to visit, with no notice. We were told to come between 8am and 4pm on a weekday so someone was available to show us the actual unit he would be in.

Praying for a place feels bad.......

[azureline**]

Crikey, most operate under the 85% of pension plus a daily fee up to $42 or a substantial deposit (higher than $150,000) It costs dad around $2000 per month just to live there.

[polksaladallie]

Polksaladallie, do you know if they would have had to pay to have a spot there? or was it a free thing by the government or something?

It was not a government run home, it was private.  Sorry, I have no idea of the fee structure then. 

Even now, if someone is a pensioner with not a penny more, they don't have to pay a bond, but they take a big slab of the pension (fair enough, we should all pay our way to some degree).  If someone has a bit more money, they take all but $35,000 approx.

The fee structure is very complicated.  Azure will know all about it.

[*crikey*mate*]

My grandma wouldn't have had a pension I don't think. Unless everyone got them back then? She had working cattle properties.

Az, that place you mention sounds awesome (as long as the care is good I spose) but it sounds like the place encourages people to want to be alive..

I know you will, but for anyone else reading, when considering this stuff, think about what the person who has to live there might like, eh? My grandma would have liked to have been able to go outside I reckon, and have some of her stuff with her.

[polksaladallie]

The place that we prefer is beautiful, they have their own rooms with ensuite, the only 2 things they must have in the room are the hospital bed and the armchair,( specially designed for safety etc) and they are huge. One lady has a china cabinet with all her lovely tea sets that she uses. She has a piano and her own furnishings, just beautiful.

Another has glass cabinets with the most beautiful porcelain dolls in it. They were all very well dressed and groomed and all occupied with activities when we went to visit, with no notice. We were told to come between 8am and 4pm on a weekday so someone was available to show us the actual unit he would be in.

Praying for a place feels bad.......

That sounds nice, Azure.  Tell us how you are going with it all. 

A piano !!!  I'll be able to take all my Elvis music with me.  😛

[*crikey*mate*]

It was not a government run home, it was private.  Sorry, I have no idea of the fee structure then. 

Even now, if someone is a pensioner with not a penny more, they don't have to pay a bond, but they take a big slab of the pension (fair enough, we should all pay our way to some degree).  If someone has a bit more money, they take all but $35,000 approx.

The fee structure is very complicated.  Azure will know all about it.

That makes me feel a bit better, at least they didn't just dump her there because it was free..

And Az - I meant to write before - I see nothing wrong with praying for a spot in that place if you think it is something your relative will like - I'll cross my fingers and send positive thoughts that they get a spot soon, although does that mean someone else has to die first? In that case it might be a bit morbid and mean?

I dunno, but getting old must really suck.

[polksaladallie]

My grandma wouldn't have had a pension I don't think. Unless everyone got them back then? She had working cattle properties.

I know someone who was fairly well off in about 1974, and every older person got a pension then, regardless of their income and assets. 

[i-once-was-bump]

I don't know about other states but here in WA you need to be assessed before you can get a place in a nursing home and the criteria are pretty strict. We also have what are called 'frail aged hostels' for people who are less incapacitated, but even for this you have to be assessed as unable to care for yourself.

It also applies in NSW thus the reason for my question, I just presumed that the rules applied to everyone and NH places here are as scarce as hens teeth so you don't just decide that you will settle yourself in early in order to be prepared for the years that are to come.