"As with all policies, failure to comply can result in disciplinary action, up to and including dismissal," the memo says.

The memo's author, Home Health Care Services manager Gail Harris, is on holidays, but health region representative Helen Carkner said the issue is liability.

Home support workers are not nurses, and whether or not they know first aid individually is not an issue, she said. The region doesn't expect its home support workers to be trained in CPR or the Heimlich, so they should not do them on the job.

The policy was not the result of a particular incident, she said, but rather a review intended to standardize policies across the region.

The explanation offered by the region baffles Terwiel, who said a person's chances of survival increases ten-fold with prompt lifesaving first aid.

"To withhold that from somebody is wrong," he said. "I would hold it against them if they had the skills and didn't use it."

In fact, Terwiel said families should sue the health region if a loved one dies because a home support worker was instructed not to help.

The issue is especially distressing to Jenny Symington, administrator director of the First Aid Academy of Emergency Training in Maple Ridge.

"My mother does receive help from a home support worker, so it hits rather close to home," she said.

Symington said her first thought was that a home support worker might offer help to a stranger on the street if they knew what to do, yet could be fired for helping a client they have developed a relationship with.