A TROUBLED TRANSITION In the rush to close institutions, Illinois ignored serious problems in group homes

Adults with mild disabilities were the most coveted.

In April 2012, as Illinois moved to close several state institutions and relocate adults with disabilities into the community, representatives from group home businesses gathered inside the Jacksonville Developmental Center for a hastily organized auction.

A state official read aloud medical histories of residents with intellectual and developmental disabilities, prompting group home officials to raise their hands for desired picks.

Group home operators knew that then-Gov. Pat Quinn wanted to empty Jacksonville quickly — before any serious union or community opposition could be mounted — but some were taken aback by what they saw as a dehumanizing approach. "We were appalled by the auction," said Art Dykstra, executive director of Trinity Services, the state's largest group home provider.

The problems with Quinn's rapid-deployment plan, however, went beyond mere awkwardness.
Officials from the Illinois Department of Human Services promised residents that group homes offered a new beginning — one that would bring them more independence, safe and compassionate care, even a private bedroom.

But those promises obscured evidence found in the state's own investigative files that revealed many group homes were underfunded, understaffed and dangerously unprepared for new arrivals with complex needs, a Chicago Tribune investigation found.

In the five years preceding the auction, Human Services' inspector general substantiated more than 600 cases of abuse and neglect in group homes, an analysis of state data shows. State investigators tracked an additional 1,420 cases that uncovered evidence of harm or deficiencies but did not result in formal findings.

The Tribune's "Suffering in Secret" investigation, first published in November, uncovered a system where caregivers often failed to provide basic care while regulators cloaked harm and death with secrecy and silence.

Some cases of neglect found by the Tribune involved individuals who had been relocated to group homes from state institutions. Among the most startling: A man transferred from a state developmental center to a series of group homes died under suspicious circumstances in 2010 after he was forced to sleep on a soiled mattress on the floor of a cluttered room used for storage.

With adequate funding and social supports, adults with disabilities fare best when mainstreamed into the community, widely accepted research studies show. Spurred by court decrees and a growing disability-rights movement, most states have closed some or all of their institutions and shifted funding to community-based residences like group homes. But in Illinois, not enough money has followed the people, the Tribune found.

Group homes have gone nearly nine years without an increase in reimbursement rates for staff wages. Overall, Illinois consistently ranks among the lowest five states for financial commitment to community care, federal records show.

"We've said all along the community system is grossly underfunded," said Zena Naiditch, CEO of Equip for Equality, Illinois' federally empowered disability-rights watchdog. "It's been grossly underfunded for decades."

Instead of opening doors to independence, dozens of financially strapped group home businesses reduced or eliminated community activities as too expensive or time-consuming, according to investigative files from multiple state agencies.

Complaints of food rationing were common. One home budgeted $1.22 per meal, limited servings to 4 ounces of protein and prohibited second helpings.

Even the state's promise of a private bedroom proved illusory. Though group home operators agreed not to admit more than four residents per home, hundreds of providers have routinely bunked up to eight people with disabilities into tight quarters, an analysis of state licensing files and advocacy group reports shows.

At the time of the Jacksonville closing, Human Services characterized the state's aging institutions as an antiquated and costly system with a long history of harm and inadequate care. By contrast, state officials described group homes as adequately funded and staffed.

But when group home providers were surveyed in 2012 to gauge support for Quinn's plan, they complained of pervasive problems, according to records obtained by the Tribune.

Several providers charged that Illinois routinely failed to fully disclose behavioral histories of state developmental center residents who represented a threat to themselves or others. Without that information, group homes can't take the steps necessary to keep all residents safe.

Providers also said state funding was inadequate to cover staffing costs, diminishing the quality of care inside group homes and decreasing residents' independence. Other group homes railed against the state's inability to fund necessary levels of nursing care, with one provider writing: "Typically, an individual is funded for approximately one hour per month for nursing oversight."

Instead of boosting funding overall or slowing down relocations, however, Human Services officials adopted an extraordinary tactic to obscure problems. They required group home executives accepting transfers to sign a pledge of loyalty, extracting a vow to "not do anything to inhibit, diminish, or undermine" the state's closure plans, the Tribune found.

Failure to sign, Human Service officials warned, would restrict access to the Jacksonville auction and result in no referrals of developmental center residents to fill empty beds.

To avoid being shut out, at least 67 businesses signed the one-page pledge, state records show.

But one group refused to be silent about the state's plans: parents of individuals in institutions who worried their children would not get the care they need in a group home. And in the town of Centralia, about an hour east of St. Louis, a battle was brewing.

Parents fight back

 

Rita Winkeler's 32-year-old son Mark has lived his entire adult life at Murray Developmental Center. His modest private room, equipped with a television and DVD player, is covered with family pictures and Chicago Cubs and St. Louis Cardinals memorabilia. 

 

Because of severe developmental and intellectual disabilities, he requires 24-hour care; he needs to be fed, diapered and bathed. Winkeler believes her son is happy and well cared for at the center.

But after emptying Jacksonville and moving most of its 180 residents to group homes, the Quinn administration set its sights on Murray.

This time, though, parents and guardians of the residents banded together and orchestrated public events to rally support from the community, state labor unions and lawmakers.

Soon "Save Murray" signs blanketed Centralia. In a city of just 13,000 people, nearly everyone knew someone who had a connection to the center through a resident, employee or contractor. The potential closure represented a cataclysmic event for the rural community, located about 275 miles south of Chicago.

Beyond the economic impact, the battle for Murray centered on choice. For many parents and guardians, Murray was a haven — a place where the staff outnumbered residents, where a registered nurse was never more than a few steps away.

In early 2013, 11 parents and guardians of adult children who lived at state institutions, including Winkeler, filed a federal lawsuit to halt the state's plan.

Murray's cinder-block buildings border a 120-acre grassy oval crisscrossed by walkways that lead to an outdoor shelter with picnic benches and gardens, a gymnasium and outdoor pool. Built in 1964, Murray resembles an aging community college. But inside it has the look of a nursing home. Its six residential buildings, sheltering about 40 residents each, are dominated by a central desk with hallways branching out to rooms.

At the time of the lawsuit, there were 274 residents and 547 staff members, an enviable ratio made possible by a $41 million annual operating budget.

Winkeler, a former third-grade teacher and head of the decades-old Murray Parents Association, said Murray families were not opposed to the group home concept. Indeed, Winkeler serves as guardian for her 58-year-old brother, who she said thrives in a group home setting.

"Group homes are great for some people like my brother," she said. "But the state wants to fit everyone into the same-size shoe."  (Click to Continue)

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A TROUBLED TRANSITION In the rush to close institutions, Illinois ignored serious problems in group homes

See Also:
Part 1: Illinois hides abuse and neglect of adults with disabilities

SUFFERING IN SECRET: Flawed investigations ignore victims of neglect

Father Doesn't Recognize Family Anymore, Son's Idea Changes Everything

Alzheimer's disease is something that affects over 5 million Americans - and millions more all across the world. Not only is the disease debilitating to those diagnosed with it, but it can also be frustrating and draining for family members and loved ones.

Unfortunately for Ted McDermott and the rest of the McDermott family, he was diagnosed with Alzheimer's several years ago. Each day his memory and temperament gets a little worse, but his son Mac found something that brings his father back - if only for a minute at a time....

Music has always been Ted's passion. He traveled the United Kingdom in his younger days, singing at clubs and venues wherever he could. But as he aged, got married, had children and his memory began to fade, it got harder and harder to perform.

Although the professional acts may be over now, Mac explained that song still roars in his heart.

"Dad was a singer all his life - he was a Butlin's Redcoat and then traveled around singing in clubs around the country. He worked in a factory after he got married and still did the bit of singing on side. His nickname is 'The Songaminute Man' - simply because of how many songs he knows.

In the last few years his memory has deteriorated a lot - often not recognizing family and with many aggressive episodes."

