Have a beef on a nursing home? Pa. inspectors won't talk to you, advocates say

Ana Escalante and Rebecca Clark

Michael Clark was shocked by how quickly his elderly mother deteriorated in May when he put her in a Philadelphia nursing home because caring for her had become overwhelming.

After 10 days, Clark found her "in the cafeteria slumped over the table in distress, not able to lift her head, complaining of neck pain," Clark said.

The next day, May 12, Rebecca Clark, 96, was admitted to Pennsylvania Hospital, where she spent two weeks, followed by 10 days of therapy at a different home.

When Michael Clark complained to the Pennsylvania Department of Health, which regulates nursing homes, he was stunned by how easily the facility was cleared.

"No interview with me. No interview with the client," Clark said, pointing to his mother, who is back in his home.

"No 'Can we see any pictures?' So what kind of investigation did they do? Really, it was a one-sided investigation where they said they went to the facility and spoke to the staff. The staff is going to give you a one-sided story," Clark said.

Advocates for nursing-home residents and their families said Clark's experience is common.

"It's like calling 911 and the police going to the suspect's house, listening to his side of the story," and then clearing the suspect, said Samuel Brooks, a senior attorney at Community Legal Services Inc., of Philadelphia.

The state Department of Health countered that it takes nursing-home complaints seriously, follows up on every inquiry, and, in the last year, has improved oversight.

"Some people being displeased with the results of our investigations doesn't mean that the investigatory process was not followed," said agency spokesman Wes Culp.

In June of last year, Community Legal Services published a report by Brooks that criticized the Health Department for dismissing 92 percent of the complaints against Philadelphia nursing homes and minimizing the severity and breadth of harm when it finds deficiencies.

The following month, Secretary of Health Karen Murphy asked Pennsylvania Auditor General Eugene A. Pasquale for an audit of how the agency ensured adequate nursing care, how it responded to complaints, and how consistently it imposed fines.  (Click to continue)

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Have a beef on a nursing home? Pa. inspectors won't talk to you, advocates say

Seniors called the “hidden victims” of opiate epidemic

LOCKPORT, N.Y. (WIVB) –  There’s a growing problem in Niagara County affecting seniors. A group focused on elder abuse says they are the invisible victims of the opiate epidemic.

Niagara County Sheriff’s Office Investigator Mike Licino said, “These people will do anything to get their drugs, and they see elderly parents elderly grandparents as an easy target.”

He works with the Coalition For Elder Abuse in Niagara County. He said he’s seen “staggering” growth in the number of fraud cases from victims’ own family members.Many of these cases are motivated by drugs:

Licino said, “These people know what they’re doing. They’ve practiced this skill of deception. It makes them an easy target, or they pray on the kindness; Your sweet Grandmother who would do anything for you, and they know that.”

Licinio says often its family members who are also caretakers or powers of attorney for the victims, meaning they handle their bills too. He says victims have worked their whole lives to build a nest egg, and now that’s being taken advantage of:

Licino said, “The banks will call us a lot of times, and the elderly person won’t want to go after their family member, they’ll want to just let it go.”

The Niagara County District Attorney’s Office says they’ve prosecuted more then 20 cases of internal family fraud so far this year. But as the referrals from adult protective services, The Assistant District Attorney said those numbers are in the hundreds.

Licino said, “Unfortunately the opiates are evil. Once it gets its’ hooks into somebody, they will do anything to chase that next high.”  Leaders say education is a huge part of prevention. Licinio says if you feel you’re at risk, dont’ be afraid to call.

There are many resources available to you. You can contact the Niagara County Office of the Aging if you feel you’ve fallen victim to family fraud. You can also find resources through the New York State Bar Association here. 

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Seniors called the “hidden victims” of opiate epidemic

With New Mandate, Special Ed Classrooms Get Cameras

KELLER, Texas — Ten years after she first asked the Keller school district and state lawmakers to install cameras in classrooms for children with special needs as a safety measure, Breggett Rideau is finally seeing her request fulfilled.

Beginning this school year, Senate Bill 507 requires Texas school districts to install, operate and maintain video cameras and video-audio recording equipment in some special education classrooms if a parent, trustee or staff member requests it. The system is intended to ensure the safety of students with disabilities in classrooms where they spend more than half their school day.

Officials say Rideau’s son’s classroom at Keller High School is one of the first in Texas to be equipped with cameras and audio equipment at the request of a parent. Terrance Rideau II, 21, known as “Lil’ T” by family and friends, is nonverbal student who uses a wheelchair and who has attended Keller schools since the age of 3.

Other Texas school districts are installing cameras or processing requests.

Rideau had been asking the Keller school district for a camera in Terrance’s classroom since 2006 — but was told it would be illegal.

In 2013, the Rideaus won a $1 million judgment against the Keller school district because of injuries — including a fractured thumb, dislocated knee and head contusion — that Terrance received between 2008 and 2010 while a student at Keller Middle School. The federal lawsuit asked the Keller district to take responsibility for the injuries, which the Rideaus say were caused by a special education teacher who is no longer with the district.

Rideau made at least 20 trips to Austin in 2013 and 2015 trying to get the law passed, even hiring lobbyists in the last session to help her win the battle.

“I didn’t have a clue how to do this when I started,” Rideau said. “I got a degree in food science, not law and public policy, but I prayed and God helped me.”

Public hearings conducted by the Texas Education Agency drew a wide range of comments, both in support and opposition to the plan.

One special education teacher commented that “a couple of bad apples should not bring on such a huge undertaking.”

Some administrators voiced concerns about how much the cameras would cost.

One person said the financial obligation would be offset by the “deterrence of abuse and neglect by educators” and the “deterrence of false accusations against educators.”

School districts updating policies

Texas Education Commissioner Mike Morath issued updated rules regarding the cameras Aug. 15, and school districts were instructed not to use federal or state special education money to pay for the cameras and related equipment.

The estimated costs vary from one district to another. The updated state rules say that “on a per classroom basis, school districts have estimated costs ranging between $3,500 and $5,500. School districts have estimated that conducting video surveillance districtwide could cost anywhere from $350,000 to $6.8 million.”

Keller district officials earmarked $100,000 in their 2016-17 budget for special education classroom cameras and recording equipment. Cost estimates range from $2,500 to $10,000 per classroom, based on recording equipment needs and the technology infrastructure in place at the campus, Keller officials said.

Many districts recently adopted or are in the process of updating policies because of the rules update. Keller is scheduled to vote on its Special Education: Video/Audio Monitoring policy at a meeting this week.

Clint Bond, spokesman for the Fort Worth school district, said that officials were still finalizing their procedures, which will go before trustees in the coming weeks. Administrators are requesting $300,000 be set aside to deal with requests. Fort Worth has received three requests for cameras, Bond said.

Northwest school district officials have received five requests so far and are finalizing the procedures to fulfill them.

In an emailed statement, Emily Conklin, Northwest communications director, said, “… we believe this is a good law to protect children and staff members; however, we continue to disagree with the Legislature’s decision not to fund this mandate. NISD will be working with our local legislators during the next session to gain funding for this new law.”

‘Every child deserves to be safe’

In Keller, in addition to the camera system at Keller High School, another one was installed in a special education classroom at Fossil Ridge High School.

Amanda Bigbee, in-house attorney for the Keller school district, said another five requests are being processed at Bluebonnet, Park Glen and Whitley Road elementary schools, the new Early Learning Center South and Trinity Springs Middle School.

Each video recording system retains six months of recordings. Before cameras are activated, all parents of students in the class and all staff members on campus must be notified. Bigbee said Keller administrators also posted signs at the door of the classroom. No one on the campus has access to the video feed.

If an injury incident is suspected, a district-level committee, which would include a special education director and a behavior specialist trained in appropriate restraint measures, would view the recording, she said. A parent would not be allowed to see the video unless an incident was confirmed by the committee.

