Nursing homes have a fiduciary relationship to nursing home residents.  By law, these are vulnerable adults.  Recently a national debate was ignited following Fundamental Long Term Care’s decision to evict two married residents who wanted to die in peace and dignity.  They had to leave the facility to die.  The New York Times had an interesting article on the issue.  Below are some excerpts:

Armond and Dorothy Rudolph had a mutual horror of a lingering decline in their final years. They’d joined an organization that supports the right to end life when illness or pain becomes overwhelming; they’d attended meetings and given both their children literature on the subject. They’d drafted advance directives.  As it happened, the elder Rudolphs had a long and satisfying old age in Albuquerque, N.M., where they lived for 60 years; they gardened and volunteered with the Boy Scouts and served as leaders in their Presbyterian church. When their large house and gardens became difficult to maintain, they built a smaller one in a neighboring town, then moved again to a retirement community.

In October, they entered an assisted living facility called The Village at Alameda, thinking it would be their last home. Both showed symptoms of early dementia. So in January, they set in motion their plan to stop eating and drinking.  The facility tried to evict the couple. The administrators, apparently on orders from the corporate legal department in Sparks, Maryland, told the family the Rudolphs had to leave the next day.

Their son Neil Rudolph protested that the couple — already on Day 4 of their fast — had nowhere to go. He also pointed out that their contract required 30 days’ notice of discharge. The following day, administrators called 911, reported a suicide attempt and told the paramedics to take the elder Rudolphs to a hospital.

So much for the peaceful passage.

Shortly thereafter, two emergency squads, from the Albuquerque Fire Department and Albuquerque Ambulance Services, converged on the scene. Neil Rudolph’s wife called a reporter from The Albuquerque Journal, to whom the elder Rudolphs gave outraged and lucid interviews. The emergency crews soon called a doctor at the University of New Mexico’s emergency medicine department, part of a consortium that consults when a 911 call brings a situation outside the norm — and this certainly qualified.

Reassured that they understood the ramifications of their decision.  The Rudolphs signed papers showing they had declined transport.  Their children transferred the Rudolphs to a rented house in Albuquerque and moved in themselves.  Neil Rudoplh has launched a campaign with Compassion & Choices to inform people about voluntarily stopping eating and drinking. The organization is circulating a rider to assisted living contracts that states, in part, “Facility will respect Resident’s end-of-life choices and will not impede any course of treatment, or non-treatment, freely and rationally chosen by Resident.”

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