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Last Updated: Friday, 24 February 2006, 05:23 GMT
Care homes 'not to resuscitate'
Elderly care home residents
The report said savings could be spent on improving care
Care homes should be able to "opt out" of attempting to resuscitate elderly patients, some medical experts claim.

Guidelines say all NHS facilities must try to resuscitate people unless they have requested to be left to die.

Simon Conroy, a clinical lecturer in geriatrics, wrote in the British Medical Journal that such interventions had a "low chance of success".

However, representatives of the elderly said the proposals were "unethical" and accused the group of "ageism".

The article was written by Mr Conroy and a team of other medical experts based in Cambridge and Nottingham.

It said intervention was unsuccessful in most cases in residential care homes and community hospitals.

Review call

Mr Conroy called for a review of the current guidelines.

"Given the likely low chance of success, it may be that the institution should not offer resuscitation at all," he said.

He said that resources saved by not spending time in training could be "better used" in improving the quality of care.

He continued: "Such practice, provided in a context of generally increased public awareness of the issues surrounding resuscitation, would be ethical and potentially achievable in practice."

Institutions could then make their non-resuscitation policy known to potential clients and their representatives, Mr Conroy suggested.

It is unethical to propose that there should be blanket removal of resuscitation protocols from care homes
Jonathan Ellis, Help the Aged

The article quoted figures from the US which showed that only up to 6% of care home residents who had been resuscitated were later discharged from hospital.

This compared with a UK acute hospital discharge rate of between 14% and 30% for people who had undergone cardiopulmonary resuscitation.

And doctors also reported that between a third and a half of people resuscitated suffer some kind of brain damage.

Jonathan Ellis of Help the Aged said older people were the "single biggest group of users" of care homes and the proposal "smacks loud and clear of ageism".

"It is unethical to propose that there should be blanket removal of resuscitation protocols from care homes simply because they might not work," he said.

He said decisions about resuscitation should be taken where possible in partnership with the patient and their family.

"Older patients should not have their right to decide taken away from them," he added.

Professor Ian Philp, National Clinical Director for Older People's Health said: "It is a core value of health and social care that the decision to resuscitate a patient is based solely on an individual's need and wishes.

"Patients are always resuscitated unless they have requested not to be - it is unacceptable to withold life saving treatment unless this decision has been made with patients and relatives."


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