As he stood before a federal judge to be sentenced for dealing methamphetamine, Joseph N. Pastore Jr. became emotional, telling the court his drug case had taken a toll on him during the 18 months since his arrest in November 2016.
"I felt like it was killing me from the inside," he said. "I had difficulty sleeping and eating. I find it difficult to lift my head and look someone in the eyes. I don't know if I will ever be able to forgive myself."
But just two months before, Pastore stood before a different judge, in a different courtroom with a much different story as he and his fiancee pleaded to become guardians for his elderly aunt.
When their bid was denied and The Arc Alliance was appointed guardian, Pastore and his family claimed they had been wronged by the court. In a Reading Eagle front-page story, the family said it felt it was attacked through an "aggressive interrogation" and painted as bad people when attorneys questioned them about Pastore's "drug charge."
While those within the system readily acknowledge there are flaws that need to be addressed, they say the process in place for identifying an appropriate guardian is thorough and reliable.
The challenge, they said, is deciphering the true motives of those trying to become guardians.
It's one of several concerns being examined by task forces, courts and state legislators in anticipation of more cases with an expanding aging population and more individuals with disabilities living longer lives.
Pastore is now serving an eight-year sentence in federal prison for that drug charge, a conviction on multiple counts of dealing almost-pure meth and using a gun for drug-trafficking. He admitted to investigators that he sold drugs for more than a decade in Berks.
Pastore pleaded guilty to all the charges in the case in June 2016 and was awaiting sentencing when the guardianship case began for his aunt Theresa Santoro, who is 91.
The pending sentencing was one of several red flags authorities uncovered during the process, which included an investigation by the Berks County district attorney's office into a sudden transfer of $180,000 from Santoro's account.
Based on everything they know about Pastore, his family and the case, District Attorney John T. Adams and other family members of Santoro adamantly believe the court made the correct decision.
"The system absolutely worked," Adams said. "This was a prime example of why we need independent guardians."
Detecting imminent risks
Santoro's case started like most others, but it quickly went awry with two emergency hearings, held within days of each other, and the investigation into the bank transfers that occurred the day after a temporary guardian was appointed to monitor her assets.
According to the court docket, the process began when a petition for a guardian for Santoro was filed Jan. 19 by the Berks County Area Agency on Aging.
Dr. Ed Michalik, executive director of Berks County Area Agency on Aging, and his deputy director, Jessica Jones, said they couldn't comment specifically about Santoro's case due to state confidentiality regulations, but spoke openly about the general process.
They said their office is just one of the entities that can petition the court for a guardian for an individual. Nursing homes, hospitals and private attorneys also can start the process.
Petitions from the Berks aging office all begin when the agency receives a "report of need" concerning elder abuse or neglect, either by the individual or another. The agency then conducts a comprehensive investigation, including months of record-taking, visits with the individual in question and an evaluation by a psychologist.
But if an "imminent risk" is identified, emergency hearings are held to fast-track the process so the individual and his or her assets are protected from harm.
Jones said such risks typically involve finances or medical needs.
"Situations such as when there's a risk of large amounts of money going away or if family has unfettered access," she said. "We become concerned if that money's gone with no potential of the consumer ever seeing it again."
Adams said that concern is what led his office to investigate Pastore and his family in the midst of their bid to become the guardian for Santoro.
"While we are not typically involved in cases involving the appointment of a guardian, we were well aware of Joe Pastore," he said.
The district attorney's office launched an investigation after the Western Berks Regional Police Department received a complaint from Phoebe Berks, the nursing home where Santoro was living, about possible elder abuse by financial exploitation.
According to the investigation and court docket:
When the Jan. 19 petition was filed for the appointment of a guardian, a hearing was set for March 6.
Pastore, meanwhile, received a certified letter Jan. 23 from Phoebe Berks, restricting him from the facility "due to disruptive and inappropriate behavior" and "verbal abuse" to staff.
Five days later, Pastore's father, Joseph Pastore Sr., and family friend Don Lebo went to Phoebe, and removed Santoro from the facility. Authorities said she was found at Pastore Jr.'s home, where Pastore Sr., 94, also lived, in Sinking Spring.
An emergency hearing was held the next day, Jan. 29, before Judge J. Benjamin Nevius for the appointment of an emergency guardian. Nevius entered an emergency order Jan. 30 that found Santoro to be an incapacitated person and named The Arc Alliance as her temporary guardian.