“The statute is pretty specific to ensure the process is not abused and cannot be used inappropriately,” Bigbee said.

Rideau, whose lobbied for the legislation, said she hopes to extend the law to the federal level to make classrooms safer for the most vulnerable students like her son, and has talked to other interested parents across the United States and in Canada. A Facebook group, “Cameras in special needs classrooms,” has more than 26,000 likes.

“Every child deserves to be safe in school,” she said.

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With New Mandate, Special Ed Classrooms Get Cameras

Disability groups seek to intervene in teen's plan to die

APPLETON, Wis. — Disability rights groups are attempting to intervene in an Appleton teenager’s decision to cease medical treatment and die of the incurable disease that has racked her body and left her in constant pain.

Carrie Ann Lucas, executive director of the Colorado-based Disabled Parents Rights, said her organization is one of several that have asked for child-protection authorities to investigate the case of 14-year-old Jerika Bolen, whose decision to enter hospice care at the end of summer gained national attention.

“A child doesn’t have the capacity to make those types of decisions, and under the eyes of the law, this is a child,” Lucas said Tuesday.

Jerika suffers from Spinal Muscular Atrophy Type 2. She and her mother, Jen Bolen, said earlier this summer that Jerika would go without her ventilator while under hospice care in early September, essentially scheduling her own death. Her story drew an outpouring of support when her family, friends and her care team held a prom, dubbed Jerika's Last Dance, in late July.



On Tuesday, Jen Bolen asked for privacy and declined further comment about her daughter's medical care.

Melissa Blom, director of Outagamie County’s Children, Youth and Families Division, also declined comment on whether her office has received a referral or opened an investigation, citing the confidentiality of child-welfare cases.

Jerika was diagnosed as a baby with Spinal Muscular Atrophy, often referred to as SMA. The incurable disease destroys nerve cells in the brain stem and spinal cord that control voluntary muscle activity. Jerika has never walked, and today her movement is mostly limited to her head and hands.

Jerika said she’s in constant pain — about a seven on a scale of one to 10 on her best days. She expressed concern that her pain and the need for more invasive medical interventions would grow as her body continues to deteriorate.

 

Jerika Bolen and her mother Jen are illuminated by green fireworks Saturday, July 2, 2016 in Menominee, Mich. Danny Damiani/USA TODAY NETWORK-Wisconsin; (Photo: (Photo: USA TODAY NETWORK-Wisconsin))

Lucas, who said she is unaware of whether a child-protection investigation has commenced, said her organization is not asking that Jerika be removed from her mother’s care.

“Foster care will not solve this problem,” she said.

But Jerika is in need of mental health care, not additional support for ending her life, Lucas said.

Lucas said four organizations sent a joint letter to the Wisconsin Department of Children and Families asking for intervention, and she followed up with a phone call to Outagamie County's Children, Youth and Families Division. The other organizations are Not Dead Yet, NMD United and the Autistic Self Advocacy Network, Lucas said.

Debate began to bubble as many reached out to celebrate Jerika's life in July. More than a 1,000 people arrived at a prom thrown in Jerika's honor as a last wish. Police and firefighters provided a motorcade. She received cards and gifts from around the world and shout-outs from a number of celebrities.

But her decision also drew pleas that she change her mind, including from adults with Spinal Muscular Atrophy.

Jen Bolen, in a July interview, said those critical of Jerika's decision fail to understand the depth of medical intervention it’s taken for her to reach her teenage years.

"I was fighting for my kid," she said. "I never thought I'd be on this side of things."

Lucas, meanwhile, said Jerika's decision — and the support she's received — is an important issue to the disability rights community. Those with disabilities have equal rights to child protection, which includes efforts to ensure parents are acting in their children’s best interests, she said.

Though Jerika's disease is progressive, it isn’t “acutely terminal,” Lucas said, and she questions whether simply withholding treatment would be sufficient to end her life quickly.

 

 Jerika Bolen laughs with friend Mackenzie Falck as they watch fireworks together with Haley Paradiso and Hanna Gove during an Independence Day celebration at Jerika's grandparents home Saturday July 2, 2016 in Menominee, Mich.    (Photo: (Photo: Danny Damiani/USA TODAY NETWORK-Wisconsin))
 
When it’s a decision of death, “it’s never in the child’s best interests,” Lucas argued.

Jerika’s story is far from the first time end-of-life decisions have drawn controversy.

Perhaps the most famous case was that of Terri Schiavo, a brain-damaged Florida woman who was taken off of life support in 2005 after a family battle and a national debate over decision-making authority.

Diane Coleman, executive director of the anti-euthanasia organization Not Dead Yet, compared the Bolens’ situation to that of Julianna Snow, a 5-year-old Oregon girl who was given the choice by her parents on whether to continue medical treatment.

Snow, who had an incurable neurodegenerative illness, chose against further hospitalization and died in June after spending 18 months in hospice care.


Coleman questioned both cases based on their ages. But her organization views euthanasia as a form of discrimination against the old, ill and disabled.

“I worry that there’s an attitude in the health care profession that really writes people off with disabilities,” she said. “I worry that people like Jerika and Julianna are in the throes of that, and without adequate support.”

The withholding of treatment from the disabled was recently subject of court scrutiny in Wisconsin based on a lawsuit brought by the Disability Rights Wisconsin organization.

In 2009, the organization sued five doctors from UW Health over their withholding of treatment from two developmentally disabled patients, including a 13-year-old boy they had placed in hospice care. Lawyers argued the boy would have recovered from pneumonia.

The case was dismissed at the circuit court level, and in 2014, the Wisconsin Court of Appeals upheld that decision, putting an end to the lawsuit.

Attorneys for Disability Rights Wisconsin argued “parents had no right to direct the withholding or withdrawal of life-sustaining medical treatment to their children who are not in (a persistent vegetative state.)”

The court rejected the organization's arguments that withholding of care violated the patients' due process rights.

Lisa Pugh, public policy director for Disability Rights Wisconsin, couldn’t be reached for comment on Tuesday.

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Disability groups seek to intervene in teen's plan to die

Piscataway Police to Train on Elder Abuse Prevention

NEW BRUNSWICK, NJ - More than 140 law enforcement officers from various departments around the state are attending a two-day conference offering instruction on how to protect and assist senior citizens by learning to recognize the signs of psychological, physical and financial abuse.

The Elder Abuse & Exploitation Conference, sponsored by the Middlesex County Prosecutor’s Office is being held Thurs. and Fri. at the Middlesex County Fire Academy in Sayreville.

Middlesex County Prosecutor Andrew C. Carey said law enforcement officers from each of the 28 police agencies in the county, including those from the Piscataway Police Department will be attending.

More than 20 guest speakers will discuss a variety of topics that will help law enforcement recognize and assist senior citizens who are being financially or physically abused by their caretakers.

The keynote speaker will be Deputy District Attorney Paul Greenwood from the San Diego County District Attorney’s office. Greenwood heads that agency’s Elder Abuse Protection Unit.

“When it comes to elder abuse and financial exploitation, our goals are twofold,” said Carey.

“First, in order to prevent crime, we must give support and identify resources available to our seniors and those who care for them,” he said. “Second, where there is evidence of crime, we must aggressively investigate and prosecute those committing these illegal acts.”

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Piscataway Police to Train on Elder Abuse Prevention

What Issues are Raised When an Inheritance Passes Outside the Family?

Anytime a person not related by blood is named as a beneficiary, lawsuits are a possibility.

Unfortunately, we live in a world where people can be selfish and dishonest.

The result?

Whether you are receiving or giving assets to a non-relative, you must be cautious, very cautious.

This topic was taken up by the New Hampshire Magazine in an article titled “Navigating Non-Relative Inheritance.”

So, what is one of the biggest concerns?

Elder abuse.

And elder financial exploitation is on the rise.

Consequently, you must do everything possible to protect yourself and your senior loved ones from predators or opportunists.

