Saturday, January 26, 2008

The Old Man and the Dog

The Old Man and the Dog, by Catherine Moore

"Watch out! You nearly broad sided that car!" My father yelled at me. Can't you do anything right?" Those words hurt worse than blows. I turned my head toward the elderlyman in the seat beside me, daring me to challenge him. A lump rose in my throat as I averted my eyes. I wasn't prepared for another battle. "I saw the car, Dad. Please don't yell at me when I'm driving." My voice was measured and steady, sounding far calmer than I really felt. Dad glared at me, then turned away and settled back.

At home I left Dad in front of the television and went outside to collect my thoughts. Dark, heavy clouds hung in the air with a promise of rain. The rumble of distant thunder seemed to echo my inner turmoil. What could I do about him? Dad had been a lumberjack in Washington and Oregon. He had enjoyed being outdoors and had reveled in pitting his strength against the forces of nature. He had entered grueling lumberjack competitions, and had placed often. The shelves in his house were filled with trophies that attested to his prowess. The years marched on relentlessly. The first time he couldn't lift a Heavy log, he joked about it; but later that same day I saw him outside alone, straining to lift it. He became irritable when ever anyone teased him about his advancing age, or when he couldn't do something he had done as a younger man.

Four days after his sixty-seventh birthday, he had a heart attack. Anambulance sped him to the hospital while a paramedic administered CPR to keep blood and oxygen flowing. At the hospital, Dad was rushed into an operating room. He was lucky; he survived. But something inside Dad died. His zest for life was gone. He obstinately refused to follow doctor's orders. Suggestions and offers of help were turned aside with sarcasm and insults. The number of visitors thinned, then finally stopped altogether. Dad was left alone.

My husband, Dick, and I asked Dad to come live with us on our small farm. We hoped the fresh air and rustic atmosphere would help him adjust. Within a week after he moved in, I regretted the invitation. It seemed nothing was satisfactory. He criticized everything I did. I became frustrated and moody. Soon I was taking my pent-up anger out on Dick. We began to bicker and argue. Alarmed, Dick sought out our pastor and explained the situation. The clergyman set up weekly counseling appointments for us. At the close of each session he prayed, asking God to soothe Dad's troubled mind. But the months wore on and God was silent. Something had to be done and it was up to me to do it.

The next day I sat down with the phone book and methodically called each of the mental health clinics listed in the Yellow Pages. I explained my problem to each of the sympathetic voices that answered. In vain. Just when I was giving up hope, one of the voices suddenly exclaimed, "I just read something that might help you! Let me go get the article." I listened as she read. The article described are markable study done at a nursing home. All of the patients were under treatment for chronic depression. Yet their attitudes had improved dramatically when they were given responsibility for a dog. I drove to the animal shelter that afternoon. After I filled out a questionnaire, a uniformed officer led me to the kennels. The odor of disinfectant stung my nostrils as I moved down the row of pens. Each contained five to seven dogs. Long-haired dogs, curly-haired dogs, black dogs, spotted dogs, all jumped up, trying to reach me. I studied each one but rejected one after the other for various reasons, too big, too small, too much hair.

As I neared the last pen a dog in the shadows of the far corner struggled to his feet, walked to the front of the run and sat down. It was a pointer, one of the dog world's aristocrats. But this was a caricature of the breed. Years had etched his face and muzzle with shades of gray. His hip bones jutted out in lopsided triangles. But it was his eyes that caught and held my attention. Calm and clear, they beheld me unwaveringly. I pointed to the dog. "Can you tell me about him?" The officer looked,then shook his head in puzzlement. "He's a funny one. Appeared out of nowhere and sat in front of the gate. We brought him in, figuring someone would be right down to claim him. That was two weeks ago and we've heard nothing. His time is up tomorrow." He gestured helplessly. As the words sank in I turned to the man in horror. "You mean you're going to kill him?" "Ma'am," he said gently, "that's our policy. We don't have room for every unclaimed dog." I looked at the pointer again. The calm brown eyes awaited my decision. "I'll take him," I said.

I drove home with the dog on the front seat beside me. When I reached the house I honked the horn twice. I was helping my prize out of the car when Dad shuffled onto the front porch. "Ta-da! Look what I got for you, Dad!", I said excitedly. Dad looked, then wrinkled his face in disgust. "If I had wanted a dog I would have gotten one. And I would have picked out a better specimen than that bag of bones. Keep it! I don't want it" Dad waved his arms cornfully and turned back toward the house. Anger rose inside me. It squeezed together my throat muscles and pounded into my temples. "You'd better get used to him, Dad. He's staying!" Dad ignored me. "Did you hear me, Dad?" I screamed. At those words Dad whirled angrily, his hands clenched at his sides, his eyes narrowed and blazing with hate. We stood glaring at each other like duelists, when suddenly the pointer pulled free from my grasp. He wobbled toward my dad and sat down in front of him. Then slowly, carefully, he raised his paw. Dad's lower jaw trembled as he stared at the uplifted paw. Confusion replaced the anger in his eyes. The pointer waited patiently. Then Dad was on his knees hugging the animal. It was the beginning of a warm and intimate friendship. Dad named the pointer Cheyenne.