These outbursts make it hard to deal with Ted, both medically and emotionally, but Mac is determined to keep his father's spirit alive. So he devised a genius plan!


When Mac realizes his father is cognizant, he turns on some of his favorite tunes and begins to sing. Sure enough, Ted remembers the words and belts them out right alongside of his son. These tiny fragments of time keep Mac motivated to help his father work through these trying times.

"Now when we've got him singing again he's back in the room. It's these moments that we treasure.

The plan is to share as much of Dad's singing as we can and hopefully help raise money to fund the work of the Alzheimer's Society - more specifically to go towards paying for a person at the end of the phone line to help other people like us."

Now Mac and Ted record their singing sessions for the world to see - they pray their journey of bonding through music can inspire others to help those with Alzheimer's cope with the symptoms. They even started a Just Giving page in hopes that they can raise enough money for Ted to produce his own album - and they vowed to donate 25 percent of the proceeds to Alzheimer's research!

Facebook/Songaminute Man

Watch Ted and Mac sing in the car in this heartwarming video!



Life may not always be easy for Ted and Mac, but at least they have each other and their music to fall back on. They will keep trying to raise Alzheimer's awareness and release the songs that bring the joy back into Ted's soul!

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Father Doesn't Recognize Family Anymore, Son's Idea Changes Everything

SUFFERING IN SECRET: Flawed investigations ignore victims of neglect

On her last night at a Lockport group home, Tina Marie Douglas tossed her few possessions in the trash and warned caregivers that she planned to run away in the morning.

It was not an idle threat. In the last three months, the 48-year-old state ward diagnosed with psychiatric and intellectual disabilities had slipped out of the home eight times and repeatedly run into the street. Her caregivers were considering moving her to a different home, one on a block with less traffic.

But that never happened. Shortly before dawn in October 2013, she broke away again, sprinted down a four-lane state road and was fatally struck by a car.

The Illinois Department of Human Services, which licensed the group home, assigned its inspector general's office to conduct a comprehensive review.

But a Tribune investigation found the inspector general's staffers never interviewed a witness, never visited the group home, never left their desks. Instead, they relied on group home employees to help investigate their own business and, based on those findings, determined the home was not at fault.
The Douglas investigation is one of hundreds in which self-policing played a role in determining whether neglect had occurred, including many where group home employees played an even more significant role — not only gathering evidence but drafting the state's final investigative reports.

These group home employees — dubbed "buddy investigators" by the Office of the Inspector General — handled at least 550 cases, the Tribune determined. And in the vast majority of instances, employees helped clear their own group homes of wrongdoing.

No other state has bestowed full-fledged investigative powers on caregivers at group homes serving people with intellectual and developmental disabilities, according to federal regulators.

The Tribune investigation, the first comprehensive examination of the state's secretive network of 3,000 group homes, also found that Human Services officials routinely obscured evidence of harm from the public.

The inspector general's office sealed 3,239 cases in which they found some evidence of abuse or neglect, a Tribune analysis of previously undisclosed state records from the last six years found.

Neither the public nor family members — not even group home residents — are allowed to know the nature of those investigations, the strength of the evidence or what reforms, if any, were mandated or made.

It's a flawed system that conceals the silent victims of abuse and neglect — some, literally voiceless — while allowing investigators to close as many cases as possible with the fewest consequences.

In one such case, the Tribune found, the inspector general's own investigators overlooked obvious clues pointing to neglect and were easily misled by a group home employee who later admitted she made up her story about what had transpired.

As a result of the Tribune's investigation, Human Services Secretary James Dimas said this month that he will seek to make public the records of all unsubstantiated cases. "We're working hard to push the envelope to become more transparent," he said. "And we're prepared to seek a change to the legislation if we decide that becomes necessary."

Additionally, Human Services Inspector General Michael McCotter has reopened both the investigation of Douglas' death and the neglect case involving the employee who gave false information.

McCotter credited the Tribune for sparking an agencywide audit and reform of investigative practices.

Human Services' oversight of group homes is fragmented, and McCotter acknowledged that his staff routinely didn't send its case reports to the division that licenses the homes — even when his investigators cited a business or its employees for abuse or neglect. He vowed to change that.

McCotter also said group home employees are no longer leading state investigations. In a policy change from the beginning of the year, McCotter began ordering his staff to visit group homes, conduct their own interviews and write all final reports.

As for state practices that have prohibited the public from knowing where abuse and neglect have occurred, he said, "It doesn't seem right, does it?" (Continue Reading)

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SUFFERING IN SECRET:  Flawed investigations ignore victims of neglect

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Part 1: Illinois hides abuse and neglect of adults with disabilities

Arkansas Judge Resigns Amid Misconduct Probe

LITTLE ROCK, Ark. (CN) – An Arkansas judge has resigned from the bench and is facing a criminal investigation over claims that he exchanged judicial rulings for sexual favors and money.

Former Carroll County District Court Judge Timothy Parker denied the allegations but agreed to never serve on an Arkansas bench again after resigning Saturday, the last day of his term, as part of a negotiated resolution.

In a Dec. 31 letter of removal, the Arkansas Judicial Discipline and Disability Commission notified Parker that its investigators were prepared to charge him with judicial violations, including evidence that he “engaged in a pattern of personal relationships with many female litigants” who appeared in his court from approximately 2013 to 2016.

“The bonds or release of these women or their family or friends were done by their request in exchange for sexual favors,” the JDDC letter states. “Allegations also exist about trading cash or prescription pills for sexual favors or money with many of the same women, as well as other women in the community.”

The commission says it has video statements from over a dozen women to support the allegations, recordings of conversations he had with jailed women, and printouts of text messages between the former judge and female litigants.

Special Prosecuting Attorney Jason Barrett is reportedly investigating the evidence against Parker, who was appointed to the judgeship in 2013, to determine if charges will be filed.

According to the JDDC, Parker admitted that he improperly performed probable cause determinations, lowered bail settings, released defendants who were friends or former clients of his, and in some cases, gave rides to defendants.

“The other allegations were not litigated, as you resigned and agreed to a permanent bar from holding judicial office in this state,” the removal letter states.

Parker told the commission that his decision to resign was influenced by the effect litigation would have on his family, as well as the time and expense issues.

Parker began his career as an attorney in private practice before serving as an elected municipal court judge from 1999 to 2004.

He will no longer be eligible to serve as a judge in Arkansas.

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Arkansas Judge Resigns Amid Misconduct Probe

Aging in Place Needs Out of the Box Thinking

The election is over. Happy or not, we can’t predict what the new administration will do. But two things are certain. First, aging issues won’t disappear. Second, we can’t expect more federal funding or new entitlements. But this could be a good thing if it pushes us to think out of the box, particularly regarding aging in place.

What Out of the Box Means for Aging in Place

What do I mean by “out of the box?” I mean focusing on the situation facing middle-income older Americans.

While low-income older adults desperately need funding and support, 70 percent of older Americans (70 million people) do not qualify for government or not-for-profit programs but, at the same time, cannot afford expensive retirement communities or 24/7 care. These people have some resources and most want to age in place. Many own their homes and spend out-of-pocket for care, which is often difficult to locate and manage.

70 million older Americans do not qualify for government or not-for-profit programs but cannot afford expensive retirement communities or 24/7 care. 

Without question, this is a cadre that needs better supports.

Out of the box is preparing homes in advance so health costs are avoided or reduced in the future. An age-friendly home helps people stay healthy longer, which reduces costs for health payers and for families. Falls are reduced. And people who do fall can return to a prepared home more quickly, saving rehab costs and improving recovery.

When a home is prepared for aging in place, family and informal and paid caregivers there are injured less frequently. That means available resources go farther.

What Business and Government Could Do

Out of the box is also looking to private investment and business to generate solutions for housing and providing services to older citizens.

Increased sales of age-friendly products would mean new jobs and training to manufacture and install the kinds of products that would transform American housing into homes to age in place.