Even if the beneficiary has pure motives, an estate could still be in trouble.

Why?

By naming an individual other than a natural heir as a beneficiary you can raise suspicions at best and trigger anger at worst—especially because assets are typically left to family or a beloved charity.

On the other hand, you must also exercise caution when receiving assets from an estate.

To protect yourself from false accusations and lawsuits, you should be take protective actions.

How?

Remove yourself from suspicious situations and circumstances.

If a person could interpret your actions as selfish or manipulative, they could work against you.

Be sure to have an expert determine and record the capacity of the non-family member wishing to benefit you.

This evidence will be useful in determining the validity of will, trust or other arrangement if (and when) later challenged.

Ultimately, there is a tension between following the wishes of the person choosing to distribute assets to his or her chosen non-family member beneficiary and protecting that same individual from elder exploitation.

The rights of each individual to distribute wealth according to his or her wishes - and to be defended from thieves - must both be taken seriously.

It is shame this is an issue at all.

For advice in preserving your rights and protecting your estate, work with an experienced estate planning attorney.

So, how do you find an "experienced" estate planning attorney?

First, ask around. Friends, family and other professional advisors are trustworthy sources.

Second, conduct an "organic" search on "Google" for "estate planning" near you (e.g., "Estate Planning Anytown MoKan").

Third, either way, verify! Check out the education, experience, ratings and client reviews of any attorney before you contact him or her.

How?

Two helpful online resources are just a mouse click away to assist with your due diligence:  Avvo.com and Lawyers.com.

Check any Avvo ratings, client ratings/testimonials and attorney endorsements on Avvo.com and any "peer ratings" by judges/other attorneys and any client ratings/testimonials on Lawyers.com.

In fact, I use both of these services to thoroughly vett attorneys before referring members of our "client" family for legal help in other areas of law or for matters in jurisdictions outside Kansas or Missouri.

Remember: “An ounce of prevention is worth a pound of cure.” When making your financial, tax and estate plans, do not go it alone. Be sure to engage competent professional counsel.

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What Issues are Raised When an Inheritance Passes Outside the Family?

TN: Feds: Patients suffered in nursing home fraud case

The federal government has sued Brentwood-based nursing home company Vanguard Healthcare LLC., alleging the company submitted false claims to Medicare and TennCare on behalf of its senior residents and failed to provide them with even basic nursing services.

Moreover, the lawsuit alleges residents suffered "pressure ulcers, falls, dehydration, and malnutrition, among other harms" due to lack of care.

The lawsuit says the falsified claims were for skilled nursing home services that were "either non-existent or grossly substandard" and also included forged physician and nurse signatures, according to the news release sent from the office of U.S. Attorney David Rivera Wednesday.

The lawsuit alleges the false claims were made at six Vanguard facilities, including the Boulevard Terrace Rehabilitation and Nursing Center in Murfreesboro; the Crestview Health and Rehabilitation in Nashville; the Glen Oaks Health and Rehabilitation in Shelbyville; the now-defunct Imperial Gardens Health and Rehabilitation in Madison; the Manchester Health Care Center in Manchester; and the Poplar Point Health and Rehabilitation in Memphis.

Investigation
Patients given wrong dose time and again
Vanguard settles fraud suit
Nursing home deals with $240K in fines

The worst allegations come against five of the six facilities, including the Boulevard, Crestview, Imperial, Glen Oaks and Poplar Point sites.

"The lack of adequate care at the Vanguard facilities included chronic staffing shortages and shortages of critical medical supplies, failure to provide standard infection control, failure to administer medication to residents as prescribed by their physicians, failure to provide wound care as ordered by physicians, failure to adequately manage residents’ pain, and providing unnecessary and excessive psychotropic medications to residents and using unnecessary physical restraints on residents," the release states.

The lawsuit alleges Mark Miller, who served as director of operations for Vanguard from September 2011 until August 2014, "knew that resident care at the Vanguard facilities was non-existent or grossly substandard but failed to correct these problems," according to the release.

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Feds: Patients suffered in nursing home fraud case

Controversial Judge Retires

Judge Pat Ferchill retires

Tarrant County Judge Pat Ferchill announced his retirement effective Aug. 31 after sitting on the bench for 35 years in Probate Court No. 2. Ferchill was two years into a four-year term that expires in 2018. He will continue to sit on the bench as a visiting judge until county commissioners appoint his successor.

Some people might shed a tear for Ferchill’s departure, we suppose. Probate courts resolve some sticky family dramas at times.

“The county is going to miss him more than they’ll know after he’s actually gone,” Associate Judge Lin Morrisett told us on the phone this week.

You know who won’t miss him? The families who have described how a guardianship system overseen by Ferchill and fellow probate Judge Steven King have ripped apart families unnecessarily in the name of greed and power. The first case we examined in the Fort Worth Weekly involved Kathie Seidel, a mother who adopted a child from Russia but later lost custody after a guardianship hearing was held by Ferchill without Seidel being present (“Saving Katia,” July 2, 2008). After that article appeared, dozens of families called the Weekly to describe similar horror stories of a powerful court system under the influence of money-hungry attorneys and healthcare facility operators more interested in lining their pockets than doing what is best for families. Associate Editor Jeff Prince has written numerous stories about the probate system and has compiled a long list of local families who describe being victimized by the probate courts.

Frank and Chila Covington were one of those families. Ferchill removed them as guardians of their Down Syndrome daughter, Ceci, without bothering to let them know that their parental rights were being questioned. Yep, the court has that power and wielded it like a baseball bat against them in 2009. The Covingtons’ crime? They did not want their daughter to be administered psychoactive drugs that they say put her in a stupor. They preferred a more natural approach to treating her mental problems.

The Covingtons say Ferchill’s decision to remove them as guardians was a way to pad the pockets of attorneys and caregivers who profit from working with Guardianship Services, Inc., the program that Ferchill and his attorney buddies helped establish in 1998 allegedly to provide help for people in need.

Ferchill just wanted to send people to Guardianship Services, Chila said.

“We were just somebody else he could manipulate,” she said. “It is just greed.”

The Covingtons spent about $400,000 in a years-long fight to regain custody of their daughter.

Kathie Seidel (with son, Greg)

Ferchill “devastated our lives with lies,” Chila said. “They decided to control my daughter’s destiny by saying she was psychotic.”

Another local woman, Dorothy Luck, was put under guardianship after the probate court decided she wasn’t mentally sound enough to manage her financial affairs correctly. Luck is elderly but quite sharp when it comes to her personal and financial affairs. But all it took was one complaint from a relative (who had a vested interest financially) and Luck found herself having to defend her abilities to take care of herself (“Grabbing the Purse,” Sept. 3, 2013). She proved herself capable time and again, but she couldn’t stand up against a court system so powerful that it can remove a person’s rights at will.

Over the next year or so, court-appointed attorneys charged about $500,000 to Luck’s bank account while, a’hem, valiantly fighting to protect her money from … uh … herself.

Seidel spent a decade fighting against Ferchill and the probate court’s methods, first as a lone voice in defense of Katia and, later, as part of advocacy groups such as G.R.A.D.E., or Guardianship Reform Advocates for the Disabled and Elderly, a group formed to help protect people from overzealous probate judges. Seidel died from cancer a few weeks ago, on August 16, at her Fort Worth home. She still blamed Ferchill for putting her family through hell unnecessarily. Shortly before she died, she e-mailed Prince.

“Things are pretty dicey with physical problems,” she wrote. “Of course, it is hard to do any letting go where my children and other loved ones are concerned. It won’t be difficult to let go of the physical challenges.”

After that first quick paragraph, she dived into the topic that drove her to rail against a powerful system for the last decade of her life. Her adopted daughter was put under guardianship, removed from her home, and prevented from seeing her mother for years.

