Saturday, April 26, 2014

From the Advocates at GRADE: Texas Sunset Advisory Commission

The Texas Sunset Advisory Commission (the "Sunset Commission") is putting DFPS, APS, CPS and DADS under a microscope, this could result with huge policy and regulatory changes. We urge the general public with issues regarding these agencies (Department of Family Protective Service (DFPS), Department of Aging Disability (DADS), Adult Protective Service (APS), Child Protective Service (CPS)) to contact the Sunset Advisory at (512) 463-1300\

The Commission seeks public input on every agency under Sunset review and recommends actions on each agency to the full Legislature. The Sunset review of most agencies occur every 12 years, and any negative outcome could have significant long-term impact. Please voice your concerns with the Sunset for these agencies Department of Family Protective Service (DFPS), Department of Aging Disability (DADS), Adult Protective Service (APS) and Child Protective Service (CPS).

It is imperative to contact the commission by May 15 as well as participating in the public hearings June 24 to June 25, 2014 (Tentative)

Sunset Commission Project Manager Contacts
Project Manager for DFPS - Amy Tripp
Project Manager for APS - Amy Tripp
Project Manager for CPS - Amy Tripp
Project Manager for DADS - Amy Trost

Next Public Meeting (Testimony): June 24 to June 25, 2014 (Tentative)

For more information please go to:
Public Input Form for Agencies Under Review

Hospital discharge law creates gap for patients in need

The ‘expedited limited healthcare fiduciary’ provision tacked onto the changes in conservatorship law is the kind of solution that can become a problem if not monitored closely.

It is another example of our “whack-a-mole” social safety net policies, in which each solution seems to reveal another problem with no readily discernible solution.

As the 2013 legislative session ended, an amendment was tacked onto the bill that revised and improved Tennessee’s conservatorship laws, creating a process for hospitals to discharge patients who are incapable of making decisions about leaving.

Hospitals can now petition the court to appoint an “expedited limited healthcare fiduciary” to make decisions about discharging a patient who no longer needs hospital care. The law was in place on July 1. The Tennessean reported that Saint Thomas and Vanderbilt hospitals have filed 12 petitions since then (11 patients were transferred to nursing homes; one patient had not yet been discharged).

“Our experience has been primarily with homeless patients who had no place to be discharged to and no one to act on their behalf,” Saint Thomas spokeswoman Rebecca Climer told The Tennessean. She added that a conservator, who also must be appointed as part of the petition, makes arrangements “to fulfill the physician’s discharge order and admission to another facility for an appropriate level of care.”

As one court-appointed attorney ad litem, the person who is responsible for looking out of the patient’s interests, told a client, “… (the hospital) was not a Hyatt Regency; we had to find him another place for him to stay.”

Hospitals are not hotels, just as jails are not mental health treatment centers, yet we seem to prefer to address difficult social problems by shunting problems to institutions where we avoid dealing with them.

Full Article & Source:
Hospital discharge law creates gap for patients in need

Attorney discipline: 13 punished in South Florida

The Florida Supreme Court disciplined 13 South Florida attorneys in recent actions brought by the Florida Bar.

Of those disciplined, one attorney was disbarred, four suspended, five publicly reprimanded and three received disciplinary revocations, according to a news release.

Here are some of the actions by the Bar:

Carl Andrew Borgan, of Coconut Grove, was suspended effective 30 days from a Feb. 7 court order. Borgan was alleged to have hidden martial assets in his trust account, and when a family court judge froze the account, he took no action to get his clients' funds released, including one client who died prior to the full disbursement of her settlement funds.

Full Article & Source:
Attorney discipline: 13 punished in South Florida

Sen. Mary Jo Wilhelm Column: Protecting Seniors From Abuse & Exploitation

April 24th 2014 Column by Sen. Mary Jo Wilhelm:

Across the country, thousands of older Americans face abuse, neglect and exploitation every year. Many of these older victims are particularly vulnerable because they depend on others to help them with the most basic activities of daily living.

Senate Democrats have worked this session to establish a comprehensive system to prevent elder abuse, provide community support, offer legal options when intervention is necessary, and prosecute those who commit elder abuse. These items were included in SF 2239, which the Senate passed unanimously on March 4. When the Iowa House took up the bill, however, they removed elder abuse support and intervention services that would have been provided in local communities by the Aging & Disability Resource Centers.