Out of the box is applying the service and delivery innovations, efficiencies and economies that emerge in privately-financed age-friendly homes to all incomes and payers. Higher concentrations of age-friendly homes will be fertile ground for a robust consumer-driven marketplace where all types of service providers can innovate, integrate and scale economically. This is an innovation and opportunity zone.

Increased government spending was probably not in the cards no matter who was next in the Oval Office. So shifting to incentivized private investment is a good strategy in today’s political climate. Incentivizing age-friendly home updates amounts to a privately- financed demonstration project. The results will be far reaching, crossing lines of business as well as government silos. What’s learned will improve the aging experience for less affluent citizens as well.

Out of the box is about government incentives for consumers to age in place, too. Just as incentives helped the solar industry take off like a rocket, government incentives could make it less expensive to update homes using age-friendly improvements.

Government incentives can leverage private retirement savings as well. For example, why not allow the use of a portion of 401(k), IRA and other health and retirement savings — without tax or penalty — to purchase appropriate technology and building products for age-friendly home updates?

Success Comes From Interdependence

Out of the box is recognizing that success really comes from interdependence. Though we idealize independence, the reality is that family, neighborhoods, community, services and networks are the foundation underlying individual success at every age — including healthier, dignified and economical aging.

Community supports are necessary resources for self-reliance.

The Power of Consumers

And out of the box is engaging consumers to consolidate their political and market power.

Legislators will pay attention to a coordinated campaign from (mostly older) consumers. Awakening consumers to the strength in their numbers, experience and shared goals is a different message than cajoling them to avoid frailty, be fearful of falling and reduce the burden on their loved ones. Acting from strength encourages self-reliance.

HomesRenewed™, the coalition of business, consumer and nonprofit stakeholders that I founded, has a goal of enabling the 70 million boomers to follow their desire to age in place. Together, we can drive policy and investment, unlocking market-based solutions to increase the number of age-friendly homes.

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Aging in Place Needs Out of the Box Thinking

Part 1: Illinois hides abuse and neglect of adults with disabilities

The house had no address; the dead man had no name.

Illinois officials blacked out those details from their investigative report. Nobody else was supposed to learn the man's identity or the location of the state-funded facility where his body was found.

The investigation was closed as it began, with no public disclosure, and the report was filed away, one of thousands that portray a hidden world of misery and harm.

No one would know that Thomas Powers died at 3300 Essington Road in unincorporated Joliet, in a group home managed for adults with developmental and intellectual disabilities.

Or that his caregivers forced a 50-year-old man with the intellect of a small child to sleep on a soiled mattress on the floor in a room used for storage.

Or that the front door bore a building inspection sticker that warned, "Not approved for occupancy."

Not even Powers' grieving family knew the state had looked into his death and found evidence of neglect.

As Illinois steers thousands of low-income adults with disabilities into private group homes, a Tribune investigation found Powers was but one of many casualties in a botched strategy to save money and give some of the state's poorest and most vulnerable residents a better life.

In the first comprehensive accounting of mistreatment inside Illinois' taxpayer-funded group homes and their day programs, the Tribune uncovered a system where caregivers often failed to provide basic care while regulators cloaked harm and death with secrecy and silence.

The Tribune identified 1,311 cases of documented harm since July 2011 — hundreds more cases than publicly reported by the Illinois Department of Human Services.

Confronted with those findings, Human Services officials retracted five years of erroneous reports and said the department had launched reforms to ensure accurate reporting.

To circumvent state secrecy, the Tribune filed more than 100 public records requests with government agencies. But state files were so heavily redacted and unreliable that the newspaper had to build its own databases by mining state investigative files, court records, law enforcement cases, industry reports, federal audits, grant awards and Medicaid data.

The Tribune found at least 42 deaths linked to abuse or neglect in group homes or their day programs over the last seven years. Residents fatally choked on improperly prepared food, succumbed to untreated bed sores and languished in pain from undiagnosed ailments.

Other residents suffered forced indignities and loss of freedom, state records show. Some were mocked for their intellectual limitations, barricaded in rooms, abandoned in soiled clothing and deprived of food.

A male group home resident, accused of stealing cookies, was beaten to death by his caregiver. Employees at one home bound a woman’s hands and ankles with duct tape, covered her head with a blanket and left her for several hours on the kitchen floor. For their own amusement, employees at another home repeatedly ridiculed residents to provoke outbursts, a game the caregivers called "breaking them."

And, all too often, vulnerable residents' health and safety has been left to unlicensed, scantly trained employees. Front-line caregivers failed to promptly call 911, perform CPR or respond to medical emergencies that resulted in death.

In hundreds of cases, the department allowed employees of group homes to investigate allegations of neglect and mental abuse in their own workplaces, the Tribune discovered. That alliance between group homes and Human Services' investigative arm, the Office of the Inspector General, is not specifically disclosed in state investigative reports.

Citing patient privacy laws, state officials maintain that the addresses of the more than 3,000 state-licensed group homes are secret. Illinois officials refuse to disclose the enforcement history of any home, even in cases of fatal abuse and neglect.

In contrast, Illinois nursing homes must maintain copies of investigative reports and surveys for public inspection. Additionally, state health officials publish a quarterly report detailing violations accompanied by nursing home names and addresses. There are no similar disclosure requirements for group homes.

In this culture of secrecy, even seemingly benign records get shielded from sight. For example, the Tribune requested a state-funded PowerPoint presentation that included a list of needed improvements to community care programs, including group homes.

The state responded. Except for the word "Recommendations," the entire slide was blacked out.
Citing the Tribune investigation, Human Services Secretary James Dimas has ordered widespread reforms to improve public accountability and streamline investigations.

"My concern is that too often agencies hide behind their confidentiality statutes, which makes it harder for the public to know what is going on," said Dimas, who was appointed last year.
Dimas said he will push for legislative changes, if necessary, to allow public disclosure of group home enforcement histories.

The shift in Illinois from large institutional facilities to less costly residential homes reflects the philosophy that these individuals, if supported, will lead fuller lives in the community, and more than 11,400 now live in group homes statewide.

Known as Community Integrated Living Arrangements, or CILAs, these homes accommodate eight or fewer adults in ordinary apartment buildings or houses.

The Arc of Illinois, a statewide advocacy group, reports that hundreds of people with disabilities have successfully transitioned into group homes in recent years. In 2011, a lawsuit brought by individuals who wanted to leave state-funded facilities resulted in a court decree that has forced Illinois to move more people into community settings.

State officials have touted group homes as a preferred option, citing cost savings that can be used to fund more community care. The annual cost of care for an institutionalized resident is about $219,000 compared with $84,000 at a group home, according to state records.

But Illinois has not increased reimbursement rates for group home staff wages in nearly nine years, leading to what industry leaders say are catastrophic conditions in which even the best operators are struggling to provide basic care. Illinois ranks among the five worst states for adequately funding community options, according to federal reports and studies by advocacy groups.

Shirley Perez, who directs a family advocacy program for the Arc of Illinois, said: "Some of the phone calls I get from families are that they are afraid."

Powers, born with a condition that led to brain damage, spent decades inside state institutions, unable to talk, unpredictable in behavior. When state officials promised him a better life in a real home and told his family he'd gain independence, Powers said yes the only way he knew how. He giggled.

But this was not the life that Powers found. Nor did thousands of other adults with developmental and intellectual disabilities, left to the mercy of a system designed to be invisible.

Failures of care

In one Will County group home, state records show, a caregiver left a frail woman alone in the bathroom after filling the bathtub with water, unaware that it was scalding because a maintenance worker forgot to install a temperature-control valve. The woman tumbled into the tub and was severely burned. The Trinity Services caregiver put the woman to bed, later pulled socks over her peeling, bleeding skin and didn't seek medical help for more than an hour. The woman died days later.

At a Springfield home owned by Sparc, a caregiver forgot to give a man his anti-seizure medication before sending him to a day program in 2013. Rather than deliver the pills, investigators found, the caregiver told a colleague to throw them into the trash. The man suffered a major seizure, turned blue and was treated at a hospital.