Guardian Services “is being informed this week that I am terminal in hopes that we can get more visits with Katia,” who is 30 years old now and living in a group home, “and to prepare her for my death,” Seidel wrote. “It kills me to think of what K will go through in having so little family support through the grief she will encounter … also, I want her to be able to go to grief counseling  –– but am doubtful she will get it. We worked for more than six months trying to find money and a high-profile attorney to advocate for her knowing this might be coming.”

She ended her e-mail by expressing fears that the probate court would toss one more indignity her way as she was dying.

“If there is retaliation toward me (threatening to put me under guardianship), I have written a letter,” she said. Her son, Greg, “knows the location of it, and you may be interested in it.”

Seidel’s friends say she would have appreciated knowing that Ferchill will no longer sit on the bench.

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Controversial Judge Retires

Zsa Zsa, 99, ‘outlived expectations’: Hubby pleads for money

Zsa Zsa Gabor in 1959

The husband of Zsa Zsa Gabor is seeking an extension of the $19,000 a month he receives from an escrow account associated with the couple’s Bel Air home so that he can continue paying conservatorship expenses regarding the former actress.

In court papers filed Sept. 1 on behalf of Frederic Prinz von Anhalt, lawyer Matthew Kanin said the ailing Gabor “has outlived expectations.” The Hungarian-born Gabor is scheduled to turn 100 years old on Feb. 6.

In May 2013,  Judge Reva Goetz, who is now retired, approved the sale of the couple’s home for $11 million in an agreement that allowed  Gabor to remain there for the time being. The sale will close either 120 days after Gabor dies or in September 2017, whichever comes first.

Last November, Los Angeles Superior Court Commissioner Brenda Penny authorized monthly payments of $19,000 from the home’s escrow account to von Anhalt, who has served as conservator of Gabor’s estate since July 2015. The judge’s order is scheduled to expire Nov. 16.

“That funding needs to continue to flow to (von Anhalt) … through September 2017 … because it is just enough to cover the normal monthly expenses of (Gabor),” Kanin states in his court papers.

The extension is needed to “avoid a budget crisis” for Gabor, according to Kanin’s court papers.

Von Anhalt believes his wife is comfortable in her home and would not want to move because it is familiar to her, according to Kanin’s court papers.

“In order to avoid having to transfer his wife to another location, von Anhalt “is currently in talks with the buyer to extend the agreement for one more year,” Kanin states in his court papers.

The excrow account currently has a balance of more than $315,000, according to Kanin’s court papers. Von Anhalt has about $62,000 in cash on hand and by the end of next year will have to spend more than $50,000 on homeowner’s insurance, property taxes and employment taxes, according to Kanin’s court papers.

A hearing on von Anhalt’s petition is scheduled Oct. 3.

In July, von Anhalt filed a separate petition seeking a $120,000 gift to himself from Gabor’s estate “to maintain (his) standard of living as he enjoyed during his long-term marriage to (Gabor).”

The petition states that prior to becoming ill and incapacitated, Gabor was the “familial breadwinner” who supported von Anhalt financially.

However, in recent years, von Anhalt has “taken no wealth for himself” and his benefits have been confined to the conservatorship providing his lodging and paying his health insurance and automobile expenses, according to the petition. He has provided full-time care for his wife since 2001, the petition states.

The Gabor conservatorship has assets of more than $10 million, according to the petition, which is set for a hearing March 1.

In November 2002, Gabor was involved in a car crash that left her partially paralyzed. She suffered strokes in 2005 and 2007, and in 2010 she fractured her hip and had a hip replacement.

In 2011, Gabor’s  right leg was amputated above the knee to save her life from an infection. In February, she was hospitalized after suffering from breathing difficulties.

Full Article & Source:
Zsa Zsa, 99, ‘outlived expectations’: Hubby pleads for money

Sam Huff needs help making life decisions; there is a fight over who should do it

On March 31, just four days after Easter, Catherine Huff visited Huff Farm, the sprawling Middleburg estate with fields fit for horses, rooms filled with football memorabilia and home to one of the most famous men to ever play for the Washington Redskins. She picked up her father, Sam Huff, the Hall of Fame linebacker, to take him to a dentist appointment. Nothing seemed amiss to Carol Holden, Huff’s live-in domestic and business partner of nearly three decades.

“Ms. Holden had no idea that [Huff’s daughter] had no plans of bringing Mr. Huff back to Middleburg or returning him to Huff Farm,” according to court records.

Five months later, Huff still has not returned. The 81-year-old member of the Pro Football Hall of Fame suffers from dementia, according to court papers, related to either Alzheimer’s or chronic traumatic encephalopathy, a degenerative brain disease researchers link to playing football. He now finds himself caught in the middle of a family dispute over who should be making medical and financial decisions on his behalf.

Holden filed a petition in May for Huff to be returned to her care, asking the court to grant an emergency appeal and appoint her as Huff’s guardian.

“It appears that [Huff’s daughter] is not concerned at all with Mr. Huff’s best interests,” Holden alleged in one court filing, “but rather in advancing her own needs and interests over those of her father or exacting revenge against Ms. Holden.”

There is a hearing on Holden’s emergency motion scheduled for Sept. 16 in Loudoun County Circuit Court. Catherine Huff has recently changed lawyers, and her new attorney, Eric Schell, said he’ll be seeking to postpone that date. He would not comment further on the case and said his client was unavailable to comment.

In Catherine Huff’s filings, she said her father was evaluated in July and “is incapacitated and is unable to make his own medical and financial decisions.” She alleged that under Holden’s care, her father was “seen wearing the same clothes day to day,” would walk outside in the winter without appropriate attire and was allowed to drive his car on the road, putting himself and others at risk.
Holden’s attorney, Kimberley Murphy, declined to comment.

Huff was known as his generation’s most bruising, hard-nosed player, personifying toughness in a hard-scrabble era of football. He was inducted into the Hall of Fame in 1982 after 13 seasons, eight with the New York Giants and his last five in Washington.

He began broadcasting Redskins’ games in 1975 and stayed behind the mike until finally stepping away in 2013. For most of that time, he offered color commentary alongside his friend and former teammate Sonny Jurgensen, their folksy banter helping to draw together a region of football fans every fall.

When Huff left Middleburg in March, his daughter did not take any of his medications, clothing or belongings with her, according to Holden’s petition. He apparently has been living in Alexandria with Catherine Huff and has had little contact with friends, neighbors and associates he’d known for years in Middleburg.

Holden and Huff never married. In court filings, Holden describes herself as Huff’s “life partner “of nearly 29 years, a characterization that Huff’s daughter calls inaccurate in her legal response.

The dispute does not appear to be a matter of money but rather a disagreement over who can make decisions on Huff’s behalf. Both sides agree that the former football great is in no condition to do so on his own.

Holden explained that Huff first had a diagnosis of dementia in 2013 and is partially incapacitated.

“While Mr. Huff can dress and undress himself and eat without assistance, he requires assistance with certain personal affairs and management of his financial affairs,” Holden stated.

While Holden has requested an emergency change of guardianship, Huff’s current condition is not clear. According to his daughter’s filings, Huff is receiving care from a “geriatric care manager” and could soon relocate to West Virginia, where Huff was born, raised and became a college football star. The court appointed a guardian ad litem in May to represent Huff’s interests.

His absence around the Redskins and Middleburg has not gone without notice. For several years, longtime friend Franklin Payne met Huff for breakfast at the Red Fox Inn in Middleburg. Eight o’clock, every single morning.

“I have not been in touch with Sam since he was kidnapped and taken away from Middleburg,” Payne said. “I would like to see Sam back here. He has so many friends here, and everybody knew him. We just don’t know how he’s doing.”

In her filings, Holden makes the argument that Huff didn’t willingly leave his home of nearly three decades — “his comfort zone, routine, friends and everything he knows and loves,” she said.