Fortunately, there is still time to make progress. The Senate has now approved an amendment to SF 2239 that defines elder abuse and financial exploitation of an elder, allows victims of elder abuse to secure protective orders to stop the abuse, and authorizes criminal penalties for financial exploitation.

This will build on protections approved earlier this session in the Uniform Power of Attorney Act, which has already been signed into law. According to Iowa AARP, it is the most important thing we can do to fight financial abuse of elders.

SF 2168 specifically addresses financial exploitation of Iowa seniors, which often occurs at the hands of family members or caretakers. Based on recommendations of Iowa’s Elder Abuse Task Force, the Iowa Uniform Power of Attorney Act will help prevent and detect power of attorney abuse.

Full Article & Source:
Sen. Mary Jo Wilhelm Column: Protecting Seniors From Abuse & Exploitation

Friday, April 25, 2014

From Private Ordeal to National Fight: The Case of Terri Schiavo

Her surname in Italian means “slave,” and is pronounced skee-AH-vo. Grim as it may be, the word could apply to Theresa Marie Schiavo, even with its Americanized pronunciation: SHY-vo. For 15 years, Terri Schiavo was effectively a slave — slave to an atrophied brain that made her a prisoner in her body, slave to bitter fighting between factions of her family, slave to seemingly endless rounds of court hearings, slave to politicians who injected themselves into her tragedy and turned her ordeal into a national morality play.

To this day, the name Schiavo is virtually a synonym for epic questions about when life ends and who gets to make that determination. It would be nice to believe that since Ms. Schiavo’s death nine years ago, America has found clear answers. Of course it has not, as is evident in Retro Report's exploration of the Schiavo case, the latest video documentary in a weekly series that examines major news stories from the past and their aftermath.

Ms. Schiavo, a married woman living in St. Petersburg, Fla., was 26 years old when she collapsed on Feb. 25, 1990. While her potassium level was later found to be abnormally low, an autopsy drew no conclusion as to why she had lost consciousness. Whatever the cause, her brain was deprived of oxygen long enough to leave her in a “persistent vegetative state,” a condition that is not to be confused with brain death. She could breathe without mechanical assistance. But doctors concluded that she was incapable of thought or emotion. After her death on March 31, 2005, an autopsy determined that the brain damage was irreversible.

Between her collapse — when she “departed this earth,” as her grave marker puts it — and her death — when she became “at peace” — the nation bore witness to an increasingly acrimonious battle between her husband, Michael Schiavo, and her parents, Robert and Mary Schindler. Mr. Schiavo wanted to detach the feeding tube that gave her nourishment. Terri never would have wanted to be kept alive that way, he said. The Schindlers insisted that the tube be kept in place. That, they said, is what their daughter would have wanted. To Mr. Schiavo, the woman he had married was gone. To the Schindlers, a sentient human was still in that body.

Full Article & Source:
From Private Ordeal to National Fight: The Case of Terri Schiavo

VfGR: Virginians for Guardianship Reform

Despite high expectations and carefully crafted safeguards, our current system of public guardianship is broken. Procedural and jurisdictional defects compound mismanagement, understaffing, poor decision-making, and inadequate care.

Instead of protecting the elderly, the numerous officials and agencies charged with accountability and oversight of the public guardianship programs cover up the sad fact that, in many cases, these programs do more harm than good.

Virginians for Guardianship Reform

Arizona assisted suicide law tightened.

The Arizona Daily Star has reported that:

The Arizona House has given final approval to a bill that aims to make it easier to prosecute people who help someone commit suicide.
Republican Rep. Justin Pierce of Mesa says his bill will make it easier for attorneys to prosecute people for manslaughter for assisting in suicide by more clearly defining what it means to "assist." 
House Bill 2565 defines assisting in suicide as providing the physical means used to commit suicide, such as a gun. The bill originally also defined assisted suicide as "offering" the means to commit suicide, but a Senate amendment omitted that word.
 The proposal was prompted by a difficult prosecution stemming from a 2007 assisted suicide in Maricopa County. 
The House approved the bill 35-19 Wednesday. It will now go to the governor's desk.
This bill was a response to an assisted suicide organizations involvement in a 2007 assisted suicide death.

