Rick Scott Leads Senate Aging Committee Hearing About The Older Americans Act

The Senate Aging Committee held a hearing entitled, "Renewing Our Commitment: How the Older Americans Act Uplifts Families Living with Aging-Related Diseases." 

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Rick Scott Leads Senate Aging Committee Hearing About The Older Americans Act

Bob Casey Leads Senate Aging Committee Hearing On Empowering People With Disabilities

On Thursday, the Senate Aging Committee held a hearing entitled, “Empowering People with Disabilities to Live, Work, Learn, and Thrive.”

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Bob Casey Leads Senate Aging Committee Hearing On Empowering People With Disabilities

Casey Holds Aging Committee Hearing on Protecting Older Adults Who Are Targeted by Frauds and Scams

September 19, 2024

At hearing, Casey released annual Aging Committee Fraud Book

Hearing featured testimony from PA scam victim, law enforcement about how to prevent scams and support victims

Casey touted his report on how 2017 Republican tax law penalized scam victims

Washington, D.C. - Today, U.S. Senator Bob Casey (D-PA), Chairman of the U.S. Senate Special Committee on Aging, held an Aging Committee hearing entitled “Fighting Fraud: How Scammers Are Stealing from Older Adults.” The hearing highlighted the psychological and economic impacts that frauds and scams have older adults, who are disproportionately targeted by fraudsters.

During the hearing, Casey unveiled the Aging Committee’s annual Fraud Book, which provides seniors with an overview of the most prevalent scams to help them identify and avoid being victimized. The Fraud Book also contains resources for scam victims. In addition to the Fraud Book, Casey touted his report on the 2017 Republican tax law, called “Scammed Then Taxed,” which details how the law’s repeal of the theft loss deduction has imposed significant taxes on many scam victims.

“At today’s hearing, we heard tragic stories from scam victims and law enforcement about how fraudsters are getting more sophisticated and aggressive with their scams and throwing the lives of older adults into chaos,” said Chairman Casey. “We must do everything we can to educate older adults about the threats they face from frauds and scams. We must also do more to provide resources for those who have been victimized by scams, including those who have been forced to pay taxes on money they’ve lost due to changes in the 2017 Republican tax law.”

Chairman Casey invited Susan Whittaker, an Administrative Assistant at Lehigh County Aging and Adult Services in Allentown, PA, to testify at the hearing about her late husband’s experience as a scam victim. Susan testified, “This scam was devastating and had a devasting effect on Bill—both financially and emotionally. Because we lost $20,000, and Bill had a lot of chronic health conditions, Bill began to ration his medications. We just couldn’t afford them anymore… He also lost his sense of self-worth. I was really sad to see this very intelligent and past business owner, become so afraid to read emails and use a phone. It was a huge setback for him, and I think contributed to his worsening health conditions...he stopped living.”

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Casey Holds Aging Committee Hearing on Protecting Older Adults Who Are Targeted by Frauds and Scams

Senate Aging Committee Field Hearing on Caregiving Support

The Senate Special Committee on Aging held a field hearing in Pittsburgh, Pennsylvania, on caregiving support for children, older adults, and family members with disabilities.

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Senate Aging Committee Field Hearing on Caregiving Support

Guardianship bills debated in state senate committee

by Mardi Link

Jun. 16—LANSING — During a state senate hearing on legislation to fix state guardianship laws, elected officials recently heard testimony on the civil rights abuses — from cryptocurrency investment schemes to arbitrary judicial decisions — often faced by those caught up in the flawed system.

"We bend over backwards for people that are accused of committing crimes, to make sure their due process rights are protected," Scott Teter, an assistant attorney general and chair of the office's Elder Abuse Task Force, said.

"These people didn't commit a crime — they got old and frail," Teter said.

Teter, division chief of the AG's financial crimes division, recently detailed a package of four bipartisan bills the House passed more than seven months ago, during a Civil Rights, Judiciary, and Public Safety Committee hearing.

The bills, if they become law, would require judges to give a reason, on the record, when they appoint a professional guardian over a family member; limit tasks professional guardians could delegate to office staff and require guardian ad litmus — those acting as the "eyes and ears of the court" — to be more detailed in their reports.