In 2011, Huff granted his daughter durable power of attorney, giving Catherine Huff control over his finances in the event he becomes incapacitated. That same day, he executed an Advance Medical Directive naming Holden his agent responsible for health care decisions, court filings show.

Five years later, on April 16, barely two weeks after Huff left Middleburg, he signed another Advance Medical Directive, this time appointing his daughter as chief agent in charge of medical decisions and naming his ex-wife as successor agent.

In a court response, Holden said that Huff was not of sound mind to make such a decision and said that Huff’s divorce was “contentious.” She said he’d never appoint his ex-wife to have any role in his affairs. Holden paints Huff’s daughter as someone unfit to properly care for him, noting an April 21 incident in which she alleges that Catherine Huff arrived at Huff Farm unannounced.

“She told Ms. Holden to pick which magazines by the kitchen table she wanted because [Huff’s daughter] was going to burn the rest,” the petition asserts.

The document claims that Catherine Huff called Loudoun County Fire and Rescue herself to warn that she was “going to start a fire” and then did just that, setting aflame two of Huff’s books, his slippers and some magazines and pictures. Photos of what Holden says are the burned items are included in the court filing as exhibits.

“During the entire incident [Huff’s daughter] was screaming incessantly, acting belligerent and accused Ms. Holden of stealing from Mr. Huff,” according to Holden’s petition.

In her response to the court, Huff denied the incident but offered no other details. A spokesman for the Loudoun County Sheriff’s Office confirmed deputies responded to a call over a civil matter at Huff’s address on that date but because it was a civil matter, there was no criminal incident report.

There are no indications that either party is seeking to amend Huff’s trust or will. Holden’s petition says Huff’s estate has a value of approximately $4 million. In addition Catherine Huff, the football great has two sons, neither of whom was reachable to comment. Along with Huff’s three children, Holden stands to inherit a sizable portion of that. The former linebacker’s will stipulates that Holden and Huff must be “living together at the time of my death,” but later points out that if the two are living apart because he required health or custodial care, “we shall nevertheless, for purposes of this Restatement, be deemed to have been living together,” according to his trust agreement.

After decades in the spotlight — first as a star with the New York Giants and later as the familiar face and voice of the Redskins — Huff has spent the past couple of years in quiet retirement in Middleburg. With his memory and observation skills slipping, Huff took on a lighter broadcasting schedule in 2012 before leaving the booth entirely a year later.

Even then, he and Holden still ran the West Virginia Breeders Classics, the October thoroughbred races in Charles Town, W.Va., and broadcast their weekly horse racing radio show from the second-floor studio of their home. The two are both longtime horse connoisseurs and bought and sold many horses together over the years. They began the Trackside radio show in 1989 and broadcast their final show in January.

Full Article & Source:
Sam Huff needs help making life decisions; there is a fight over who should do it

Can Account Watching Stop Financial Elder Abuse?

EverSafe – a web-based financial account monitoring service for the elderly and those who protect them – exists because people took advantage of Howard Tischler’s mother.

It’s a story that may be sadly familiar to financial advisors.

People age 50 and over own 67% of U.S. bank deposits, according to the AARP. This, says the retired-persons’ advocacy group, make older people “targets of the fastest-growing form of elder abuse: financial exploitation.”

The average victim of this abuse loses $120,000, says the same source. That’s almost what the average age-50-plus household has in savings.

So, though the tale of Tischler’s mother may have triggered an unusual response, it’s far from unique.

Mrs. Tischler, a former accountant with a lifelong habit of financial prudence, had set herself up for a comfortable retirement, says Tischler, EverSafe’s founder and CEO.

But on a visit to his mother, Tischler saw a credit card bill addressed to her for $8,000 — an alarming amount for such a careful spender, he says.

As the story unraveled, a national-name company had phone-sold his mother an $80-a-month automobile-upkeep plan.

“Which may seem reasonable,” says Tischler, who’s been building technology companies since the mid-1970s. “Until you understand she had no license, no car and was legally blind.”

From there, Tischler suspects his mother “got on a suckers list.” By the time Tischler and his brothers could understand how bad the problem was, she’d already succumbed to a host of other pitches — some even more outlandish than the car-care scheme.

To meet her mounting financial obligations the retiree, in a more advanced state of cognitive impairment than her family suspected, had plundered her savings and made a hash of her finances.

“It was a spiral,” says Tischler. “She couldn’t keep up.”

By the time his mother died a few years ago, she’d been bilked out of her nest egg for things she didn’t need and on terms she didn’t understand.

“There should at least be an obligation to know your customer,” says Tischler.

But, as the serial entrepreneur discovered when he reached out to Elizabeth Loewy — for three decades an assistant district attorney in the Manhattan District Attorney’s Office and head of its groundbreaking Elder Abuse Unit — there isn’t.

In fact, very little of what had happened to his mother was illegal. The companies had secured the woman’s consent.

According to a five-year-old study by MetLife, criminal financial elder abuse costs its victims about $3 billion a year.

But Loewy, now EverSafe’s general counsel and head of industry relations thinks such crimes are under-reported in the first place. And they’re easily eclipsed by financial victimization of the elderly that, as Tischler’s family experienced, isn’t strictly against the law.

When you add this not-criminal activity, one study suggests the annual cost to victims of financial elder abuse balloons to $36.5 billion.

That’s the problem EverSafe was designed to fix.

Essentially it’s a permission-based account-oversight system that factors in established spending habits to identify and flag unusual spending and track suspicious-activity resolutions.

“The idea is to open up a family conversation about the issue and, in practical terms, keep an eye on things,” says Loewy, who in 2009 successfully prosecuted Brooke Astor’s son for plundering the famous socialite’s fortune.

EverSafe reports are viewable to the primary client and — where the client’s permission is given — to who Loewy calls “trusted advocates.” This category includes adult children, power-of-attorney holders, financial advisors, accountants and lawyers. And while activity reports can be shared, account balances can be shielded from any and all of these trusted advocates.

The pricing seems reasonable — though it’s tough to make comparisons where competitors are few and far between. It’s $7.49 a month for basic monitoring, $12.99 and $22.99 for tiers that include options around identity-theft prevention.

“We’re trying to make it really affordable,” says Loewy, who joined EverSafe in 2014. “We don’t want people to think twice about the cost of this kind of protection.”

Full Article & Source:
Can Account Watching Stop Financial Elder Abuse?

Fewer With Disabilities Employed, Data Shows

The unemployment rate for Americans with disabilities is edging up as less people in this population actively seek work, according to new data from the U.S. Department of Labor.

Figures released just before Labor Day show that the jobless rate for those with disabilities hit 11.3 percent in August, up slightly from 11.1 percent the month prior.

The shift appears to be due at least in part to more individuals with disabilities giving up on the job market altogether.

Meanwhile, the economy added 151,000 jobs in August and the unemployment rate for the general population was unchanged at 4.9 percent.

Federal officials began tracking employment among people with disabilities in October 2008. There is not yet enough data compiled to establish seasonal trends among this population, so statistics for this group are not seasonally adjusted.

Data on people with disabilities covers those over the age of 16 who do not live in institutions. The first employment report specific to this population was made available in February 2009. Now, reports are released monthly.

Full Article & Source:
Fewer With Disabilities Employed, Data Shows

Oscar, the Cat Who Rules the Dementia Ward

Therapy cats are especially valuable when interacting with Alzheimer’s Disease patients, by stimulating both memory and forgotten emotions.

One of the most astounding cases of cats assisting Alzheimer’s patients is Oscar, the cat who rules the third floor dementia ward of Steere House Nursing and Rehabilitation Center in Providence, Rhode Island.

Oscar has the almost mystical ability to sniff out patients who face imminent death, and he invariably stays with them until they have passed over.

Often, Oscar will not leave a patient’s bedside until someone arrives to remove the deceased. Then, he will turn to the next most needy patient.

Oscar’s story has been told in the masterful book, Making Rounds With Oscar, by David Dosa, M.D., a staff physician at Steere House, with a background in Geriatrics.

