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Resuscitation Policies in Long-Term Care Institutions

 

Michael Gordon, MD, FRCPC
Vice President Medical Services and
Head Geriatric and Internal Medicine
Baycrest Centre for Geriatric Care
Head, Division of Geriatrics
Mt. Sinai Hospital
Professor of Medicine
University of Toronto 

Cardiopulmonary resuscitation (CPR) is commonly perceived as a miraculous treatment that averts death. For many, the understanding of CPR comes from television and movies where, inevitably, death is cheated by heroic resuscitation. North Americans especially have, since its discovery more than thirty years ago, been fascinated with CPR.1 CPR, however, is not always an appropriate or humane medical procedure. For defined segments of the elderly population, especially those requiring long-term institutional care, it may be a last, undignified rite of passage in a world that has become mesmerized by technology. It is for the benefit of this elderly population that we must strive to tailor our resuscitation policies in order to realistically serve their needs, without exposing them to ineffective CPR attempts. The goal of institutional policy should be to define the framework by which we can provide appropriately humane care without denying CPR to those members of older populations who can, within reason, hope to benefit from it.