Some elder advocates say the changes don't go far enough. Some professional guardians and probate court judges say they go too far. Few can argue that any substantive reform has been a long time coming.

"Broadly speaking, the bills come from one simple truth, which is there's too many vulnerable adults across the state who have been taken advantage of, exploited and abused," said Rep. Graham Filler, R-Clinton County, sponsor of HB-4911.

"This is a very contentious subject and I do believe these bills are in a good place to move forward," said Rep. Kelly Breen, D-Novi, sponsor of HB 4909.

In 1996, a state Supreme Court Task Force began examining how to improve the way probate court judges vet, appoint and oversee record-keeping for guardians and conservators and then, in 1998, issued several recommendations.

In 2007, then-Gov. Jennifer Granholm appointed social service advocates and others to a similar task force, which issued its recommendations — chief among them was to adopt those recommendations issued by Michigan's Supreme Court's task force nearly a decade prior.

In 2019, AG Dana Nessel renewed the reform effort, appointing members from dozens of organizations and municipal offices to yet another elder abuse task force, and that group, too, has issued its recommendations.

"Here we are, 25 years later, and we still have not adopted all of the recommendations from that task force — one of which is certification," Teter said.

State statutes give court-appointed guardians power over a person's housing, medical and other personal needs while conservators are tasked with making financial decisions.

Michigan is among several states which do not require certification or licensure for either role, even though each task force has recommended it in some form and a 2021 study found certification and licensure both increase knowledge, professionalism and effectiveness of professional guardians.

A fifth house bill, HB 5047, sponsored by Rep. Betsy Coffia D-Traverse City, addresses certification and, if passed, would create an office of state guardian, but this bill was not discussed at the hearing.

Teter promised further discussions on this issue, while adding that the requirement for professional guardians is not supported by everyone.

Calhoun County Chief Judge Michael Jaconette told the committee such an addition could have a "catastrophic impact" on the ability of courts to find suitable guardians to serve the state's most vulnerable people.

Jaconette told the committee he also had issues with a portion of the bill that addressed guardian ad litems, while Sen. Jim Runstead, R-White Lake, suggested a "blind draw" where judges could not hand-pick who was assigned to which case.

Some courts use a blind draw, testimony stated, other counties do not. It is a county-by-county decision and not required by law.

Jaconette said the Probate Court Judges Association, of which he is president, gave reluctant support to the four bills in their initial form, although they had concerns about subsequent changes and had withdrawn that support.

Some professional guardians have said the actions of a few have cast aspersions on a reputable profession and that the cost of certification or licensure could make it difficult, even impossible, to serve more than just a handful of indigent adults.

Committee Chair Sen. Stephanie Chang, D-Detroit, invited written remarks be submitted to the committee and a second hearing is scheduled for next week.

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Guardianship bills debated in state senate committee

Attorney General's office supports reform bills on guardianship

By Legal Newsline

LANSING – Today, Scott Teter, Division Chief of the Department of Attorney General Financial Crimes Division and head of the Elder Abuse Task Force, testified before the Senate Civil Rights, Judiciary, and Public Safety Committee in support of House Bills 4909, 4910, 4911, and 4912. Michigan Attorney General Dana Nessel announced that this bill package is a first step toward implementing reforms to Michigan’s guardianship statutes.

“I’ve seen firsthand how Michigan’s guardianship and conservatorship system has failed vulnerable adults in our state,” Nessel said. “I am glad some improvements are being made, but we can’t stop here. I will continue to push for the long-awaited reforms as recommended by our Elder Abuse Task Force, which will help create a system that truly treats all Michiganders with the dignity, compassion, and autonomy they deserve.”

"A system that ignores the rights of vulnerable adults and dehumanizes them and ignores the concerns of family members doesn’t do justice and must be changed,” Teter said. “There are common-sense reforms in these bills that are long overdue that will help fix a broken system, but we are not done yet and have more work to do.”

