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...

[azureline**]

cheap? it is if he has a home worth that much, which he doesn't and our preferred place is not bonded.

[rosieglen]

Accommodation Bonds in Mainstream High Care? Currently (as from 20th March 2013) there is no accommodation bond applicable if a person enters a mainstream (general service) high care home.

However, this situation is expected to change if the current Productivity Commission Submissions recommend that bonds are applicable in all level of Commonwealth subsidised residential care.

In 2008, Aged care providers refused to take up over a third of the new bed licences issued by the Commonwealth because they cannot afford the cost building and staffing new facilities.

This is not surprising since 40% of high care providers now operate at a loss. The Hogan Report into Aged Care Funding arrangements found that a fair, efficient and sustainable solution to the problems facing high care nursing homes was to extend the existing accommodation bond system, and allow 'high care' nursing homes to charge residents a bond to offset the cost of their care, as well as fund the construction of additional capacity.

Bonds can currently be levied by aged care providers for places in "low-care" facilities. This has led to spectacular growth in that segment of the aged care market. Demand for high care beds will increase over the next 20 years as the proportion of the population aged over 85 expands.

The Hogan Report found that the uncertainty the inability to levy bonds creates discourages investment and restricted long-term planning and development decisions. The high care sector is already heavily dependent on taxpayer funding.

The Commonwealth government will not be able to provide the estimated $27 billion capital required over the next decade alone to expand and modernise high care facilities.





 

[azureline**]

Rosie, it was ARCARE who called me, there is a vacancy at Peregian Springs that would have suited but she was quite specific this morning when she called, she stated that "there is a bond of $2000,000 for their high care places and residents must be left with $43,000 so he needs to have $243,000 minimum .

What you have posted says differently?

[cherples]

I have done CPR on elderly- it feels awful to feel the ribs 'groaning' and cracking. The old bones are just so brittle.

I have never seen an elderly person survive.

I have. The old person was already in a nursing home (before new system with different care levels) and after CPR they spent 3 years bed bound, unable to communicate, waiting for another chance to die in peace.

[azureline**]

It appears that Nursing Homes with high care places that offer extra services charge a bond.

Extra services? what are they?

A better class of service, room furnishings, more high class hotel type she says.:|

I have an apt at 2pm to view a vacancy close to us.

[azureline**]

I could cry :_| they have a bed for him.... but it's horrible....... it smells enough to make me gag........

The "living/dining/activity" room was reminiscent of the one in Prisoner.......(tv show) the rooms are tiny and shared. The outdoor area is minuscule.....

I took paperwork for it but told my OH and his sister it is their call.... but I say no.

[polksaladallie]

I could cry :_| they have a bed for him.... but it's horrible....... it smells enough to make me gag........

The "living/dining/activity" room was reminiscent of the one in Prisoner.......(tv show) the rooms are tiny and shared. The outdoor area is minuscule.....

I took paperwork for it but told my OH and his sister it is their call.... but I say no.

Sounds awful.  Keep looking, something OK will come up. Is he somewhere now that you all don't like? 

Azure, do you live on the Sunshine Coast?  I ask because you were talking about a Peregian Springs home.

[kengillard]

Think Az lives further south a bit allie

[kengillard]

Most dementia places smell......incontinence etc.  urine mostly.

[azureline**]

No, not Sunshine Coast, between Brisbane and Gold Coast but will take whatever we can get if it is good.

He is getting good care where he is, no complaints about the home or his care, we want him closer so we can see him daily as he is needing that? He is unhappy about being visited weekly.