Full Article & Source:
Arizona assisted suicide law tightened.

Thursday, April 24, 2014

Saying Patients are PVS Allows Courts to Starve Them to Death, What if the Diagnosis is Wrong?

I have written time and time again about the dangerous and dehumanizing persistent vegetative state (PVS) diagnosis. Actually, we saw in my family’s battle to save my sister, Terri Schiavo, from death by dehydration, that a tremendous amount of debate raged over whether or not she was in this condition.

In fact, this diagnosis is what allowed the court to order the removal of Terri’s food and water. Yet despite continuing research validating that the PVS diagnosis is growing in its inaccuracy, the medical community uses this diagnosis to end countless lives of our medically vulnerable patients who are allegedly in this condition.

This latest finding is one of a continuous stream of reports that have been issued on the inaccuracy of the PVS diagnosis. From the Report, Brain Scans Show Vegetative Patients May Actually Recover:

The Journal’s report, released on Feb. 3, revealed that some patients who were believed to be in a PVS were actually able to understand and communicate. Through the use of functional magnetic resonance scanning (fMRI), researchers in the United Kingdom estimated that a percentage of those patients suffering from profound brain injuries possessed the capacity to comprehend and communicate in limited ways.

Indeed, every time these studies are published we should move to abolish the PVS diagnosis, in particularly, using it as a reason to kill. Sadly, however, despite these imaging studies and what they reveal about the human brain, the vast majority of the medical community sees nothing improper about using such an unscientific diagnosis for, what usually turns out to be, reasons almost never in the best interest of the patients.

Furthermore, not only can the PVS diagnosis be used as an actual death sentence for a patient, but as a death sentence figuratively speaking, as well. And it seems both are supported under the pretext to save health care costs. You see, the PVS can also be used to cut off funds for a person in need of vital rehabilitation. Because once insurance providers receive the PVS diagnosis in regards to the patient’s condition, no longer are they willing to pay for any rehabilitative services.

Full Article & Source:
Saying Patients are PVS Allows Courts to Starve Them to Death, What if the Diagnosis is Wrong?

How to See Pain when Dementia Blocks Communication

Watch Teepa Snow demonstrate how to detect pain in a person with dementia and how you can help them.

This video is an excerpt of "End of Life Care & Letting Go", a 2 hour training DVD for caregivers.

Teepa Snow, a nationally acclaimed Alzheimer's and dementia care specialist, teaches her students how a person with dementia perceives his/her world and how to properly adapt one's own behavior to increase communication and mutual understanding.

Learn to recognize a patient's progression into the final stages of dementia and provide the best care with Teepa Snow's hands-on, disease-level appropriate techniques.

Full Article & Source:
How to See Pain when Dementia Blocks Communication

Aid lacking for elderly protective services , experts say

A proposal to add $10 million a year to the state budget for adult protective services would better equip Ohio to fight a growing epidemic of abuse, neglect and financial exploitation of the elderly, advocates say.

Even more money is needed, they said, if the state wants to reach elderly residents who suffer silently in the shadows, too frail to care for themselves or afraid to turn in their abusers.

The $10 million in the current proposal “would be between three and four times what the state has ever invested in adult protective services, which is great,” said Will Petrick, state director of Advocates for Ohio’s Future. “But I would hope the investment is just the first step.”

The House Finance and Appropriations Committee added the money as part of an amendment to a larger midterm-budget proposal. The bill passed the House and is waiting to be debated by the Senate.

The state currently provides $500,000 annually, with 52 counties receiving less than $3,000 a year. Over the years, funding levels have seesawed from zero to a high of slightly more than $3 million in the mid-1990s.

The Ohio Department of Job and Family Services, which oversees adult protective services in the state, hasn’t taken a position on the proposed increase, spokesman Benjamin Johnson said.

A coalition of advocates plans to ask the Senate to consider raising the investment to $20 m illion. Similar recommendations have fallen on deaf ears in the past, partly because of the state’s precarious budget.

Full Article & Source:
Aid lacking for elderly protective services , experts say

Wednesday, April 23, 2014

Last-minute change in law lets hospitals drop patients

A few weeks before Terry Gordon died, a court-appointed lawyer paid a visit to the 63-year-old homeless man in his seventh-floor hospital room at Saint Thomas Midtown Hospital.