Teter’s testimony highlighted specific concerns faced by the Department, the Elder Abuse Task Force, and their partners under the current system. The proposed legislation aims to address these issues by:

- Requiring courts to make findings of fact if a person with priority for appointment, such as a family member, is passed over in favor of a professional guardian;

- Establishing a clear asset and income threshold above which the appointment of a conservator is required;

- Requiring guardian and conservator letters of authority to expire after 15 months;

- Clarifying and expanding the guardian ad litem’s responsibilities;

- Improving protections for wards when professional guardians seek to remove them from their homes;

- Requiring professional guardians to file petitions seeking court authority to move wards;

- Mandating courts appoint guardians ad litem or counsel for wards where appropriate before authorizing moves to new residences;

- Enhancing basic standards for medical reports used in guardianship and conservatorship hearings;

- Refining the process for emergency petitions for guardianship/conservatorship to ensure an actual emergency exists.

In his testimony, Teter also encouraged legislators to adopt additional legislation creating family consent laws and Personal Protection Orders (PPOs) for elder/vulnerable adults. He provided an overview of the guardian certification initiative.

The Department expressed support for Senate Bill 656 which would restrict investment types allowed by conservators managing estate property. This bill requires conservators to invest according to the Michigan prudent investor rule and mandates investments through brokerage firms insured by the United States Securities Protection Corporation. Additionally, it prohibits investments in cryptocurrency.

Michigan's Elder Abuse Task Force was launched in 2019 with more than 55 organizations from public, private, and nonprofit sectors collaborating against elder abuse. The task force comprises over 100 individuals divided into seven committees working on nine initiatives including wholesale reforms like certification and training requirements for professional guardians.

Achievements include adopting a Vulnerable Adult Incident Report form used statewide by law enforcement along with related training sessions. The Financial Exploitation Prevention Act was also passed ensuring mandatory reporting from financial institutions on suspected fraud or exploitation. Another law added financial advisors and securities brokers as mandatory reporters. The Uniform Power of Attorney Act becomes effective July 1, 2024 making powers of attorney more accessible through standardized forms within statute.

More than 73,000 older adults in Michigan suffer from elder abuse involving neglect or exploitation. Residents seeking elder abuse resources can call 800-24-ABUSE (22873) or report suspected abuse at 855-444-3911.

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Attorney General's office supports reform bills on guardianship

Sparks fly in Lansing as probate judges push back on proposed guardianship reforms

By: Heather Catallo

LANSING, Mich. (WXYZ) — Sparks flew during a Senate committee hearing today in Lansing as probate judges pushed back on proposed guardianship reforms. Local families have been demanding changes to Michigan’s laws after 7 Investigator Heather Catallo’s years-long investigation into the state’s guardianship system.

Catallo has been exposing abuses in the system since 2017, and advocates for the elderly have been trying to get new legislation passed since 2021.

On Thursday, the head of Attorney General Dana Nessel’s Elder Abuse Task Force announced that they have had to drop the bill that would have formed an Office of the State Guardian, at least for now.

“They took my mom before I knew it,” said Chandra Drayton during a 2021 interview with Catallo, about her family’s experience with a professional guardian in Detroit.

“It's disgusting. Our elderly people shouldn't be a commodity and shouldn't be able to be trafficked by these people,” said Gretchen Sommer, whose aunt and uncle were separated from family members by a guardian who erected a 6-foot privacy fence around the elderly couples’ home in Macomb County.

Sommer and Drayton are just some of the family members across our community demanding change. And so are the members of the Attorney General’s Elder Abuse Task Force as they fight to get four bills passed in Lansing.

“A system that ignores the rights of vulnerable adults and dehumanizes them and ignores the concerns of family members doesn’t do justice and it must be changed,” said Financial Crimes Division Chief Scott Teter during testimony in front of the Senate Committee on Civil Rights, Judiciary & Public Safety. Teter is the head of the Elder Abuse Task Force.

The task force has worked for years to increase protections in Michigan’s guardianship laws for vulnerable adults. If you’re placed under guardianship, you’re declared legally incapacitated and no longer have any rights.

“They determine whether or not you can marry, whether or not you can divorce, whether or not you can live in your own house,” said Rep. Kelly Breen (D-Novi). Breen is one of the sponsors of the bills.