A caregiver at a Macomb group home managed by Mosaic allowed a man to sleep with a stuffed snowman even though he had been diagnosed with pica — a disorder that compels people to eat nonfood items — and had a history of consuming stuffing, according to inspector general records. In 2012 the man tore open the snowman, ate the filling and choked to death.

In case after case, group home businesses have delegated frontline care to inexperienced caregivers with negligible training, a cost-cutting combination that has led to harm, the Tribune investigation found.

Indeed, when the newspaper reviewed more than 200 substantiated cases of abuse and neglect, it found the vast majority of injuries and deaths are linked to inadequate staffing levels and failure to closely monitor fragile residents. Records show caregivers trying to cover up mistakes, failing to understand dangers of missed medications and underestimating the complex nature of disabilities.

Sparc's chief operating officer, Ryan Dowd, said his company fired the caregiver who directed a colleague to throw out anti-convulsant medicine, added more surveillance cameras in its group homes and switched from paper to electronic medication records so a nurse can better catch mistakes.

Nancy Davis, a Mosaic vice president, said her organization dismissed the caregiver who allowed the man to sleep with a stuffed snowman, hired outside behavioral experts to address the needs of residents with pica and retrained caregivers on how to protect those individuals.

Caring for adults with profound intellectual and developmental disabilities can be challenging. Some have the strength of a weightlifter with the impulsiveness of a child. In the blink of an eye, they can find themselves in crisis.

Yet caregivers in group homes earn an average of $9.35 an hour, according to the Illinois Association of Rehabilitation Facilities. That wage is below the federal poverty level for a family of three. Low pay is a contributing factor in high staff turnover — more than 40 percent annually in some homes.

"Staff turnover — it's like a cancer that affects care," said UCP Seguin of Greater Chicago CEO John Voit, who has worked in the industry since the 1970s.

Group home executives complain that inadequate state funding has not allowed the industry to increase entry-level pay or raise existing salaries to retain skilled supervisors. They say caregivers can earn more money in many other industries, citing the experienced employees who recently resigned to take higher-paying jobs at Amazon warehouses.

To fill vacancies, business operators said they have turned to workers whose backgrounds would have disqualified them from jobs in the past.

"You're scraping the barrel," said Little City Executive Director Shawn Jeffers, whose agency's services include group homes for adults with disabilities in the Chicago area. "I have some folks who do some really dumb stuff."

Responding to what group home owners call a staffing crisis, state lawmakers in both houses this summer overwhelmingly approved $330 million in funding to boost pay for caregivers. But Gov. Bruce Rauner vetoed the measure in August, citing a lack of state funds.

The Tribune also found that the group home industry is exempt from basic staffing standards required elsewhere in the state's long-term care system.

Nursing homes, state institutions and other extended-care facilities are required by law to employ on-site registered nurses who can detect and react to sudden changes in patient conditions. Even low-level employees must be state-certified aides who update skills through continuing education.

Group homes are not bound by these requirements. Many group home residents are not examined by a licensed nurse for weeks at a time, sometimes for many months, state enforcement records show. Instead, registered nurses often work from remote locations and supervise dozens of residents over the telephone.

Some unlicensed workers also are allowed to pass out prescription medications — a practice prohibited by law at nursing homes and state-owned facilities.

These and many other relaxed policies place group home residents at greater risk of undetected complications.

Few daily activities underscore the dangers of thin staff or the critical role of competent caregivers like the simple act of eating.

In 2014, a UCP Seguin group home resident attending the company's day program in Cicero choked to death on a marshmallow that a caregiver handed out as a treat. The victim had dysphagia, putting him at high risk of choking, and staff were supposed to give him only pureed or finely chopped foods, the inspector general found. UCP Seguin CEO Voit said his organization, one of the state's largest group home providers, has retrained staff on choking risks and revised safety protocols.

That same year, a man at a Trinity Services group home in Peoria fatally choked on a cheeseburger, carrots and applesauce when a caregiver stepped away. The victim's medical files warned he often swallowed food too fast and needed close supervision, but staff members were not properly trained about his special needs, state records show.

In response, Trinity Service officials said, they created a training manual for each group home that details how to monitor residents with diet restrictions and choking risks, including pictures that illustrate how to chop or puree food properly.

For Loren Braun, death came from a McDonald's hamburger and an inattentive caregiver who had been hired specifically to watch him.

At 61, Braun had no teeth and couldn't wear dentures. Born with developmental disabilities and diagnosed with schizophrenia, he had lived since 1997 in a North Side group home managed by Anixter Center.

Braun had a history of choking. His food had to be soft and cut into tiny pieces, and someone had to coach him at every meal to eat slowly and drink water between bites.

Braun's sister, Barbara Chyette, tried to protect her younger brother as best she could. (Click to Continue)

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Part 1: Illinois hides abuse and neglect of adults with disabilities

Attorney General Laxalt announces third elder exploitation guardianship abuse prosecution

Attorney General Adam Laxalt announced that 27-year-old Yohannes Habtemicael of Washoe County was arrested on one count of exploitation of an elder person, one count of theft and one count of embezzlement of an older person, all category "B" felonies.

The alleged crimes were committed between August 2014 and November 2015.

According to the complaint, Habtemicael was appointed as the permanent guardian of his 67-year-old father Tewolde Habtemicael and his estate after it was determined that he was unable to take care of himself.

As a guardian, Yohannes was entrusted with funds for limited purpose of providing his father's care. He allegedly subsequently converted more than $80,000 of his father's funds for his own personal use.

The State of Nevada V. Habteicael criminal complaint represents the third guardianship exploitation criminally charged by the Nevada Attorney General's Office.

Laxalt said, “I will continue to work collaboratively with local law enforcement and district attorneys to protect the rights of our elderly and ensure they are treated with the dignity and respect they deserve.”

A criminal complaint contains allegations that a defendant has committed a crime. Every defendant is presumed innocent until and unless proven guilty in a court of law.

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Attorney General Laxalt announces third elder exploitation guardianship abuse prosecution

Tampa lawyer accused of bilking nearly $1 Million from clients' trust accounts

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TAMPA, Fla. - Hiring a lawyer may be one of the most important decisions you will ever make, but when an attorney fails to represent their clients' best interest, the fallout can be devastating.

As the I-Team uncovered, a local attorney is now under suspension by the Florida Bar, after bank records show he spent nearly a million dollars of clients' money at casinos, gun stores and fancy restaurants.

“We loved that house. It hurt to leave,” said Janet Crawford.

Janet and her husband Tom hired Tampa attorney James Lee Clark to save their Wesley Chapel home from foreclosure.

“We were getting behind in payments on the house. My husband was sick, he had a heart attack,” said Janet Crawford.

They paid Clark thousands, then followed his advice and signed their deed over to a company owned by Clark's paralegal and former roommate Eric Liebman.

“They all worked together. They seemed like they were a team. And I trusted my lawyer,” said Janet Crawford.

The Crawfords moved out, after they say they were told Liebman would pay them $5,000 and the bank would forgive their loan.

But they say they got nothing.

Liebman quickly leased the house to another of Clark's clients, who made a down payment and made monthly payments for nearly two years, believing they were leasing to own the home.

She filed for bankruptcy to try to keep the bank from taking it, but the bank ended up foreclosing, giving them just days to move out.

The Crawfords didn't know that Clark had been placed on probation by the Florida Bar while he was handling their case for failing to diligently represent other clients.

“I didn't do research. I should have done research,” said Janet Crawford.

“It appears as though Mr. Clark removed over $900,000 of my client's money,” said Morgan & Morgan Attorney L. Reed Bloodworth.

Bloodworth’s clients are now suing Clark, alleging Clark took money the client received from selling two assisted living facilities.

“I don't know if that are any assets left to recover for my clients,” Bloodworth said.