The Arc Alliance is a nonprofit advocacy organization that provides various services, including professional guardianship, in four counties.
A full hearing to determine permanent guardianship was scheduled for Feb. 8.
However, the next day, Jan. 31, Pastore Sr. and Lebo were back at Phoebe and again removed Santoro from the facility.
Detectives discovered Pastore Sr., Lebo, and an unidentified driver took Santoro to at least two banks and withdrew more than $180,000 from her accounts. The visits and transactions were captured on the banks' surveillance videos.
A second emergency hearing was held Feb. 2 before Nevius. The court ordered Santoro's family to immediately return the missing money and gave Arc emergency guardianship until the next hearing.
While some of the funds were returned Feb. 2, authorities said the full amount wasn't restored until three days later.
Adams said his office determined it could not pursue criminal charges in the matter because the money was returned after the court order.
However, he said the lack of charges didn't diminish the suspicious activity and risk authorities discovered in the case.
Historically, Adams said, almost every time his office investigates matters like this, it discovers evidence that the family was trying to steal money. He said he was unaware of any case in which his office determined a court-appointed guardian was exploiting the elderly.
"Upon reviewing our investigation and the information that we were privy to, I was shocked that anyone would claim that Joe Pastore should be a guardian," Adams said.
In the original story, Pastore said his aunt always provided a much-needed escape for him during his rough childhood and he wanted to now care for her. He said she didn't need a guardian because she had family.
Finding appropriate guardians
With Arc in place as the temporary guardian to protect Santoro's finances after the emergency hearings, the case moved forward to the Feb. 8 hearing to determine her permanent guardian.
Berks Aging's attorney was asking for Arc to remain in place while Pastore and his family tried to have Hillary Button, Pastore's fiancee, appointed guardian. An attorney entered his appearance for Button only the day of the hearing, having previously represented only Pastore in the case.
The hearing itself was closed to the public, but in the prior Eagle story, Pastore and his family said they were upset about being questioned by the attorney from Berks Aging about when he and Button would be married, his criminal history and drug case, how frequently they visited Santoro, and Pastore's past career as a boxing trainer.
Speaking generally, Michalik and Jones of Berks Aging said their investigations look at many factors as they try to determine if the person petitioning to be a guardian is appropriate.
"We're really here to be the safety net for individuals who are at risk," Jones said.
The agency focuses on several things, including financial situations, living arrangements and availability to provide proper care for the incapacitated person, she said. The biggest red flag is if the potential guardian is financially dependent on the older adult.
"There's all kinds of questions in the interviews of these individuals as it evolves," she said. "We really have to vet them out and determine if it will work. We have to figure out if they do have an ulterior motive."
The findings from Berks Aging's investigations are first reviewed with a unit supervisor, then presented to Jones to show why they are asking for a guardian. Such a matter is then taken to Michalik, who ultimately signs off on it before submitting it to the county solicitor's office.
The solicitor then meets with the agency to discuss its recommendation to see if there's a strong enough case.
"And then we have to go convince the court," Michalik said.
But the investigations rarely go that far.
For example, in the most recent fiscal year from July 2016 through June 2017, Berks Aging sought guardians in fewer than 3 percent of the cases it handled.
Jones said the agency received 1,112 reports of alleged abuse of individuals older than 60. From those reports, 869 warranted investigations.
The agency substantiated 242 of the cases, meaning it found evidence of abuse and identified potential risks, but petitioned the court for a guardian in only 33 cases. In the other cases, guardians were not needed because the individuals were either found to be competent or had family and others who could help.
Michalik said family members sought to become guardians in only five of the 33 cases from that year, and in two of them, they were appointed.
As far as the other three, Michalik said in one case a family member withdrew his request to avoid drama with other family members and in another the incapacitated person didn't want her children appointed.
The remaining case was the only contested guardianship Berks Aging had that year after finding the potential guardian was inappropriate.
Michalik said his office has seen an uptick in recent years in the number or reports of need due to increasing elder abuse. In a four-year span from 2013-14 through 2016-17, that number went from 477 to 1,112. However, the number of guardian petitions has remained roughly the same at 2 percent to 4 percent.
"We don't just get involved with things we don't have to get involved with," Michalik said. "If we pick someone bad (as a guardian), that's on us."