“The bills come from one simple truth, which is there are too many adults across the state who have been taken advantage of,” said Rep. Graham Filler (R-St. Johns). Filler has sponsored legislation twice, trying to make changes to the guardianship laws.

During Thursday’s testimony, the head of the Elder Abuse Task Force announced they’ve had to drop a bill that would have established an Office of the State Guardian and require certification of professional guardians.

“We will be coming back with it next year. It’s not going anywhere. Certification has to happen in the state of Michigan,” said Teter.

But the bills still provide several protections, including making sure probate judges put their reasons on the court record if they choose a professional guardian over a family member who wants to take care of their own loved one.

“How do you appeal a non-record? The answer is you can’t,” said Teter.

The changes to the law would also expand the responsibilities of someone called a Guardian ad Litem (GAL). The GAL is supposed to inform a potential ward of their rights. That’s something that never happened in Rodrick Gordon’s case because his GAL never found an interpreter to communicate with Gordon, who’s Deaf-Blind.

“Do you consider yourself incapacitated,” Catallo asked Gordon in a 2021 interview.

“No! Absolutely not,” said Gordon.

But the bills have powerful opponents. Three different probate judges, including the head of the Michigan Probate Judges Association, testified Thursday that they oppose the bills.

“I think the consequences of the legislation would be to reduce the number of professional guardians available to serve the community,” said Kent County Chief Probate Judge David Murkowski.

“The system is not supposed to be designed to protect the interests of judges, lawyers, and guardians. It’s supposed to serve and protect vulnerable adults,” said Teter.

In a press release, the Attorney General said the bills will also:

• Require the court to make findings of fact if a person with priority for appointment, such as a family member, is passed over in favor of a professional guardian;
• Establish a clear asset and income threshold above which the appointment of a conservator is required;
• Require guardian and conservator letters of authority to expire after 15 months;
• Clarify and expand the guardian ad litem’s responsibilities;
• Improve protections for wards when professional guardians seek to remove them from their homes;
• Require professional guardians to file petitions seeking court authority to move wards;
• Require courts to appoint guardians ad litem or, where appropriate, counsel for wards and to schedule hearings before authorizing moves to new residences;
• Improve basic standards for medical reports that are used in guardianship and conservatorship hearings;
• Refine the process for emergency petitions for guardianship/ conservatorship to ensure an actual emergency exists; and more.

There will be another hearing Thursday, June 20, 2024. Family members who lost loved ones to professional guardians plan to testify at that hearing.

Full Article & Source:
Sparks fly in Lansing as probate judges push back on proposed guardianship reforms

Casey Holds Hearing on Local Impact of the Older Americans Act

May 23, 2024

Pennsylvanians testified at hearing about the importance of programs like Meals on Wheels, senior community centers, and home- and community-based services, which are funded by the Older Americans Act

At hearing, Casey committed to fighting to keep these programs authorized and fully funded

Watch full hearing video here

Washington, D.C. - Today, at a U.S. Senate Special Committee on Aging hearing, Chairman Bob Casey (D-PA) highlighted how programs funded by the Older Americans Act (OAA), such as Meals On Wheels, senior community centers, and home- and community-based services, play a critical role in keeping American seniors active, healthy, and connected to their communities. Older Americans experience disproportionate levels of loneliness, isolation, and difficulty accessing meals and health care services, and OAA-funded programs provide a lifeline for seniors struggling to meet these needs. The hearing, entitled “The Older Americans Act: The Local Impact of the Law and the Upcoming Reauthorization,” featured testimony from experts and Pennsylvanian beneficiaries about the importance of ensuring full funding for these vital programs. At the hearing, which comes as the Senate prepares to reauthorize the OAA, Chairman Casey laid out his top priorities for reauthorization, which include supporting states in long-term planning for senior services, substantially increasing funding for long-term care ombudsmen, who ensure the safety of nursing home residents, and increasing investments in nutrition programs.

“Since its passage, the Older Americans Act has served as the foundation for community social services for older adults—from funding Meals on Wheels to local senior centers to home and community-based caregiving,” said Chairman Casey. “These programs are vital for older adults across Pennsylvania and the Nation, and as we prepare to reauthorize the OAA, I am going to fight to ensure they get the full amount of funding that our seniors need and deserve. Our Nation’s older adults have fought in our wars, raised our children and grandchildren, and built our communities—they deserve our support as they age.”

