Here's a very disturbing article concerning the death of an elder who resided in an independent living facility in California. Despite the rather obvious risk that elderly people living in their facility may have medical emergencies that require CPR or other life-saving interventions,the facility has a policy forbidding staff–including the nurse on duty –from providing medical help beyond calling 911.  The facility's executive director said that the nurse acted appropriately under the terms of its policy, even though the 911 operator begged the nurse to perform CPR or get someone who would.

We'll never know, of course, whether the elder would have survived had CPR been provided while waiting for the ambulance to arrive. Statistics show that as few as 3% of persons administered CPR survive. But that's not the point. The nurse apparently was just following orders, even though most states have “Good Samaritan” laws which waive liability for anyone responding to an emergency. Further, it's possible that unless the nurse knew the elder had a Do Not Resuscitate order, her failure to provide CPR might result in a legitimate complaint to the California agency which licenses nurses.

So what's the takeaway here? In Massachusetts, independent senior residences and assisted living facilities are governed by landlord-tenant law and are not created with the intent to provide medical care. However, medical emergencies happen and the staff may be the only persons who are physically capable of reacting quickly and providing care until the ambulance arrives. So you need to ask some questions about the facility's medical emergency policies and procedures before signing your lease or rental agreement. Ask whether the facility will provide additional assistance beyond calling 911 in the event of an emergency or if its policy bars employees from providing that assistance. Ask for a written copy of its policy and if they don't have one, ask why. Ask what training employees have had in CPR and other types of emergency care. Ask whether there are any portable defibrillators on the premises and whether the staff has had training in using them. And above all, have the lease or rental agreement reviewed by an attorney to be sure that you won't be giving the landlord carte blanche to walk away from its ethical duty to allow its staff to provide CPR or other non-invasive lifesaving care.