"I explained to him that this was not the Hyatt Regency, but we had to find him another place for him to stay," the lawyer, George Duzane, later reported to the court.

But the visit, which took place in August of last year and led to Gordon's temporary departure from the hospital, had its origin in a last-minute amendment to legislation involving conservatorships approved earlier that year.

The amendment, sponsored by Rep. Andrew Farmer after he was approached by various hospitals, was added to a bill designed to protect those who are placed in the care of conservators. The amendment gave hospitals a way to petition for court approval to discharge patients they say no longer need the costly care of a major health facility.

In Nashville the add-on provision has been used a dozen times to try to discharge people, more than half of them listed on court documents as currently or formerly homeless. In nine of the cases, including Gordon's, the petitions were approved by Davidson Probate Judge David "Randy" Kennedy.

The petition for Gordon's dismissal from the hospital was filed Aug. 8. He died less than a month later, on Sept. 2.

It's not clear from records and interviews who bore ultimate responsibility for the care of the patients involved. No one has alleged that the care they received was substandard. What is known is that the legislation gave hospitals a new way to move patients into other facilities.

Adrienne Newman, associate executive director of FiftyForward, which had been named as Gordon's health care fiduciary under the new law, said Gordon was transferred to a rehabilitation facility but then sent back to Saint Thomas Midtown Hospital on the day he died.

Full Article & Source:
Last-minute change in law lets hospitals drop patients

Government would pay seniors to create advanced directives under Senate bill

Medicare beneficiaries would be paid to create advance directives and store them in an easy-access system if a recently proposed Senate bill were to become law.

The “Medicare Choices Empowerment and Protection Act” was introduced Friday by Sen. Tom Coburn, M.D. (R-OK). It would pay eligible beneficiaries $75 for creating an online advance directive or $50 for creating one manually in 2015, with incentives in subsequent years tied to consumer price inflation.

It also calls for an accreditation process to be established for advance directive vendors participating in the program, and the creation of a system to facilitate easy access to advance directives for beneficiaries, suppliers, providers and healthcare proxies. Registration of the directives would occur during a beneficiary's initial enrollment in Medicare Part C, commonly known as Medicare Advantage.

The bill says that the Centers for Medicare & Medicaid Services should consult with experts when establishing and implementing the program, including nurses, palliative care experts and health information privacy authorities.

Advance directives generally are seen as instrumental in guiding healthcare for those who lose the ability to communicate their wishes, including long-term care residents with advanced dementia. Recent studies have indicated that directives might be enhanced by including more information about preferred treatment settings and “gray area” issues, such as providing antibiotics to terminal patients.

Full Article & Source:
Government would pay seniors to create advanced directives under Senate bill

Kansas elder abuse measure becomes law

TOPEKA, Kan. (AP) — Kansas Attorney General Derek Schmidt says elderly residents will have new protections against fraud and financial abuse under a new state law.

Legislation creating the crime of mistreatment of an elder person was signed by Gov. Sam Brownback last week.

The law is aimed at protecting people 70 and older who are victims of financial abuse. People convicted of large-scale abuse could be sentenced to more than 40 years in prison.

Schmidt said Monday the law adds protections against misusing a financial trust or power of attorney for the purpose of misappropriating a person's life savings.

The measure was sponsored by Senate Vice President Jeff King of Independence and Sen. Michael O'Donnell, both Republicans. King and O'Donnell say it gives law enforcement another tool to protect older residents.

Full Article & Source: 
Kansas elder abuse measure becomes law

Tuesday, April 22, 2014

Linda Kincaid Reports: California’s AB 2171 introduces Bill of Rights for assisted living residents

On Tuesday, April 22, 2014, the California State Assembly Committee on Aging and Long-Term Care will hold a hearing on Assembly Bill 2171. Introduced by Assembly Member Bob Wieckowski, AB 2171 will establish a comprehensive Bill of Rights for residents in assisted living, often called residential care facilities for the elderly (RCFEs). The hearing will be webcast live and archived for later viewing.

The proposed Bill of Rights includes the right to visitors, the right to phone calls, the right to mail, as well as the right to not be physically restrained or chemically restrained. Elder advocates throughout California strongly support AB 2171. Many RCFEs oppose AB 2171.

