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California nursing home incident brings to fore end-of-life issues

 

Slim Smith

 

My last job before returning to Mississippi was a gig as a graveyard-shift janitor at a 55-plus living facility in Mesa, Ariz., called Venture Out. 

 

It was the sort of job you would expect a convicted felon who had gone from one minimum-wage job to another since being released from prison would have. 

 

The job pretty much guaranteed time for self-examination, usually around 2 or 3 in the morning as I mopped floors or cleaned restrooms in the quiet of the facility's empty activities center. 

 

When my spirits were particularly low, I thought about how far I had fallen, from a respected newspaper columnist at a major metro newspaper to janitor -- and graveyard shift janitor at that. I recall thinking that this was about as low down the job ladder as you could get. Worse yet, it was a seasonal job: The janitorial staff was reduced by two-thirds when spring arrived. As with most such communities, about 75 percent of the residents are winter residents, who leave for their homes in cool climes at the first hint of the arrival of the oppressive Arizona summer. What would I do come spring? 

 

In those fits of near-despair, I wondered what would become of me. 

 

Fortunately, though, those fits were few and brief. 

 

Although it might be hard to believe, there was much I did like about the job. Venture Out was a happy place and I was happy to be there, I realized. I especially enjoyed the last couple of hours in my shift, when the early risers began to filter into the activities center to drink coffee, read the newspaper and socialize. There were a lot of early-risers there, as you might suspect. Because I had finished most of my work by then, I was able to engage in conversation with a lot of the residents, who didn't seem to find it unbecoming to talk to a janitor. The residents were always fascinating to me. They came from all over the country, had worked in all sorts of fields, had interesting hobbies and interests and were good for a story. Some of them seemed genuinely interested in my story, depressing as it was at the time. I never got the sense that any of the residents looked down on me, although it would have been perfectly understandable if they had. 

 

Yes, it was a happy, cheerful place -- even for a temporary graveyard shift janitor. 

 

Last week, a news story out of California caught my attention and stirred memories of my janitor days at Venture Out. 

 

It involved a 911 call from a retirement home in Bakersfield, Calif., an incident that alarmed people around the country because no one at the retirement home could be found to administer CPR to an elderly woman. According to the staff member at the facility, company policy prevented the staff from performing CPR or asking someone else to do the procedure. The 87-year-old woman died en route to the hospital. 

 

Interestingly, the woman's mother said she supported the retirement home's decision and Bakersfield police announced no charges would be filed. 

 

Still, the idea that a person could die simply because no one could be persuaded to provide CPR left people all over the country shaking their heads in disbelief. 

 

As I thought about that incident, I thought, too, of my days at Venture Out. 

 

I mentioned that I worked the graveyard shift during my time there. There was one exception, though. 

 

One day, I was pulled over to the day shift, specifically so I could receive CPR training. The management assembled every employee for a half-day training session, from office workers to maintenance to janitors. 

 

Clearly, Venture Out's policy about providing emergency assistance differs greatly from the policy that led to the incident in California. 

 

I'm glad for that and also glad that I never had the opportunity to put what I learned into practice. 

 

But it was a good thing to know, and I was pleased that the management made it a priority for all staff members to learn CPR. 

 

As America's Baby Boomers age, more and more will find themselves in retirement communities, assisted living facilities and nursing homes. The California incident should serve as a reminder that it is important to know the emergency care policies of those facilities. It cannot be assumed that the policy allows CPR, after all. 

 

It is also a good time for us, especially as we get older, to consider having a Living Will. 

 

When my mother fell into a coma as a result of a fall, my siblings and I faced a difficult decision. Two weeks into the coma and with no signs of brain function, the doctors asked us if we wanted to "let her go.'' It was a difficult decision to make, of course. But it would have been a far more difficult decision if mom hadn't made her wishes known in her Living Will. Assured that we were making the decisions she would have made for herself, we took her off life support and she died peacefully two weeks later. She was 84. 

 

Really, there should never be a question in these situations if we are aware of the policies where we or our loved ones live and if we have put down in writing our wishes in the event of such emergencies.

 

Slim Smith is a columnist and feature writer for The Dispatch. His email address is ssmith@cdispatch.com.

 

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