No one knows precisely what alerts Oscar to the pending demise of a patient, although there are several theories, including the odor of ketones on the patients’ breath, signaling the breakdown of body cells.

Source:
Oscar, the Cat Who Rules the Dementia Ward

Simi Valley resident awarded $16M in MetLife financial elder abuse scheme

A grandmother who invested her life savings in a fraudulent investment scheme hatched by a MetLife insurance agent was awarded $15.6 million.

Simi Valley resident Christine Ramirez invested $279,769 with a real estate fund Diversified Lending Group that promised that the unregistered and ultimately worthless securities would provide a 12 percent annual return, according to a complaint filed in Los Angeles Superior Court in March.

The court ruled on Aug. 31 that MetLife allowed former managing partner Tony Russon to use insurance sales meetings with prospective MetLife customers to promote DLG investments. DLG was run by Bruce Friedman who died in 2012, according to a news release from Santa Barbara law firm Foley Bezek Behle & Curtis and Tustin-based Donahoo & Associates PC.

After an eight-week trial, the jury unanimously found that Russon, MetLife and two of its subsidiaries — New England Life Insurance Co. and New England Securities — were liable on four civil counts of violation of California securities laws, negligence, and aiding and abetting deceit and financial elder abuse.

The court expedited Ramirez’s case because she is suffering from stage-four breast cancer, said Thomas Foley of Foley Bezek Behle & Curtis.

“It’s tragic,” Foley told the Business Times. “There are a lot of people in the group like that who are losing their homes. Hopefully this ruling means MetLife will be paying punitive damages conceivably in 98 other cases.”

It is the first of 98 client cases against MetLife and its subsidiaries, Foley said.  Ramirez is one DLG investor whose pursuit of a class-action case against MetLife was denied last year. Individual cases, however, were allowed to proceed and Ramirez’s was the first to go to trial.

Other than Ramirez, there are several more tri-county victims, according to the complaint.

“I am so grateful to the jurors for seeing through MetLife’s finger-pointing argument that they weren’t responsible for the loss of my retirement savings,” Ramirez said in a news release.

Despite MetLife’s argument that they knew nothing of the scheme, the jury awarded Ramirez $10 million in punitive damages from MetLife, $2.5 million from New England Securities, $2.5 million from New England Life Insurance and $330,000 from Russon.

Testimony revealed that Friedman and DLG were brought into the MetLife sales operation by Russon, who was owed $750,000 by Friedman. Friedman promised Russon half of DLG securities sales revenue.

The Securities & Exchange Commission sued Friedman and DLG in 2009, alleging that the enterprise was actually a $216 million fraudulent ploy to sell unregistered securities that financed Friedman’s lavish lifestyle.

Friedman fled the country after the SEC suit, but died in a French jail in 2012 while awaiting extradition.

“MetLife spends millions in advertising to build up their brand so people trust the name that’s been around for a long time,” Foley said. “They have got to do a better job supervising their salespeople. They could’ve stopped this years ago.”

MetLife was ultimately liable because it failed to adequately surveil its employees via email and compliance officers, he said.

Ramirez was represented by Foley of Foley Bezek Behle & Curtis; Richard Donahoo of Donahoo & Associates PC; and John Stillman of Good Wildman.

Financial losses in elder abuse cases can often be difficult to recoup. But targeting affiliated third parties has proven to be a successful strategy, Foley said.

In related news, the California Legislature recently blocked a bill that would’ve helped dependent adults and elders, like Ramirez, who were victims of financial abuse.

AB 1754 would have created a pilot program in San Diego County to provide victim compensation funds for services like mental health counseling and financial counseling, which could include restructuring budgets, accessing insurance and public assistance, settling bankruptcy and preventing foreclosure and garnishment.

Full Article & Source:
Simi Valley resident awarded $16M in MetLife financial elder abuse scheme

Augusta woman pleads to reduced charge in elder exploitation case

An Augusta woman accused of helping herself to the bank account of a 96-year-old nursing home patient pleaded guilty Wednesday.

Patsy Sheppard, 60, had been charged with two counts of exploitation of an elder person, two counts of attempted exploitation of an elder person and one count of theft. She pleaded guilty to a single count of theft.

Judge James G. Blanchard Jr. accepted the plea deal and sentenced Shep­pard to 10 years of probation, all but six years of which will be suspended if she pays restitution of about $4,000.

Initially, Sheppard was accused of taking $7,833 from the victim’s bank account in the summer of 2014 and of twice trying to become a joint account holder on the woman’s investment account, which contained $156,000.

The case was a lot more complicated, defense attorney Kimberly Wilder said at Wednesday’s hearing.

Sheppard met the woman through a fellow church member and the two became close. They considered each other family, Wilder said. When the elder woman was put in hospice in a nursing home, Sheppard took over her care, fed her and nursed her back to health, Wilder said. The
woman did get better and the two continued to spend a lot of time together.

In 2014, the woman wanted out of the nursing home and Sheppard offered her home, which Sheppard paid to make handicapped accessible, Wilder said. She was able to provide receipts for most of the money she took from the woman’s account, Wilder said.

Lyndie Freeman, an assistant attorney general, countered that there were a number of questionable money transfers and that the attempt to become a joint account holder on the investment account was stopped because a bank employee realized the elderly woman couldn’t even identify Sheppard.

As conditions of Sheppard’s probation, she cannot work in any residential care facility for disabled or elderly people, nor serve in any position of trust for any disabled or elderly person, nor use anyone else’s financial or personal identity documents.

Full Article & Source:
Augusta woman pleads to reduced charge in elder exploitation case

County seeks more staff to address growing social service caseloads

Washington County officials are requesting more staff next year to address increased caseloads for social service programs.

The Washington County Board of Commissioners conducted their second 2017 budget workshop after their Aug. 23 meeting. The board heard budget requests from Community Services, Public Health and Environment, and the Library System.

Dan Papin, community services director, submitted a budget request of $43,890,700. His department’s workload is growing, he said, and state dollars are not keeping pace. 

“The feds continue to hold up their end of the bargain but it's frustrating since the vast majority of the mandates that we provide — and they’re not all all bad mandates, don’t get me wrong — but they are imposed by the state. Everything we do as a department is to comply with those mandates.”

Papin cited two main areas of concern: 

-- an increase in applications to MnSure, the state run health care exchange for which the county pays 50 percent of the cost to administer;

-- a jump in assessments for MnCHOICES, an independent living support program for the elderly and disabled.

While the MnCHOICES program is paid for by state and federal tax dollars, Papin said they need to hire an administrative worker to deal with a bigger caseload. 

“We don’t mind paying our share,” he said. “They continually have reduced the state share, added more county share, yet the mandates haven’t changed. So it falls on the backs of the county commissioners to balance the budget.”

The property tax increase requested is 1.9 percent in Community Services.

“We do shift dollars where we can to minimize the impact on taxpayers,” Papin said. “Not everything translates to a levy increase.”

The youngest and oldest citizens in the county continue to be exploited, Papin said. He is asking the Washington County Board to hire a full-time adult protection social worker to help respond to a 54 percent increase in adult elderly exploitation reports over a two-year period.

He also cited increased caseloads in child protection investigations and family assessments, which are on pace to exceed last year’s.

Full Article & Source:
County seeks more staff to address growing social service caseloads

Steve Miller: Ghost Of Old Soldier Takes Revenge On Politician And Private Guardian

From his grave, a 95 year old WW2 hero exposes ex-Nevada Attorney General Catherine Cortez Masto and her ties to crooked for-hire guardian Jared E. Shafer.

LAS VEGAS - On a cool winter day in 2013, I was invited to meet then-93 year old Guadalupe Olvera on the veranda of his million dollar hilltop home in Sun City Anthem overlooking the Las Vegas Strip.