Together he and Cheyenne explored the community. They spent long hours walking down dusty lanes. They spent reflective moments on the banks of streams, angling for tasty trout. They even started to attend Sunday services together, Dad sitting in a pew and Cheyenne lying quietly at his feet. Dad and Cheyenne were inseparable throughout the next three years. Dad's bitterness faded, and he and Cheyenne made many friends. Then late one night I was startled to feel Cheyenne 's cold nose burrowing through our bed covers. He had never before come into our bedroom at night. I woke Dick, put on my robe and ran into my father's room. Dad lay in his bed, his face serene. But his spirit had left quietly sometime during the night. Two days later my shock and grief deepened when I discovered Cheyenne lying dead beside Dad's bed. I wrapped his still form in the rag rug he had slept on. As Dick and I buried him near a favorite fishing hole, I silently thanked the dog for the help he had given me in restoring Dad's peace of mind.

The morning of Dad's funeral dawned overcast and dreary. This day looks like the way I feel, I thought, as I walked down the aisle to the pews reserved for family. I was surprised to see the many friends Dad and Cheyenne had made filling the church. The pastor began his eulogy. It was a tribute to both Dad and the dog Who had changed his life. And then the pastor turned to Hebrews 13:2. "Be not forgetful to entertain strangers." I've often thanked God for sending that angel," he said.

For me, the past dropped into place, completing a puzzle that I had not seen before: the sympathetic voice that had just read the right article...Cheyenne's unexpected appearance at the animal shelter...his calm acceptance and complete devotion to my father...and the proximity of their deaths. And suddenly I understood. I knew that God had answered my prayers after all.

The above was sent from a NASGA member saying:
"The best guardian might not be a human."

Friday, January 25, 2008

Massachusetts Senior Citizens

The Boston Globe reports: Dawn Cromwell dares not leave her building. If she tried, a device girding her ankle would sound an alarm. For over a year, she has had to use store-bought reading glasses because her pleas for a prescription pair have gone for naught. She is given medications, but, she says, no one will tell her what they are. For 20 months now, Cromwell's life has been defined by a 10.5-by-12.5-foot living space at North End Rehabilitation and Nursing Center. In her tiny closet, there are virtually no clothes, and she has no idea what's become of the cherished possessions in the Boylston Street apartment where she lived for years. At 73, Cromwell is one of hundreds of forgotten docket numbers in Massachusetts probate and family courts, where judges routinely fast-track infirm elders into the care of guardians, often with little evidence to justify such wrenching decisions.

Apparently, the Cromwell case typifies an everyday practice in Massachusetts probate courts.

The Boston Globe also reports: "After the court declares someone mentally ill and appoints a guardian, for all practical purposes most of the patients officially vanish. Almost none of the state's probate courts have any mechanism to track their whereabouts, monitor their treatment, determine whether they have recovered enough to reclaim their freedom and autonomy, or even learn whether they are dead or alive.

Handcuffed by an antiquated computer system, the courts know how many cases are filed but do not know how many people judges put under the control of guardians each year. The number in Massachusetts each year almost certainly exceeds 2,000.

Virtually unregulated, guardians, many of them lawyers and social workers, regularly ignore requirements that they file an initial inventory of assets of the people they are responsible for and an annual accounting of how they managed a person's finances. In Suffolk Probate Court, where five years of guardianship filings were examined, there were no financial reports in 85 percent of the cases."

Source: Courts strip elders of their independence

The Boston Globe found: "There were 308 cases filed in Suffolk in the past five years involving people who were entrusted to guardians after they were ruled to be mentally ill. In 72 percent of the cases, mostly filed by hospitals and nursing homes, the medical certifications were so brief - some just a sentence or two - or so vague that they fell well short of what the court requires. Many were handwritten, some illegibly.

The court's form states: "Describe in detail the diagnosis leading to the aforementioned opinion (including the types of decisions which the proposed ward has sufficient mental ability to make)." An examination could find no cases in which the petition cited any decisions patients could make on their own - and no evidence in the files or audiotapes of hearings that judges objected to the scant evidence before them.

A study coauthored last year by Jennifer Moye, a Harvard Medical School and Veterans Administration psychologist who specializes in gerontology, compared medical certifications in guardianship cases in Massachusetts, Pennsylvania, and Colorado. Massachusetts fared worst. The study found that in 154 cases in Massachusetts, the median length of the medical certification was 83 words. In one case, it was just seven words."