The Florida Bar subpoenaed hundreds of pages of bank records related to that case, which appear to show Clark transferred money from his client's trust accounts into his own bank account.

They show Clark spent more than $518,000 at the Hard Rock Casino, $13,000 at bars and liquor stores, $21,000 at gun stores and $17,000 on meals at a casino steakhouse.

Clark also paid for vacations in the Bahamas, London, Paris and Amsterdam.

“Using other people's money to enjoy himself, it makes me pissed off. I want him disbarred and thrown in jail as well,” said Janet Crawford.

The Florida Supreme Court issued an emergency suspension of Clark's law license, which went into effect last month.

After multiple attempts to locate Clark, we found him working on his BMW at his South Tampa home, which is under foreclosure.

“I can't talk about it. I'm sorry,” Clark told us.

“Hiring an attorney is an important decision, whatever that matter may be. I think clients should look into their attorneys,” said Bloodworth.

Bloodworth says clients should consult the Bar and avoid attorneys who have been in trouble.

The Crawfords agree.

“Get comments from other people. Check it out before you sign on any dotted line,” Janet Crawford said.

“Do the footwork or you could end up like my wife and myself,” said Tom Crawford.

You can log on to the Florida Bar’s website to find out if any licensed attorney has been disciplined.

Full Article, Video & Source:
Tampa lawyer accused of bilking nearly $1 Million from clients' trust accounts

Three arrested in New York death of ventilator-dependent resident

In a December 28th press release, Eric Schneiderman, the Attorney General of New York, announced the arrest of two registered nurses and a certified nurse aide in connection with the death of an 81-year-old ventilator dependent resident of the A. Holly Patterson Extended Care Facility in Uniondale, NY.

According to the press release

The resident, whose identity is being kept confidential, lived on a specialized ventilator unit at the facility. She required a mechanical ventilator to breathe and was entirely dependent on the nursing staff; the resident passed away after the defendants failed to respond to the ventilator alarms. If convicted, the defendants, none of whom still work at the facility, each face up to seven years in prison.

“These allegations paint a picture of blatant neglect that ultimately resulted in the death of a patient,”

“My office will always hold accountable those medical professionals and others who knowingly ignore a patient’s basic needs or recklessly place any nursing home resident in a life-threatening situation.”

The media release described the case:

The complaint alleges that on the morning of December 20, 2015, the resident–who was wheelchair bound and ventilator dependent–became disconnected from her ventilator. The resident was unable to breathe without the assistance of her mechanical ventilator. A visual and audible alarm was immediately triggered which notified nursing staff on the floor that this resident was in an emergency, life-threatening situation.

Sijimole Reji, Annieamma Augustine and Martine Morland were at the nursing station near the resident’s room when the alarm sounded throughout the unit. All nursing staff who work on the ventilator unit at A. Holly Patterson Extended Care Facility are required to immediately respond to resident ventilator alarms. These three defendants–Reji, Augustine and Morland–ignored the emergency ventilator alarm for more than nine minutes and failed to provide any assistance to the resident who languished without oxygen.

Eventually, when staff entered her room, they discovered that the resident was unresponsive and unconscious. The resident was transported from A. Holly Patterson Extended Care Facility to Nassau University Medical Center, where she died the following day, December 21, 2015.

Deaths and abuse in care homes is not uncommon. Recently a nurse was charged in the deaths of eight people who lived in care homes in Woodstock and London Ontario.

The victim’s life was in the hands of her care-givers. Data from Belgium shows that a significant number of lives are ended each year without request. Usually these people are incompetent or completely dependent on their care-givers.

Full Article & Source:
Three arrested in New York death of ventilator-dependent resident

5 Things Sociopaths and Narcissists Say to Make You Feel Crazy

When you hear the word "psychopath", you might think of Hannibal Lecter or Ted Bundy, but most psychopaths are actually non-violent and non-incarcerated members of society. In fact, there's a good chance they'll seem exceptionally altruistic and innocent to the average onlooker.

As described in the Psychopath Free book, psychopaths are first and foremost social predators. With no conscience, they're able to use charm and manipulation to get what they want from others—whether it be families, friendships, relationships, cults, the workplace, or even politics. The bottom line is, they modify their personalities to become exactly the person they think you want them to be. And they’re good at it.

But when they no longer need anything from you, that's when the crazy-making behavior begins. Here are some common phrases you'll hear from a psychopath who's trying to make you doubt your sanity:

1. "You over-analyze everything."

Of course there are people who DO read too much into situations. The difference with psychopaths is that you'll always discover you were correct in retrospect. They intentionally do things to make you feel on-edge or paranoid, like flirt with a once-denounced ex over social media for the whole world to see. When you question them, they accuse you of over-analyzing the situation. But then a month later, you discover they were actually cheating with that person. Psychopaths want you to doubt your intuition by making you feel like a crazy detective, constantly planting hints to make you feel anxious and then blaming you for having that anxiety.

2. "I hate drama."

And yet, you’ll soon come to discover there’s more drama surrounding them than anyone you’ve ever known. Psychopaths will first idealize you above everyone else, praising you for your perfect easy-going nature. But because they are perpetually bored, this never lasts long. They are pathological liars, serial cheaters, and eternal victims. Before long, these qualities inevitably start to surface and cause you overwhelming confusion. Any time you mention your concerns or frustration, they’ll declare their hatred of drama and make you feel bad for reacting to their horrible behavior (instead of addressing the behavior itself).

3. "You're so sensitive."

Psychopaths manufacture emotions in others—it’s what they do. After once showering you with 24/7 praise and flattery, they’ll ignore you for days on end and wait for you to react. When you finally do, they’ll accuse you of being sensitive or needy. They’ll insult, belittle, and criticize you (usually in a teasing/joking demeanor), pushing your boundaries until you finally speak up. Then they use your manufactured reactions to make you seem crazy. Within weeks, psychopaths can turn an exceptionally easy-going person into an unrecognizable mess of insecurities and self-doubt.

4. "You misunderstood me."

Sure, healthy couples have misunderstandings and miscommunications all the time. But with psychopaths, they’ll intentionally say things they know will provoke you. Then when you react, they’ll turn it around on you and blame you for misunderstanding. Oftentimes, they’ll even deny that they ever said it. This is called gaslighting—blatantly doing or saying something, and then blaming you for misinterpreting it (or denying that it even took place). The fact is, you understood what they said perfectly fine. They’re just trying to make you doubt your sanity.

5. "You're crazy / bipolar / jealous / bitter / in love with me."

The name-calling usually starts when things are going downhill fast. According to a psychopath, all of their ex lovers, colleagues, and friends are crazy, bipolar, jealous, bitter, or in love with them. This becomes very confusing when they start reaching out to those very same people they once denounced to you, using them to triangulate and cause chaos (making the psychopath appear in high-demand at all times). Then they toss you in that very same "crazy" bucket, continuing their never-ending cycle of idealizing and devaluing anyone unfortunate enough to cross their path.

The only way out is to go No Contact. This means no texts, calls, emails, or even Facebook friendships. Otherwise you can be guaranteed that they’ll do anything and everything in their power to make you feel crazy. The good news is, when a psychopath tries to make you doubt your intuition, it means your intuition was causing them trouble. Psychopaths seek to psychologically destroy anyone who might threaten their illusion of normalcy to the world. So when they begin playing mind games with you, it’s actually a strange indirect tribute to your ability to notice that something was “off” about them.

Full Article & Source:
5 Things Sociopaths and Narcissists Say to Make You Feel Crazy

Mentally ill people trapped in nursing homes because Louisiana lacks support programs, DOJ investigation finds

Thousands of Louisiana residents with mental illnesses are being unnecessarily housed in nursing homes, deprived of independent living and cut off from their friends and families, because the state has failed to provide them with more humane options, according to an investigation by the U.S. Department of Justice.