Mr. Olvera was there to list the fully-paid-for 3,000 square foot house with a realtor. The house was his last remaining asset from an exploitative guardianship that would later become the basis of a $1.2 million dollar political advertising battle for the about-to-be vacated U.S. Senate seat of Harry Reid.

Olvera explained that he was going to sell the house before his court appointed private guardian Jared E. Shafer could transfer title to himself and sell the property, or as Mr. Olvera feared, move his own family in to enjoy the home Olvera and his late wife Carmela had planned to live in during their golden years.

Jared Shafer

Up until that day on the veranda, most of Olvera's liquid assets totaling over $420,000 had been drained by Shafer and his attorneys with the approval of Clark County Family Court Judge Charles Hoskin and his appointed Hearing Master Jon Norheim, that's until a California Superior Court Judge put a stop to the exploitation and terminated Shafer's years-long control of Olvera's person and assets.

My February 25, 2013 AmericanMafia.com story “GUADALUPE OLVERA'S WAR” told of Mr. Olvera’s battle to regain his civil rights. Three years earlier, Olvera had violated Shafer's orders and moved back to Santa Cruz, County, California to spend his remaining years with his family. In retaliation, Shafer had Judge Hoskin issue a Contempt of Court arrest warrant for Olvera's daughter. Meanwhile, Jared Shafer and his lawyers embarked on a mission to drain all of Olvera’s liquid assets, Shafer charging $250 per hour to read emails, and paying high priced Las Vegas attorneys to try to force the old soldier to return to Nevada where he had no family or friends.

The story of Olvera'’s plight began to inspire news coverage as Shafer bled the elderly gentleman's trust and attempted to gain title to his plush home on the hillside in Henderson. In the meantime, calls and letters went out to then-Nevada Attorney General Catherine Cortez Masto from Olvera’s only living relative Becky Schultz and others asking the AG to intervene and stop the exploitation. They were in response to Cortez Masto's website that said the AG would stop elder abuse and exploitation. Nonetheless, the AG refused to help Olvera and other wards of Shafer. This became the basis for last week’s Associated Press stories published in newspapers across the nation about a well documented political TV ad exposing Cortez Masto turning away guardianship victim's complaints. This during her highly contested race for national political office.

See the POLITICAL TV AD and BACKGROUND INFORMATION

Full Article and Source:
Ghost Of Old Soldier Takes Revenge  On Politician And Private Guardian

See Also:
NASGA:  Victim Profile:  Lupe Olvera, NV/CA

9 Tips for Coping with Agitation and Aggression

As Alzheimer's progresses, people may become more agitated or aggressive. Check out 9 tips for handling it.

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Agitation means that a person is restless or worried. He or she doesn't seem to be able to settle down. Agitation may cause pacing, sleeplessness, or aggression, which is when a person lashes out verbally or tries to hit or hurt someone.

Causes of Agitation and Aggression

Most of the time, agitation and aggression happen for a reason. When they happen, try to find the cause. If you deal with the causes, the behavior may stop. For example, the person may have:

• Pain, depression, or stress
• Too little rest or sleep
• Constipation
• Soiled underwear or diaper
• Sudden change in a well-known place, routine, or person
• A feeling of loss—for example, the person may miss the freedom to drive
• Too much noise or confusion or too many people in the room
• Being pushed by others to do something—for example, to bathe or to remember
events or people—when Alzheimer's has made the activity very hard or impossible
• Feeling lonely and not having enough contact with other people
• Interaction of medicines

Look for early signs of agitation or aggression. If you see the signs, you can deal with the cause before problem behaviors start. Try not to ignore the problem. Doing nothing can make things worse.

A doctor may be able to help. He or she can give the person a medical exam to find any problems that may cause agitation and aggression. Also, ask the doctor if medicine is needed to prevent or reduce agitation or aggression.

Tips for Coping

Here are some ways you can cope with agitation or aggression:

1. Reassure the person. Speak calmly. Listen to his or her concerns and frustrations. Try to show that you understand if the person is angry or fearful.
2. Allow the person to keep as much control in his or her life as possible.
3. Coping with changes is hard for someone with Alzheimer's. Try to keep a routine, such as bathing, dressing, and eating at the same time each day.
4. Build quiet times into the day, along with activities.
5. Keep well-loved objects and photographs around the house to help the person feel more secure.
6. Try gentle touching, soothing music, reading, or walks.
7. Reduce noise, clutter, or the number of people in the room.
8. Try to distract the person with a favorite snack, object, or activity.
9. Limit the amount of caffeine, sugar, and "junk food" the person drinks and eats.

Here are some things you can do:

• Slow down and try to relax if you think your own worries may be affecting the person with Alzheimer's.
• Try to find a way to take a break from caregiving.

Safety Concerns

When the person is aggessive, protect yourself and others. If you have to, stay at a safe distance from the person until the behavior stops. Also try to protect the person from hurting himself or herself.

Full Article & Source:
9 Tips for Coping with Agitation and Aggression

Families Fight To Bring Nursing Home Lawsuits Out From Behind Closed Doors

CREDIT: AP PHOTO/CARLOS OSORIO

Piri Balazs didn’t intend to stay at Cambria Care Center, a nursing home in central Pennsylvania, for more than a week or two. The otherwise healthy 91-year-old woman had fallen and fractured her hip while gardening — which required surgery — and was directed to Cambria for a brief rehab stay. “No more than ten days,” her doctor had said.

Instead, Piri was taken out of Cambria by her sons three months later in drastically worse shape than she was when she entered.

    “My mother was a very proud woman. She was a charming and happy person. It was immediately obvious something had changed.”

A clear case of neglect, Piri’s sons decided to sue Cambria, in what they thought would be a cut-and-dry case. But, thanks to a growing trend among nursing homes to push lawsuits behind closed doors, instead of to a juried, public court trial, they quickly discovered it wouldn’t be so simple.

Their mother’s case illustrates the dangers of the status quo — one that, despite serious pushback from advocates and lawmakers, continues to go unchecked while hundreds of mistreated and abused nursing home patients are left without justice.

Piri’s sons, Joe and Csaba, were shocked by how quickly their mother’s health deteriorated under Cambria’s “care.”

With two spine fractures from serious falls, a large, infected ulcer on her heel that prevented her from walking, incontinence from not being able to get to the bathroom, receding gums from poor hygiene assistance, and a dramatic weigh loss from not being given her dentures, Piri had become a “changed individual.”

“My mother was a very proud woman,” said Joe. “She was a charming and happy person. It was immediately obvious something had changed.”

Joe and his brother had pulled their mother out of Cambria after weeks of demanding change from staff and administrators. Instead, staff changed her records to cover up this neglect. Only after the Department of Health inspected the facility — altered to the problems by the Balazs brothers — did they realize nothing was going to improve.

Only after returning home, and receiving needed care from an in-house nurse, did Piri’s health finally improve. But, Joe said, she never was quite the same. She passed away within the year. And her sons sued.

The case was quickly forced into private arbitration from a judge, since Cambria had a document showing Joe’s sign-off of an arbitration deal (a document that he doesn’t recall). To a judge with a full docket, it was likely an easy decision. But to the Balazs’ attorney, Peter Giglione, the move meant all transparency was out the window.

“Private arbitration means no public court records, no accountability,” Giglione said. “It’s a way to keep the company’s public image clean.”

First, Cambria refused to share any medical records or documents Giglione requested prior to the arbitration — something that would be mandated by law in a normal court proceeding.

    “Private arbitration means no public court records, no accountability. It’s a way to keep the company’s public image clean.”

Then, there was the silence. Following the July 2015 arbitration, Giglione and the Balazs brothers were told they’d get a decision in “two to three” weeks. Despite numerous calls and emails, they have yet to hear a word back from the arbitrator.

“It’s been over a year now of me calling at least once a week,” Giglione said. “No response.” There’s no strict deadline to rule on a case in arbitration.