'No funds for a nurse'
The Feb. 8 hearing for Santoro's permanent guardian included hours of testimony. While the hearing was closed, its transcript became part of Pastore's sentencing hearing in Allentown on April 3.
Pastore and his attorney, Leonard D. Biddison, repeatedly asked the federal judge to consider a sentence that would allow him to continue to care for his father. They said Pastore Sr. suffers from dementia and has terminal cancer and claimed Pastore was his sole caretaker.
The prosecutor, Assistant U.S. Attorney Alicia M. Freind, argued that Pastore Sr. had many options for care. She quickly noted that Button, the fiancee, testified at the guardianship hearing that she would care for Pastore Sr. and Santoro when Pastore Jr. went to prison.
The defense responded, saying Button works a full-time job and wasn't able to provide the necessary care for Pastore Sr. Biddison said Button would have been able to do it only if they had been granted guardianship for Santoro because she has the financial means to pay for a nurse's aide.
Freind quickly rebutted that Santoro's money was for her care and could not be used for Pastore Sr. She also noted that as a World War II veteran, Pastore Sr. receives veterans benefits for such care and that his son previously testified that he's never touched that money.
Biddison's only response was that there were simply "no funds for a nurse."
In a video interview that accompanied the prior Eagle story, Pastore claimed the individuals from Phoebe, Berks Aging and Arc were wrongly accusing his family of being after his aunt's money.
"Moving my aunt here was going to be a challenge for Hillary and I, but it was the right thing to do," he said in the video. "That was the only motivation that we had."
Judge: 'Honor her wishes'
The case was resolved Feb. 20 when Nevius appointed Arc as the permanent guardian for Santoro and her estate.
The final order is the only public document from the case, other than an entry listing, available from the Berks County Register of Wills office following legislation that went into effect this year.
In the order, Nevius said he found clear and convincing evidence that Santoro suffers from significant cognitive deficits that impair her ability to make sound decisions and properly care for herself and her finances. He said the appointment of a permanent guardian was necessary to ensure Santoro receives proper medical care and her finances are spent for her care and benefit.
The judge instructed Arc to consult with Santoro on all decisions and to "honor her wishes to the greatest extent possible." He also ordered that Arc be paid its usual fee for such care, as long as sufficient funds were available, but not to exceed $600 a month.
Paul Stengle, the CEO for Arc Alliance, also declined to comment on Santoro's case specifically, but he stressed that Arc is not involved in the actual guardianship proceedings. He said it is notified shortly before a hearing date to see if it would be willing to serve as guardian, then attends merely to observe. In most cases, he said, there's only one hearing.
"We would never be invited if there was a family member that looked to be good," Stengle said. "The courts want to give it to families."
When Arc is appointed as a guardian, Stengle said, it tries to be "least restrictive" to allow the individual to do as much on his or her own as possible and work with other family members.
"We believe in inclusion," he said. "When we become guardian, we aid with decision-making and work to keep them in the community."
He described Arc as a family-driven organization concerned about its clients' rights.
"We have come down on the sides of families at times when the courts didn't want to," he said. "We have also told the courts individuals don't need a guardian."
'I want her to stay there'
Mary Bagley said she found out about the guardianship for Santoro, her godmother, only after her hairdresser read about it in the Eagle. She said she and her three siblings didn't even know Pastore Jr., her cousin, was close to Santoro and were alarmed to hear he and his fiancee were trying to become her guardian without alerting the rest of the family.
"I can't believe that anybody would do something like that knowing there's other family members and didn't let anyone else know," Bagley said. "If we're so close and so family-oriented, why don't you call me up?"
Bagley said she frequently calls her aunt. The only thing she heard Santoro say about her cousin's family was a complaint that Pastore Sr. frequently asked her for money. Bagley said she would be uncomfortable with anyone from that part of the family being able to make decisions about her aunt's care and finances.
"Heavens no," she said. "If I had known about all of it, I would have stepped in."
Bagley, a former nurse, said she would like to be the guardian for her aunt's medical needs, but is unable to do so now and is grateful to have Arc play that role. She praised her aunt's guardians and the staff at Phoebe Berks, saying they are always willing to answer any questions she has about her aunt's care.
Based on their many phone calls, Bagley said her aunt seems comfortable and content.
"I want her to stay there," she said. "If she's happy, it's her money. She earned it, she worked hard for it, she can stay. I'm happy with her there."
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A closer look at one case of guardianship in Berks County