Paula M. Carey, the new chief justice of Massachusetts Probate and Family Court, is quoted as saying "I recognize that we in Massachusetts are not in the forefront in terms of guardianship reform" and "We are now making significant efforts."

NASGA certainly hopes that Massachusetts takes a good hard look at the broken guardianship system, repairs it with reformed legislation, and holds firmly accountable any and all hospitals, judges, lawyers and guardians whom under the guise of "protection" have failed our precious senior citizens.

See also:
Old, sick, and unbefriended

Disrespecting our elders

Angry, MGH heart patient challenged process

Court strips elders of their independence:
The article was reported and written for a graduate seminar in Investigative Reporting at Northeastern University by eight students: Nicholas Coates, Meghan Gargan, Jeff Kelly, Maggie Kowalski, Candice Novak, Yerina Ranjit, Amanda Smith, and Richard Thompson. Their work was overseen and this article was edited by Northeastern journalism professor Walter V. Robinson, former editor of the Globe Spotlight Team. Robinson's e-mail address is Confidential messages can be left at 617-929-3334.

Thursday, January 24, 2008

Connecticut Conservatorship

NASGA member Dee King and her father Daniel Gross are featured in a December 2007 issue of Healthcare Liability & Litigation from the American Health Lawyers Association.

From the article:
"His lawsuit says Daniel Gross, an eighty-six-year-old resident of New York, went to a Connecticut hospital for treatment of leg problems and ended up, as a result of a conservator’s appointment, on a locked ward of a nursing home where he unnecessarily remained for almost ten months. During that time, Gross charges that his assets were dissipated, visitation with his family restricted, and that he suffered abuse from his nursing home roommate.

A federal civil rights action by Gross is now pending in the United States District Court for Connecticut. The federal lawsuit names as defendants the nursing facility, Connecticut Governor M. Jodi Rell, the former acting Connecticut long term care ombudsman, the probate judge who issued the conservatorship order, the conservator, and the attorney appointed to represent Gross in the conservatorship case.

A May 2007 ruling dismissed the claims against the probate court judge on the ground of absolute judicial immunity. Gross’ attorney has filed a notice of appeal from a subsequent order denying a motion for reconsideration of the immunity ruling.

The claims against the nursing facility include conspiracy to deprive Gross of his civil and property rights, violations of Gross’ right to privacy and familial integrity, the Omnibus Budget Reconciliation Act of 1989 (OBRA), the Americans with Disabilities Act (ADA), the Connecticut Patient’s Bill of Rights, and intentional and negligent infliction of emotional distress. Among other averments, the complaint maintains the nursing home is required by the Social Security Act, 42 U.S.C. § 1396r(b)(2), to provide services to maintain the highest practicable physical, mental, and psychosocial well-being of its residents and that it failed to do so."

Gross v. Rell, No.
3:06cv1703 (VLB), United States District Court for the District of Connecticut

About the AHLA (from the site):
Leading health law to excellence through education, information, and dialogue, the American Health Lawyers Association (Health Lawyers) is the nation's largest, nonpartisan, 501(c)(3) educational organization devoted to legal issues in the healthcare field with more than 10,000 members. Currently 37 staff members are responsible for the operational activities of the organization.

For more information visit: American Health Lawyers Association

Dee is a valuable member and honorable advocate. When NASGA spoke to Dee, she talked about him looking down from heaven and celebrating Maydelle’s freedom. Dee said she had told her father that he made a difference and it was because of him that the movement began in Connecticut.

Daniel Gross will live in our hearts forever.

See also:
With Law, Justice is Conserved

Reform, Not Now, Not Ever

The Scandal of Connecticut's Probate Courts

Wednesday, January 23, 2008

Maydelle is free at last!

NASGA has received some very good news from one of our members and daughter of conservatorship victim Maydelle Trambarulo, "Maydelle is FREE AT LAST!!!!"

The Trambarulo family story was published in the New Haven Advocate after Maydelle Trambarulo's expected 30 to 60 days stay in Connecticut lasted over three years: Losing Control: Bringing Maydelle Home

According to an update also published in the New Haven Advocate, even after a Superior Court judge ruled that Maydelle, the New Jersey woman stuck in an East Haven nursing home and a protracted custody battle, could return to her family, Maydelle's conservator had asked the judge for a stay of Maydelle's release from his custody: "Losing Control" Update: Maydelle Cleared to go Home

The Harford Courant had reported, "The latest outrage-of-the-month comes from the Woodbridge probate district, where a judge last year denied a request by the children and husband of an elderly New Jersey woman, Maydelle Trambarulo, that she be allowed to leave a Connecticut nursing facility and return home": Probate Court: Offering Unequal Protection Under the Law

Anne Trambarulo Haines testimony of her mother Maydelle was included in the 2006 Federal Options to Improve America’s Ailing Guardianship System: A White Paper for the Senate Special Committee on Aging

NASGA is thrilled to hear the good news of Maydelle now reunited with her family!