The Justice Department's investigation, which spanned more than two years and was detailed in a letter to Gov. John Bel Edwards this month, found that some 4,000 people with serious mental illnesses are cooped up in costly nursing homes in Louisiana. These people are often much younger and physically healthier than the typical elderly nursing home resident and have no clear path to regaining independence. They also receive minimal mental health services at the nursing facility, the report said.

The report concluded that Louisiana is in violation of state and federal laws, such as the Americans with Disabilities Act, that require states to provide options other than institutionalization to people with disabilities. Chiefly, the state should be improving access to "community-based services," which allow people to be treated in their own homes, often at a lower cost than nursing homes. The Justice Department estimated that the state is spending as much as $7,000 more per person, per year, to treat a mentally ill person in a nursing home instead of in his or her community.

"Louisiana's unnecessary reliance on nursing facilities violates the civil rights of people with serious mental illness," the report said. "By contrast, community integration will permit the State to support these individuals in settings appropriate to their needs and in a cost-effective manner."

The reason so many mentally ill people end up in nursing homes is because the state lacks an adequate supply of community-based services to treat people in their own homes. Louisiana also does not identify people with mental illnesses, once they're in the facilities, to inform them of their options and plan for a transition back to their homes, the report stated.

The Justice Department reported that 14.5 percent of people in Louisiana nursing homes have a serious mental illness, which is among the highest percentages in the nation. At least eight unnamed nursing homes in Louisiana had such high populations of mentally ill patients that people in the community identified them as psychiatric facilities instead of nursing homes, the report said.

Many of the patients interviewed over the course of the investigation told the Justice Department they hoped to be able to leave, and at least two people said they felt like "prisoners."

Remarkably, the report found that some of the people staying at the nursing homes were fairly healthy mentally and physically.

"One woman with serious mental illness experienced a crisis after the death of a family member, leading to her nursing facility admission. Four years later and still in her fifties, she remained in the nursing facility, despite needing minimal physical and psychiatric care," the report said. "She longed to go home saying, 'I would like to be normal, complete, whole again -- like I used to be.'"

In a emailed statement, Louisiana Nursing Home Association executive director Mark Berger said he had not yet fully reviewed the data to support the Justice Department's findings, which made responding to the allegations difficult. But he said the association would be working with the state to improve mental health outcomes.

"The report mentions hundreds of instances where Louisiana's nursing facilities successfully discharged residents into the community," he said. "It is important to note that nursing facility residents are voluntarily admitted and are free to leave the facility except in the rare case of a court order."

Louisiana currently offers a variety of community-based programs for the mentally ill, such as housing assistance, crisis intervention services and at-home primary health care services. But the report said there aren't enough of these resources available.

Many of the people with mental illnesses who end up at the nursing homes come from private psychiatric hospitals, where they are admitted for acute care after a crisis. State hospitals were another source, discharging 153 people with serious mental illnesses directly into nursing homes, between 2010 and 2014.

"One man's journey into the nursing facility began when he had a mental health crisis a few years ago and repeatedly called 911 about his blood pressure. Instead of connecting him to community treatment services, he was charged with abusing 911, sent to jail, and then admitted to a State hospital," the report said, adding that the man was eventually discharged to a nursing home.

"Six years later, the man, who is in his sixties, remains in the same nursing facility, even though he wants to return to the community and could do so with proper physical and psychiatric supports. This man's story is not unique."

Full Article & Source:
Mentally ill people trapped in nursing homes because Louisiana lacks support programs, DOJ investigation finds

Maryland Sues ‘Inhumane’ Nursing Home Provider

WASHINGTON (CN) – The state of Maryland wants treble damages from a nursing home operator that it says has dumped at least 1,000 elderly residents, oftentimes at homeless shelters, after they’ve exhausted their Medicare coverage for a short-term stay.

Maryland Attorney General Brian Frosh notes that Medicare pays for post-hospitalization care “at substantially higher daily rates than Medicaid pays for long-term care,” making it more lucrative for unscrupulous facilities to replace one resident for someone whose care will be reimbursed at a higher rate.

Frosh filed the complaint on Dec. 21 in Montgomery County Circuit Court, taking aim at Neiswanger Management Services, or NMS, the operator of five nursing homes across the state.

“Each year, NMS unlawfully evicts from its nursing facilities hundreds of frail, infirm, mentally ill, and physically and intellectually disabled people,” the complaint states.

Frosh says NMS gave 1,061 residents the boot between January 2015 and May 2016 – more than twice as many evictions as all other nursing homes in the state combined over the same time period.

NMS usually accused the evictees of not paying for their care, but the complaint says the real reason for this inhumane conduct is maximizing reimbursements from taxpayer-funded public health insurance programs.

“In 2015, the five NMS facilities received more than $100 million in reimbursement from Medicare and Medicaid, including more than $35 million from Maryland’s Medical Assistance program,” the complaint states.

Evicted regardless of their health status, former NMS residents frequently appear in hospital emergency rooms within days or weeks of eviction, according to the complaint.

Frosh says these individuals are usually “facing serious or life-threatening medical complications caused by their evictions,” and that the state is left to cover the cost of the emergency care they require.

“NMS often abandons its evictees far from their hometowns, in places where they have no family connections to assist them,” the complaint states.

Mark Yost, CEO of NMS told the Washington Post that they would fight the complaint.

“NMS strongly denies any wrongdoing and disputes the entirety of the attorney general’s allegations in this matter,” Yost said. “We intend to prove our case and will respond in the appropriate forum in due time.”

Attorney General Frosh details how NMS tossed out one cancer-stricken woman named Vonda Wagner from its Hagerstown facility last year.

A woman named Sharon Isaacs allegedly drove the 85-pound woman to one of the Baltimore row houses she operated and housed with “frail and disabled people.”

“NMS and Ms. Isaacs have a longstanding partnership under which NMS rids itself of residents whose Medicare post-hospitalization benefits it has already extracted or whose public health insurance profile it otherwise regards as no longer attractive, and under which Ms. Isaacs then strips these vulnerable and often helpless NMS evictees of social security payments and other public benefits,” the complaint states.

The complaint names seven individuals as defendants but Isaacs is not one of them.

During Wagner’s stay at the row house for several weeks, she was deprived of her medication and was fed only instant ramen noodles and water, according to the complaint.

Frosh says Isaacs beat Wagner and dropped her at a homeless shelter when upon learning that Wagner had canceled a state-issued debit card Isaacs had confiscated.

Wagner eventually went to the emergency room and remains homeless to this day, according to the complaint.

Another resident had more than $2,000 in social security benefits stolen from him in a similar scheme, according to the complaint, which also describes the abandonment of a “cognitively impaired” resident in the driveway of her son’s house on a 95-degree day. The son allegedly found his mother wandering toward the woods.

Frosh says more than 700 current residents in the five nursing homes Neiswanger manages are at risk of eviction if the court does not step in and grant the state’s request for an order preventing the company from issuing more evictions without reason.

“NMS and its leadership have compromised the health and safety of hundreds of vulnerable people with whose care they have entrusted,” Frosh said in a statement. “My office will fight to put a stop to NMS’ unsafe and inhumane practices. We will also seek to recover from NMS the public funds that the Medicaid program paid to NMS while it was engaging in this unlawful conduct, as well as the amounts that the Medicaid program paid to hospitals and other medical providers that cared for former NMS residents after they were evicted.”

The state seeks $10,000 per violation of the False Health Claims Act as well as three times the damages Maryland sustained for such violations.

In addition to NMS CEO Yost, the complaint names as defendants former CEO Matthew Neiswanger and the administrators of each nursing home it operates.

Full Article & Source:
Maryland Sues ‘Inhumane’ Nursing Home Provider

Vulnerable Adult Protective Investigative Team responds to elder abuse

One of the more baffling trends in Tennessee is the rise in incidents of elder abuse, but there is one thing that’s certain: Prosecution of the perpetrators must be swift and unfailing.

Whether the abuse is financial or physical, taking advantage of those experiencing the vulnerability brought on by age is, like child abuse, an unpardonable crime.