Elder advocates urge individuals to contact Committee members with their concerns about abuse and lack of accountability in RCFEs. Committee member names, phone numbers, and email addresses are given below. An email of support followed by a phone call could be especially effective.

Assembly Committee on Aging and Long-term Care

Marc Levine

(916) 319-2010

Cheryl R. Brown

(916) 319-2047

Tom Daly

(916) 319-2069

Shannon L. Grove

(916) 319-2034

Donald P. Wagner (Vice-chair)

(916) 319-2068

Adam C. Gray

(916) 319-2021

Mariko Yamada (Chair)

(916) 319-2004

The Coalition for Elder and Dependent Adult Rights (CEDAR) reviewed abuses by RCFEs and urged the Committee to support AB 2171.

AB 2171 is necessary to clarify personal rights in residential care facilities for the elderly (RCFEs) and to close gaps in existing regulations. The bill would also provide needed monetary penalties for violations.

At present, there is no remedy for elders who suffer abuse in RCFEs. Community Care Licensing (CCL), the Long-Term Care Ombudsman, and law enforcement are unable or unwilling to protect RCFE residents. Civil courts hold that families have no standing to protect loved ones until after the death of the victim.

Coalition for Elder & Dependent Adult Rights (CEDAR) is a collaboration of advocates with firsthand experience of horrific abuse in RCFEs. Each of us watched a loved one victimized for an extended period of time. Each of us found that Community Care Licensing (CCL), the Long-term Care Ombudsman, law enforcement, and civil courts offered no remedies for abuse of our loved ones.

Full Article & Source:
California’s AB 2171 introduces Bill of Rights for assisted living residents

10 Dirty Tricks of Guardians

Pinellas County Internal Auditor Robert W. Melton  lectured at Eckerd College in St. Petersburg on: "Dirty Tricks of Guardianships – The Need for Change."

Here are just 10 of the "dirty tricks," as outlined by Pinellas County Internal Auditor Robert W. Melton taken from Justice for FL Senior's website:

1) Guardian creation of a trust: Remove all oversight by the court as a provision of the trust agreement; guardian becomes trustee; provide that the trustee can do whatever they want at their sole discretion.

2) Sell real estate at lowball price: Use "lowball" valuations as a benchmark; don't list property with Realtors; sell to a land trust, where nobody knows the beneficiary; watch property resold a few months later for a huge increase.

3) Maximize your (or your crony's) profit from investments: Hire money manager for "financial expertise" and let the manager select an investment broker; invest in volatile stocks and trade frequently to generate commissions; if you run up a large gain, don't selectively liquidate over time to pay the taxes but hold a "fire sale" to raise funds all in one day.

4) Undervalue beginning inventory: Have a used-furniture "friend" value a house full of antiques for $3,000; "forget" to put some of the more expensive items on the inventory; "forget" to include a $40,000 certificate of deposit.

5) Pay yourself first: Make payment of guardian and attorney fees the highest priority; disregard mortgage payments and let ward's home go into foreclosure; squirrel away money in the attorney's escrow account for possible future expenses.

6) Maintain guardianship at all costs: Keep family members uninformed; if family members try to become guardian, accuse them of stealing; use the ward's assets for legal fights to retain guardianship.

7) Improper financial reporting: Bury asset-management and brokerage fees as aggregate capital losses "due to market fluctuations"; don't classify disbursements separately; file incomplete or incorrect safe-deposit box inventories.

8) Forced incompetency: Visit assisted-living facilities and establish employee contacts; obtain voluntary limited financial guardianship; if there is money in the estate, do paperwork to force an evaluation of competency; get control over everything and the ward loses all rights.

9) Pay your attorney well: Let attorney bill full rate to shop for a computer and set it up for the ward; let attorneys bill their full rate, even if work is done by a paralegal or assistant.

10) Forget to file federal tax returns: Ensure there is a refund; wait till the ward dies; get check without oversight.

Glen Campbell Moved Into A Care Facility

Glen Campbell has been moved into a care facility three years after being diagnosed with Alzheimer's disease, reports.

"He was moved to an Alzheimer's facility last week," a family friend told the title. "I'm not sure what the permanent plan is for him yet. We'll know more next week."

