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*]

My grandma had a beautiful old honky tonk iron frame piano. Apparently she got it in 1904 and she carted it on bullock wagons etc whenever her family moved LOL - She used to sit and play it for hours and I can remember my grandpa getting her to play Moonlight and Roses over and over again - he'd always be calling out to her to "play it again Gracie".

And she was always pretending to be cross with me because when I'd play it with sticky fingers or spin around on the stool (it is one of those ones on like a corkscrew that you spin around to make higher or lower)

She would have liked her piano too.

[i-once-was-bump]

The NH my father was in was privately owned and assessed as the top home in the state back when he was there.

One lady had brought her dog in with her and her family used to come every morning and evening to walk the dog.

Weekends there were so many dogs (and my cockatiel) visiting it was like a dog show.

It was a beautiful place.

My father had aroma therapy but we didn't tell him what it was because he probably wouldn't agree to it but he loved it.

[bright.ton42]

Crikey you must have loved your grandma very much,  and miss her now.  :-x

Polksaladallie thanks for your answer to my general question (way back in the thread)

and explaining it. 

Reading here I can see how complicated it all can be , which is a pity, it shouldn't be

like that.  

[azureline**]

We have to wait for someone else to meet their maker, according to the home. 😞

A home I am visiting Friday has pets. 🙂

The one we want, he will have access to a huge garden and some bushland over the fence. At present his area outdoors is just a patio, this is where he scaled the 2m fence. He will love being able to go out to the garden as he pleases, most rooms also have huge windows with nice views.

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.

Same here Bump as in NSW. hard to find suitable places. I had one today but it wasn't secure. I had one last week that was high care but not secure, the week prior, low care but secure.

Minefield and so much time wasted.

[cherry*135]

It does seem a minefield, az. Then when you find something you think suits, no beds available at present.

[*crikey*mate*]

ok - a bit of cross thread referencing here...

so what's the point of doing all this prevention stuff so people can live longer but then there is nowhere suitable for them to go when they do manage to live into old age?

[cherry*135]

Perhaps there are places, but people like az..are concerned enough to find the BEST place for her FIL, so are prepared to wait until a bed comes up in one. 

Not every elderly person ends up in care either.

[azureline**]

That's the thing, there is somewhere to go, the problem is, no one (not many) plan for it ahead of time. Then the family have to find a place, find out how, make decisions, without really knowing what the person might want for themselves.

I didn't have a clue in February, until I asked here and got some info that was badly needed and appreciated. :-x

We now know that Dad was having problems with dementia 2 years ago but some people kept it hidden.

I had assumed you just called one and a place was there. There are services that will find a placement for you but they cost a fair amount.

Sad you have such unhappy memories of your Grandma's last days Crikey but she may have been happier than you think.

[azureline**]

Perhaps there are places, but people like az..are concerned enough to find the BEST place for her FIL, so are prepared to wait until a bed comes up in one. 

Not every elderly person ends up in care either.

yes, exactly, something that suits him, where he will be happy. Ideally he would have lived with us or his older daughter but we realised we are not equipped to give him quality of life, alone. A good care facility allows us to spend quality time with him, take him out etc.

[bright.ton42]

Just wondering -  what happens to people who suddenly need a nursing home but 

have no-one close to find one for them.  Do they have to go where they are put?