It is often thought of as an institutional issue, but largely occurs in the victims’ own homes, and the abusers are often family members.

The formation of a special investigative team at the Shelby County district attorney’s office to investigate abuse of the elderly and disabled is an appropriate response to the actions of those who attack the elderly physically, financially or sexually, often preying on their fragile emotional or mental state.

The Vulnerable Adult Protective Investigative Team, formed by District Atty. Gen. Amy Weirich, will satisfy state legislation passed this year that requires all state district attorneys to establish an elder abuse response team in their district effective Jan. 1.

And it will address a crime that has increased in frequency as the Baby Boom generation reaches a vulnerable stage of life.

Senate Majority Leader Mark Norris, in a Viewpoint guest column published in July, reported a rise of almost 20 percent in simple assaults against older adults statewide from 2009 to 2013 and an increase the number of reported cases of fraud against older individuals of 21 percent over the same period.

The Tennessee Commission on Aging and Disability has estimated that only one in 23 cases of elder abuse is reported, attributing the silence to the fact that the victim often lives with someone who controls his or her access to the outside world, finances, meals, medication and everything else.

Representatives of the DA's office, local law enforcement, the state Department of Human Services and the Coordinated Response to Elder Abuse, or CREA, which includes the Aging Commission of the Mid-South, Memphis Area Legal Services and numerous other agencies, are on board  in this battle.

Solidly behind the initiative is the Plough Foundation, which conducted a two-year study of the issue, found that there was no single organization with the capacity or resources to lead the charge against elder abuse, and supported the creation of CREA with a $3.45 million grant.

The foundation is also providing funds to support the prosecutor's new elder abuse team, consistent with its leadership in the effort to facilitate independent living for the elderly.

The foundation has leveraged a $4 million grant into a $6 million Aging in Place program over the past two years, working with partners Service Over Self and MLGW.

People who suspect elder abuse can report it to adult protective services at 1-888-277-8366 or the Memphis and Shelby County Family Safety Center at 901-222-4400.

These new programs should encourage more reporting of elder abuse so that more abusers can be held accountable for this largely invisible crime.

Full Article & Source:
Vulnerable Adult Protective Investigative Team responds to elder abuse

Millions missing from lawyer's trust account, bar alleges after he abruptly closes law firm

A Las Vegas probate and real-estate lawyer transferred a home purchased for nearly $1 million to his wife amid an investigation into missing client funds and the abrupt shuttering of his law practice.

The allegations surrounding lawyer Robert Graham raise questions about the need for additional safety nets for lawyer trust accounts, according to Brandi Cassady, one of the attorneys appointed to assume control of Graham’s files and law practice.

Graham was arrested on Wednesday in connection with the theft of $2.1 million from clients in three cases, the Las Vegas Review-Journal reports. Chief Deputy District Attorney J.P. Raman said in court that the total amount stolen may be more than $15 million.

Raman said that, when Graham closed his law firm, he deleted nearly 3,000 files relating to clients, wire transfers and operations. The initial charges are “just the tip of the iceberg,” she said.

Graham was temporarily suspended as a result of action by the State Bar of Nevada, which says Graham closed the practice on Dec. 2, abandoning more than a hundred client files. The bar has filed a complaint alleging Graham stole millions of dollars from his clients before closing his firm, the Las Vegas Review-Journal reports. Prior stories by the newspaper are here, here and here.

Graham transferred the Colorado home to his wife just days after he closed his law practice, according to property records examined by the Review-Journal.

The bar complaint says Graham should be holding more than $13 million in safekeeping for his clients, but account balances “total much less.” The money should have been held in deposit in Graham’s Interest on Lawyers Trust Account, known as an IOLTA account, according to the bar.

Brandi and Jasen Cassady of the Cassady Law Office have both been appointed to take over Graham’s law practice at his Lawyers West firm. Brandi Cassady tells the ABA Journal in an email that the vast majority of lawyers are decent people who would never touch the money held in IOLTA accounts. “Collectively, we hold billions without issue,” Brandi Cassady said.

“However, I think the time has come for additional safety nets to be added when appropriate. You cannot legislate a moral compass, and stealing client money held in a lawyer’s trust account is already illegal, but I think bonding for attorneys who hold trust accounts would be an excellent solution,” Cassady said.

“The legal community will be brainstorming to create a viable solution that will protect the public and keep the process affordable and realistic for solo attorneys and small firms, and thus, the clients,” Cassady added. “I think bonding that is specific to attorneys would be a great idea and keep the process affordable and keep the courts unclogged.”

Graham told the Review-Journal in a December interview that his law practice was a business failure. “I was responsible for the litigation and felt I had no out,” Graham said. “So bit by bit, I moved the chairs on the deck. Each year, things got worse and worse, and I tried to bail myself out and just couldn’t.”

The newspaper asked Graham about what he would say to his former clients. “There’ll be a time when I can fall to my knees and ask them to please forgive me,” he said. “I’ve been sidetracked. How I ended up here, I’ll never know.”

Graham’s public defender, Bryan Cox, says his client disputes the prosecutor’s allegations about deleted files. Cox told the Review-Journal that the files may have been moved to a hard drive for preservation.

Full Article & Source:
Millions missing from lawyer's trust account, bar alleges after he abruptly closes law firm

My mother told me to let her die rather than let her live in a wheelchair

My mother thought limited mobility would end her independence. But her life is still full of love.

My mother didn’t want to live if she had to use a wheelchair. But things change.

The night before my mother had her knees replaced almost 15 years ago, she took me aside. “If I end up in a wheelchair,” she said, “I want you to promise you will have them pull the plug.”

My mother was 75. She had five children, nine grandchildren and a husband of 55 years who still wrote love poems for her. She was frightened, vulnerable, unable to imagine a life worth living if she couldn’t walk. Fiercely independent her whole life, she’d agreed to surgery in the first place only because my sister, a physician, warned her that without it she was headed to a wheelchair.

“Promise me,” she said through tears. “I can’t live in a wheelchair.”

I was taken aback, surprised that she’d rather die than adapt, and hurt that her personal calculus devalued maximizing time with those who love her.

Neither of us were our best selves.

“No,” I said, “I won’t promise. Besides, there’d be no plug to pull.”

The surgery was excruciatingly painful but a success, leaving my mother ornery for a time but on the mend. Only afterward did the surgeon tell her that knee replacement is one of the most painful operations.

For two months, my parents lived in our downstairs den as my mother slowly recovered. She was diligent about her physical therapy. With my mother using crutches, we ventured first to the corner, then, with a cane, to the coffee shop, and finally, just before my parents returned home, we walked to the synagogue three blocks away for my daughter’s bat mitzvah. Before the surgery, my mother could not climb the curb from street to sidewalk without wincing in pain. Now she walked up a full flight of concrete stairs to the sanctuary inside.

Today my mother is 89. Her knees don’t hurt, but other parts do, and her heart, grown softer and sweeter over the years, has weakened. After months of resistance, she uses a walker even to traverse the short distance from her bedroom to her living room in the independent living facility in California where she now lives. She has recalibrated her understanding of dependence and independence, and, given the choice between staying home or using a wheelchair in the airport, she chooses the wheelchair and the chance to travel.

This travel — to a grandson’s college graduation in Chicago, a granddaughter’s graduation in Maine, another granddaughter’s graduation in  Atlanta — is not the travel she did with my father, the returning GI she met in 1946 at age 19 in engineering school. They traveled together to Europe, China, various states. Neither is it the business travel to Japan and Russia she undertook while managing international fusion research projects for the U.S. Energy Department. But it is travel nonetheless.

A few years after my mother had her knees replaced, my father started to suffer from dementia and Parkinson’s disease, and my mother (eventually with round-the-clock help) kept him at home longer than seemed possible to my siblings and me. When we finally moved my father to a nursing home in 2013, my sister and I, wanting to introduce and honor the man beneath the disease, made a sign for his door that read: “Husband. Father of five. Grandfather of 12. Retired nuclear engineer. Fluent in five languages. Philosopher. Poet.”

