https://www.leadingagenc.org/forums/posts.aspx?topic=1264936 Tue, 21 Jul 2026 04:19:22 GMT Thu, 5 May 2016 21:05:14 GMT Copyright © 2016 LeadingAge North Carolina https://www.leadingagenc.org/forums/posts.aspx?topic=1264936 https://www.leadingagenc.org/forums/posts.aspx?topic=1264936 Our community is exploring whether to install AEDs (automated external defibrillators) on campus and if so, where to locate them, who/how to train, etc. In our discussions we are considering our commitment to uphold resident wishes regarding resuscitation, the outcomes of AED use in older adults and the fact that our community includes staff of a variety of ages. The taskforce is wondering if your community has struggled with this question and how you responded.]]> Sun, 24 Apr 2016 14:15:43 GMT https://www.leadingagenc.org/forums/posts.aspx?topic=1264937 https://www.leadingagenc.org/forums/posts.aspx?topic=1264937 1. Researched with the help of our Medical Director the data regarding effectiveness of defibrillation on senior adults and the likelihood of a positive outcome. Data confirms minimal likelihood of a favorable outcome given the level of assault on the senior body which is compounded after the heart stoppage by the defibrillation itself. The specter of snatching someone back from the brink who then spends years in skilled care with low quality of life is real and common.
2. Discussion in the Resident Life Committee of the Board. Resident members of this committee had opposing opinions about this. Over all the Committee was unenthusiastic about locating defibrillators in the building because of the certainty they’d never be in the right places at the right time. Once you start, pressure mounts for more and more in wider and wider spread areas throughout the broad geography of any campus (another community experienced this and I think they now have 12). There can never be enough, and the more you’ve got the greater the likelihood that equipment failure will occur because someone misses a PM order (we found churches that attested to how easily one can lose its charge and become non-operational and no one will know until the crisis event occurs).
3. Presentation to Residents of benefits and risks after which a vote, presented from the outside as non-binding on the matter, was taken via printed ballot. Overwhelmingly residents voted against having them. This however is clearly a matter in which minority rights have to be considered.
4. Back to the Resident Life Committee for formation of a recommendation to the Board. This discussion was informed by the resident vote and by legal counsel commentary that having them in place burdens the facility with assuring their effective use and ready availability. Because independent residents don’t have their advanced directives tattooed on their foreheads, the loom question became how would you know when and on whom to use the devise. The prospect of going against advanced directives on file somewhere in the facility raised a whole new realm of liability. Generally we felt there were so many variables we could not control our liabilities are lesser by not having them than by having them. Recommendation: That defibrillators not be installed anywhere in our campus. Instead increase the number of staff properly trained in CPR (which we have done)
5. Approval of the recommendation by the Board of Directors. Board approval took into consideration that the industry has not yet adopted defibrillation as a best practice and that its use in retirement communities remains fairly limited (though the trend is moving in the direction of inclusion of the devises I fear). We’re to keep an eye on this and if it begins to be standard in CCRCs we will likely review its position.

Hope this is helpful in some way. Best of luck.]]> Sun, 24 Apr 2016 14:18:17 GMT https://www.leadingagenc.org/forums/posts.aspx?topic=1264938 https://www.leadingagenc.org/forums/posts.aspx?topic=1264938
The initial impetus for the program came from our residents. To be frank, there were two vocal parties in the discussion. One group of residents felt that we should do anything possible to protect the lives of our residents. There was another vocal group that insisted that they did not want the AED’s and offered to sue us if we ever used one of the devices on them. The discussions continued for 18 months, until I personally made the decision to install the devices. We dealt with the “controversy” by reminding residents that city or county EMT’s would resuscitate them anyway, unless they actually had a DNR form on their person. (We received this information directly from town emergency authorities.)

In response, the residents developed a “necklace” of sorts, which contains a small plastic envelope in which their nametags and DNR forms can be placed. I suspect about 10% of our residents faithfully carry their forms at all times.

Now, as to the actual use of the AED’s: we have used the equipment on two residents in 14 years. One survived, and one did not.

As I have often said, there is far more likelihood of the AED’s being used successfully on a guest or employee. ]]> Sun, 24 Apr 2016 14:19:20 GMT https://www.leadingagenc.org/forums/posts.aspx?topic=1264939 https://www.leadingagenc.org/forums/posts.aspx?topic=1264939 o One in each area of healthcare
o One in a small IL building
o 3 in another big IL building
o One in the community area
· First Responders trained to used them.
· Annual checking list for them to make sure proper PM.
· Residents have the right to use them – I think we checked with an attorney regarding good Samaritan Law
o We don’t train the residents, but they have the right to bring someone in and train themselves. I don’t think they have done that yet or taking the opportunity to do that.
· We also have the IL residents DNR’s on the frig’s for the first responders.]]> Sun, 24 Apr 2016 14:20:33 GMT https://www.leadingagenc.org/forums/posts.aspx?topic=1265987 https://www.leadingagenc.org/forums/posts.aspx?topic=1265987 Of course, there is the issue of using on someone designated as a DNR, however with the success of using AED’s quickly and the increased rate of survival, we have opted to have them. As you well know, we also take into consideration our staff, and visitors who could very well need the use of an AED.
AED training is now included in CPR training. The important part of having them is to be sure that they are checked regularly for battery charge and that your staff know how to use them. It is a HUGE liability to have them and not use them because you have a dead battery or no one is trained to use them.
I hope that this information is helpful.]]> Wed, 27 Apr 2016 23:06:54 GMT https://www.leadingagenc.org/forums/posts.aspx?topic=1268553 https://www.leadingagenc.org/forums/posts.aspx?topic=1268553 Thu, 5 May 2016 22:05:14 GMT