The singer, whose "Rhinestone Cowboy" topped the charts in 1975, had been suffering from short-term memory loss in recent years. He was diagnosed with Alzheimer's disease in early 2011.

Full Article & Source:
Glen Campbell Moved Into A Care Facility

Monday, April 21, 2014

Claims of abuse at local nursing home


SAN ANTONIO -- Several senior citizens, some of them U.S. military veterans, have filed a lawsuit against a local nursing home, claiming severe abuse and neglect.

Parklane West Healthcare Center on the Northeast Side is being sued by three San Antonio families. The attorney representing the families, Marynell Maloney, held a news conference Tuesday. Maloney claims her clients have been repeatedly abused and neglected over several years.

The family of one man, a colonel who has since passed away, claims he had fallen one day but didn't receive treatment for his pain until 14 hours later.

Full Article & Source:
Claims of abuse at local nursing home

Suspended lawyer seeks removal of disciplinary judge

Judge William "Bill" O'Neil
A suspended lawyer who practiced law extensively in the gay community and who is fighting additional state Bar allegations argued Wednesday that Arizona's top disciplinary judge should be removed from her case because he is biased against gays.

Jane O. Ross testified that presiding Disciplinary Judge William "Bill" O'Neil violated her rights and manipulated a previous disciplinary case against her because she is a lesbian who challenges judicial authority and fought for an anti-discrimination rule on behalf of gay lawyers.

"It is exactly that discrimination I'm alleging," Ross said during a hearing to determine whether O'Neil should be disqualified from the case. "I pushed both of his buttons. ... I challenged judges, and I'm homosexual."

Full Article & Source:
Suspended lawyer seeks removal of disciplinary judge

Scammers Bilk Elderly Women Out of Thousands in Queens, Police Say

QUEENS — Thieves have been targeting elderly women — including one who was 86 years old — in Queens to scam them out of tens of thousands of dollars by promising them winning lottery tickets and large cash sums, police said.

At least two such cases recently took place within the 102nd Precinct, which covers Kew Gardens, Woodhaven and Richmond Hill, police officials said.

And police sources said that several similar incidents targeting elderly women recently took place in Forest Hills as well. Details were not immediately available about the additional incidents or if they were related to the ones in the 102nd Precinct.

In the latest incident, which occurred in Kew Gardens on April 9, a couple approached an 86-year-old woman on Lefferts Boulevard, near Cuthbert Road, according to Deputy Inspector Henry Sautner, the precinct's commanding officer.

The couple told the women that they found $150,000 and they were willing to give her $50,000, but they would first need a $10,000 finder’s fee.

Full Article & Source:
Scammers Bilk Elderly Women Out of Thousands in Queens, Police Say

Sunday, April 20, 2014

California seniors have highest poverty rate, study finds

 Allen Stross of Berkeley started working at age 13. He's been a delivery boy, a sign painter, a Navy sailor and a photographer for the Detroit Free Press. Now, at age 90, he and his wife live on about $21,000 a year. After they pay for rent and medications, they're left with just $416 a month.
Allen Stross - Photo: Lea Suzuki, The Chronicle 

"No restaurants. No movies. No new clothes. We look for a lot of freebies," he said. "But I try not to worry about things I can't control, such as the past or the future. My wife's a Buddhist. That helps."

Stross and his wife, a retired art history teacher, are among a growing throng of formerly middle-class Americans who find themselves in poverty as seniors. For about 6.3 million seniors nationwide living below the poverty line, that means eating most meals at free dining rooms, rarely turning up the heat, rationing medications and praying that emergencies never strike.

California, with its high cost of living and health care, leads the nation in the percentage of older adults living in poverty, according to a 2013 report by the Kaiser Family Foundation. Twenty percent of California adults over age 65 live below the poverty threshold of about $16,000 annually, when taking into account the higher cost of housing and health care.

Full Article & Source:
California seniors have highest poverty rate, study finds

Young and Old Share Support at Oregon Housing Complex

At a special housing development in Oregon, families who adopt foster children live side by side with seniors who volunteer their time in exchange for affordable rent. The NewsHour's Cat Wise reports how members of the intergenerational community find support and connection together.

Full Article & Source:
Young and old share support at Oregon housing community