My father died in his sleep a few months later. By then, my mother had weathered his frustration and anger at knowing, helplessly, that his mind was slipping away. When that awareness vanished, leaving him gentle and serene, my mother preserved his dignity with attentive home caretakers who treated him with respect, even affection.

The man my father had been would have been appalled at the man he had become, incapable of navigating his way from the start of a simple sentence to the end, too unsteady to have much use for his walker, unable to groom himself. He would not have wanted to live in such a state. But the man he had become suffered no pain. Loved and loving his entire life, his face exploded with a smile at the sight of my mother or one of his children. Sometimes my mother’s daily visit to the nursing home consisted of little more than holding the hand of the husband who, in a poem, once described happiness as the moment she came home. His life still had value, for him and us.

Every year for the past several years, I have taken my mother to New York, where she grew up.

Together, we visit the Museum of Modern Art, the Museum of the City of New York and the Jewish Museum. In every museum, I check my mother’s walker and borrow a wheelchair. We go to a Broadway show and eat at a restaurant next to the theater because, despite the walker, my mother no longer has the strength to walk more than half a block without resting. We don’t venture more than a few doors from the hotel when we go out for breakfast.

“Next time,” I said to my mother as our last visit drew to a close, “let’s rent a wheelchair so I can take you to Central Park.”

More grateful now for what she can do than mournful over what she can’t, my mother said, “Okay.”

Full Article & Source:
My mother told me to let her die rather than let her live in a wheelchair

Rome Woman Charged with Stealing Thousands of Dollars from Elderly Grandmother

Molly Elizabeth Mason, 27 of Rome, was arrested on Wednesday for burglarizing and exploiting an 89 year-old woman.

Reports stated that in December of last year Mason stole several checks from her 89 year-old grandmother at her home on McGrady Road. She then allegedly passed them at numerous locations, racking up over $4,000 in purchases.

Later last month she is accused of entering into the President’s Office at Berry College and stealing a Visa credit card.

Police added that it was also discovered that between October 19th and October 31, 2016 she presented checks at Heritage First Bank in the amount of $1,564.56 that was supposedly made by her elderly grandmother. She also presented checks for $2,310 to Coosa Valley Credit Union and $3,380.02 to Wal-Mart.

In late December she is also charged with stealing her grandmother’s visa credit and Belk charge cards.

Mason is charged with two counts of first degree burglary, exploitation of the elderly, financial transaction card theft and three counts of forgery.

Full Article & Source:
Rome Woman Charged with Stealing Thousands of Dollars from Elderly Grandmother

How Social Isolation Is Killing Us

My patient and I both knew he was dying.

Not the long kind of dying that stretches on for months or years. He would die today. Maybe tomorrow. And if not tomorrow, the next day. Was there someone I should call? Someone he wanted to see?

Not a one, he told me. No immediate family. No close friends. He had a niece down South, maybe, but they hadn’t spoken in years.

For me, the sadness of his death was surpassed only by the sadness of his solitude. I wondered whether his isolation was a driving force of his premature death, not just an unhappy circumstance.

Every day I see variations at both the beginning and end of life: a young man abandoned by friends as he struggles with opioid addiction; an older woman getting by on tea and toast, living in filth, no longer able to clean her cluttered apartment. In these moments, it seems the only thing worse than suffering a serious illness is suffering it alone.

Social isolation is a growing epidemic — one that’s increasingly recognized as having dire physical, mental and emotional consequences. Since the 1980s, the percentage of American adults who say they’re lonely has doubled from 20 percent to 40 percent.

About one-third of Americans older than 65 now live alone, and half of those over 85 do. People in poorer health — especially those with mood disorders like anxiety and depression — are more likely to feel lonely. Those without a college education are the least likely to have someone they can talk to about important personal matters.

A wave of new research suggests social separation is bad for us. Individuals with less social connection have disrupted sleep patterns, altered immune systems, more inflammation and higher levels of stress hormones. One recent study found that isolation increases the risk of heart disease by 29 percent and stroke by 32 percent.

Another analysis that pooled data from 70 studies and 3.4 million people found that socially isolated individuals had a 30 percent higher risk of dying in the next seven years, and that this effect was largest in middle age.

Loneliness can accelerate cognitive decline in older adults, and isolated individuals are twice as likely to die prematurely as those with more robust social interactions. These effects start early: Socially isolated children have significantly poorer health 20 years later, even after controlling for other factors. All told, loneliness is as important a risk factor for early death as obesity and smoking.

The evidence on social isolation is clear. What to do about it is less so.

Loneliness is an especially tricky problem because accepting and declaring our loneliness carries profound stigma. Admitting we’re lonely can feel as if we’re admitting we’ve failed in life’s most fundamental domains: belonging, love, attachment. It attacks our basic instincts to save face, and makes it hard to ask for help.

I see this most acutely during the holidays when I care for hospitalized patients, some connected to I.V. poles in barren rooms devoid of family or friends — their aloneness amplified by cheerful Christmas movies playing on wall-mounted televisions. And hospitalized or not, many people report feeling lonelier, more depressed and less satisfied with life during the holiday season.

New research suggests that loneliness is not necessarily the result of poor social skills or lack of social support, but can be caused in part by unusual sensitivity to social cues. Lonely people are more likely to perceive ambiguous social cues negatively, and enter a self-preservation mind-set — worsening the problem. In this way, loneliness can be contagious: When one person becomes lonely, he withdraws from his social circle and causes others to do the same.

Dr. John Cacioppo, a psychology professor at the University of Chicago, has tested various approaches to treat loneliness. His work has found that the most effective interventions focus on addressing “maladaptive social cognition” — that is, helping people re-examine how they interact with others and perceive social cues. He is collaborating with the United States military to explore how social cognition training can help soldiers feel less isolated while deployed and after returning home.

The loneliness of older adults has different roots — often resulting from family members moving away and close friends passing away. As one senior put it, “Your world dies before you do.”

Ideally, experts say, neighborhoods and communities would keep an eye out for such older people and take steps to reduce social isolation. Ensuring they have easy access to transportation, through discounted bus passes or special transport services, can help maintain social connections.

Religious older people should be encouraged to continue regular attendance at services and may benefit from a sense of spirituality and community, as well as the watchful eye of fellow churchgoers. Those capable of caring for an animal might enjoy the companionship of a pet. And loved ones living far away from a parent or grandparent could ask a neighbor to check in periodically.

But more structured programs are arising, too. For example, Dr. Paul Tang of the Palo Alto Medical Foundation started a program called linkAges, a cross-generational service exchange inspired by the idea that everyone has something to offer.

The program works by allowing members to post online something they want help with: guitar lessons, a Scrabble partner, a ride to the doctor’s office. Others can then volunteer their time and skills to fill these needs and “bank” hours for when they need something themselves.

“In America, you almost need an excuse for knocking on a neighbor’s door,” Dr. Tang told me. “We want to break down those barriers.”

For example, a college student might see a post from an older man who needs help gardening. She helps him plant a row of flowers and “banks” two hours in the process. A few months later, when she wants to cook a Malaysian meal for her boyfriend, a retired chef comes by to give her cooking lessons.

“You don’t need a playmate every day,” Dr. Tang said. “But knowing you’re valued and a contributing member of society is incredibly reaffirming.”

The program now has hundreds of members in California and plans to expand to other areas of the country.

“We in the medical community have to ask ourselves: Are we controlling blood pressure or improving health and well-being?” Dr. Tang said. “I think you have to do the latter to do the former.”

A great paradox of our hyper-connected digital age is that we seem to be drifting apart. Increasingly, however, research confirms our deepest intuition: Human connection lies at the heart of human well-being. It’s up to all of us — doctors, patients, neighborhoods and communities — to maintain bonds where they’re fading, and create ones where they haven’t existed.

Full Article & Source:
How Social Isolation Is Killing Us