Bill Aims to Extend “Do Not Resuscitate” Loophole to Senior Care Providers

A recently proposed bill will grant health care providers in Washington state legal immunity to honor the last wishes of elderly patients. If approved by the full legislature, the “do not resuscitate” bill will close a loophole for senior care providers, according to the Seattle Times.

In states like Washington, facilities that care for seniors—such as assisted living communities and nursing homes—are not legally protected from honoring “do not resuscitate” wishes.

Even if elderly residents have signed forms that clearly detail their desires to not be rescued, their wishes may fall on deaf ears if they live in these communities.


Seattle Times writes:

“Clara” was in her late 80s, with serious heart disease and early dementia. She wanted to die a natural death, without medical intervention, in familiar surroundings.

With her daughter, she talked to her doctor about what she wanted, and filled out the official form called the Physician Orders for Life-Sustaining Treatment (POLST), used in this state to allow patients facing the end of their lives to specify their wishes for CPR and other medical treatment.


But as it turned out, Clara fell into a loophole in state law because she lived in an adult family home. Last summer, the state sent out a “dear provider” letter telling providers who work in adult family homes and assisted-living facilities that they might not have legal immunity if they followed a resident’s no-CPR instructions.

So Clara’s caregivers started CPR — against her wishes — and she ended up in a hospital, where she spent four days in intensive care before her heart gave out for the last time. It was four days of “very invasive, very painful, very unpleasant care,” said Gregg VandeKieft, the medical director of Providence Hospice at Providence St. Peter Hospital in Olympia.

“Based on my experience, the POLST has been an essential tool for our sickest and oldest patients when they make it clear they want death to occur naturally at home,” Debra Everson of the Adult Family Home Nurses’ Association told the committee. “Many of the patients have made it abundantly clear they never want to return to the hospital — but some of the residents’ decisions to refuse CPR and die a natural death are being disregarded.”

While POLST protocol began in the early 1990s, questions arose last summer as to whether workers in senior care facilities were legally protected in following patients’ wishes under the form.

Since then, the article notes several advocates have stepped forward, one of which saying Washington is one of only 14 states that does not protect everyone “on the health-care team” from liability.

Read the Seattle Times article.

Written by Jason Oliva

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