This isn’t the first time Giglione’s been strung along by residential care companies. Balazs’ case is the sixth lawsuit against a nursing home he’s arbitrated on. These kind of closed-door cases have quickly become commonplace under the federal law allowing them, a law that civil rights advocates say take advantage of the most vulnerable.

When a client is admitted to a nursing home, either they or a family member are given a stack of paperwork to sign off on. Buried in this stack is a contract about private arbitration, whose wording can easily convince a rushed reader that it’s a smart call. Like Joe, the clients usually discover this only after they sue.

“It is unreasonable to assume that residents or their loved ones are able to comprehend the likelihood of grievous harm or poor care occurring within a facility when these agreements are signed upon admission,” wrote a group of 39 health and aging advocates in a letter to Medicare and Medicaid Services (CMS) in October. “No one should be expected to anticipate or contemplate the occurrence of such tragedies.”

Those advocates — along with 34 senators, 16 state attorney generals, 32 House members, 19 consumer justice groups, and the American Association of Retired Persons (AARP) — are pressing the federal government to update its nursing home standards to address this issue.

    “There’s no real reason for this rule to exist.”

The first “major update” in nursing home standards in 25 years could have finally banned private arbitration clauses in nursing home contracts. Instead, to advocates’ upset, it only proposed updated wording in the contract itself in an attempt to make it clearer.

This proposed update won’t help people like Sherry Turner-Frazier, who signed her admittance papers at a Kentucky nursing home despite having “severe dementia.” One of those papers was an arbitration agreement that was used against her when her family sued the hospital for neglect.

In early August, CMS sent the final text of the updated standards to the federal budget office, but it’s yet to be known if they took advocate’s comments into consideration.

If they didn’t, Giglione said, “they aren’t going to change anything.”

“The only real way to stop this is to get rid of arbitration all together.”

Full Article & Source:
Families Fight To Bring Nursing Home Lawsuits Out From Behind Closed Doors

What a medical student learned after living in a nursing home for 10 days

Marilyn Gugliucci

Joshua Allen, a second-year student in the College of Osteopathic Medicine at the University of New England, eats a meal during one of his 10 days living at the St. Andre Health Care nursing home in Biddeford this summer.

By Joshua Allen, Special to the BDN
Posted Aug. 19, 2016, at 1:53 p.m.   

“So, what was it like living in a nursing home?”

This is a common question that I now get after being “discharged” from St. Andre Health Care, the nursing home in Biddeford that I volunteered to live at for 10 days this summer.

I am second-year student in the University of New England College of Osteopathic Medicine, and this summer I participated in the Learning by Living Nursing Home Immersion Project that was designed and implemented by Dr. Marilyn R. Gugliucci, a professor in the Department of Geriatric Medicine.

As a participant in this project I lived the life of an elder nursing home resident complete with standard procedures of care, such as being toileted, bathed and eating pureed foods. Because of my “stroke diagnosis” — I was not able to use my dominant right side — I had to wear an oxygen tube in my nose, use a wheelchair to get around, and rely on the staff to transfer me from my bed to the chair and my chair to the toilet.

So, after this total nursing home immersion, this question, although straightforward, is particularly difficult for me to answer.

For somebody to even remotely understand what it was like, they would have to read the journal I wrote during my stay in its entirety — all 118 pages of it! To fully understand one would have to go a step further and go through the same process I did and be “admitted” into St. Andre Health Care. This project truly is “learning by living,” and it cannot be taught in a classroom.

I cannot think of another experience in my life that taught me more about the human condition and about myself. Maybe the most challenging part for me was that, for a few days, I had no independence. Staff had to help me use the bathroom, change my clothes and shower me. I even had to wear Depends. So many things that I took for granted were no longer available to me.

When I mention these things to people, they usually become very uncomfortable and say, “I can’t imagine myself doing that.” This certainly begs the question of why I chose to do this project as part of my summer break.

Being “admitted” into the nursing home was a learning experience I thought I was prepared for. I have volunteered in nursing homes and enjoy being around older adults. But being in the role of an elder resident for an extended period of time was something entirely different.

When I mention that it is embarrassing to have somebody assist you with toileting, one might think, “Yeah, I can imagine that,” and a made-up mental image comes up in one’s mind. For me, when I think of that now, I have a memory ingrained in me of what it was like having to wait for somebody to come help me and a visceral feeling that my sense of dignity was challenged as the certified nursing assistant dropped my pants and helped me sit down.

Because of the many experiences I encountered, as a future physician, I will be mindful when I write prescriptions, as I truly understand now what it means to eat pureed foods, to take nighttime medications, and to be restricted from moving on one’s own or from going outside. I have lived this life.

I have emerged from this project learning it is easy to take dignity for granted; life is more fragile than you think.

The nursing home community actually is quite special. Age is much more abstract than I realized, and I now know to look for the person that is behind every pair of eyes, no matter how old or ill they appear.

I am a happier person because of this project, as odd as that might sound. I will always be grateful for the chance to have participated in this project, and I encourage anyone presented with this opportunity to seize it.

Joshua Allen is a second-year student in the College of Osteopathic Medicine at the University of New England. Marilyn R. Gugliucci, a professor in the Department of Geriatric Medicine at UNE, contributed to this OpEd.

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What a medical student learned after living in a nursing home for 10 days

Nursing Homes Added to Federal Watch List for ‘Grotesque’ Abuse

FOR IMMEDIATE RELEASE

Families for Better Care today announced that two Florida nursing homes were recently added to the Center for Medicare and Medicaid Services’ Special Focus Facility list—a federal watch list for nursing homes with a “history of serious quality issues.”

The nursing homes are Palm Garden of Winter Haven and University City East in Deland.

“Past inspection reports for each facility reveal grotesque and chronic abuse and neglect of residents,” said Brian Lee, Executive Director of Families for Better Care.  “Families should be aware of the multiple infractions and associated penalties at these watch list nursing homes so they can take appropriate precautions to keep their loved ones safe from harm.”

A summary of state inspection reports for Palm Garden of Winter Haven read:

“A resident with Alzheimer’s Disease was physically abused by six staff members on seven different occasions.”  The resident was hospitalized with “skin tears and bruising up and down his arms, from his knuckles to his elbows.”  The concerned resident’s family installed a hidden camera in the resident’s room and recorded several abusive incidents by a number of caregivers. 

During one event, two caregivers entered the resident’s room.  One employee “put her hand over the resident’s face swiping down over his nose in a provoking manner and then striking his left upper arm . . . [the employee] then made two quick jabbing punches toward his face.”

The family shared this recording and nearly 12 hours of other video with a local advocacy group and also used it to confront facility representatives.  State officials found that Palm Garden of Winter Haven failed to “take steps to detect, prevent and report abuse.”

Surveyors who inspected University of City East documented:

Widespread medication errors, sloppy medication records, and numerous “medication variances.”  These divergences were associated with a licensed practical nurse who allegedly stole residents’ “controlled drugs” and, on one occasion, was found “staggering, stumbling, and slurring her words” after she returned to her shift following her break.

Residents alerted facility personnel that they had not received prescribed medications as many as “six or seven times” over a three-month period, but the facility failed to properly document the residents’ complaints.  One employee told state inspectors that she was uncertain if 22 residents received their “evening Insulins or medications” during one of the shifts the nurse worked. 

The facility later terminated the nurse’s employment for “not documenting” because the administrator “could not prove she took the medications” from the nursing home.

“Vulnerable nursing home residents deserve better respect and treatment than what’s reflected in these reports,” Lee stated. “This additional public scrutiny by federal regulators will keep the pressure on these nursing homes to perform better, hopefully preventing similar abuse and neglect from happening to other residents.”

Fourteen other nursing homes were newly added to the Special Focus Facility list this month in addition to the two Florida nursing homes.  The list is updated monthly.

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Nursing Homes Added to Federal Watch List for ‘Grotesque’ Abuse