Chairman Casey invited Janet Billotte, a resident of West Decatur, PA, and a recipient of home-delivered meals and other services from her county Area Agency on Aging. She testified about how the services provided to her by OAA-funded programs have improved her life, saying, “Last year, I was diagnosed with Stage 3 colon cancer and I was also caring for my husband who had been sick with many issues for a long time…Many days, I didn’t feel well and it was very helpful to have these meals delivered to us…I’m very grateful to be receiving these services, and…I know many older adults who receive Meals on Wheels are thankful like I am. I also understand that there are many more older adults on the waiting list for these services. I ask you to please help more people get into the program and be able to receive these great services.”

Watch the full hearing here.

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Casey Holds Hearing on Local Impact of the Older Americans Act

Assisted living’s real problem: Staffing and acuity, not lack of regulation

by Neville M. Bilimoria 

Dec. 17, The Washington Post published a special investigation highlighting dozens of assisted living resident deaths across the country due to wandering or elopements.

As a result, Sen. Bob Casey (D-PA) scheduled a hearing before the Senate Special Committee on Aging, which he chairs, to look into why those deaths were happening, with at least a handful occurring in Casey’s home state of Pennsylvania. This was the first hearing of its kind for the assisted living industry in almost 20 years.

Well, the Senate Special Committee on Aging held its hearing on Jan. 25, eliciting testimony from advocates, industry leaders and families. It didn’t go so well for the assisted living industry, pointing once again toward increased fervor over possible federal legislation for assisted living communities nationwide:

• “Unfortunately, what I heard today makes clear that we have a long way to go when it comes to guaranteeing the level of care that older Americans in assisted living facilities deserve.” — Sen. Bob Casey (D-PA)
• “This has gone on long enough without federal oversight.” — Sen. Elizabeth Warren (D-MA).

Those hearings were not too surprising, because the Post painted a very dire picture of assisted living today in its expose. The Post had documented 2,000 assisted living wandering incidents since 2018, with more than 100 of them fatal. But the Post article, and what occurred at the hearing, highlights the big question: Is federal regulation the answer? No, I posit to you.

We all know what federal regulation did to the nursing home industry and how it currently affects that industry through increased enforcement, driving up costs, and even today, leading to nursing home closures. In today’s environment, and with the assisted living industry post-COVID-19, the last thing folks need is federal regulation as senior living communities are struggling to get back to their pre-pandemic staffing levels, all while dealing with residents’ greater health needs and an aging population in their homes at the same time.  

But what was interesting about the Senate hearing were the seemingly ignored comments of industry leaders from the American Health Care Association / National Center for Assisted Living and Argentum, and particularly Julie Simpkins, a member of the NCAL Board, who made a good point during the hearing:

“When we talk about assisted living, it’s important to note that every state, every facility and every resident is different. …Efforts to standardize all assisted living communities would be both unworkable and irresponsible for resident care.”

I think Simpkins is right. What happened to those residents is truly tragic (also acknowledged by Simpkins), but the call for increased state regulatory oversight is not just a veiled attempt by AHCA/NCAL and the industry to avoid more regulation. Most assisted living companies are operating and providing a good quality of care. Punishing a majority of assisted living communities with greater federal regulation isn’t necessarily the answer. Why not try, as advocates suggested at the Senate hearing, to allow state regulators to continue regulation, and also crack down on the poor-performing providers.

Further, allowing greater state oversight makes real sense for those of us who have been in the nursing home/assisted living industry; after all, more regulation at the federal level is only going to muck things up further, perhaps adding to or, even worse, exacerbating, the real problem: staffing shortages. Increased federal regulation only makes it more costly for facilities to achieve compliance, and that money could be better spent on workforce programs to attract more and better assisted living workers.

We can’t just look at staffing statistics for assisted living and open positions to really encapsulate the full gravity of the staffing shortage problem. The other problem is the pool of caregivers that operators have to choose from and the need for better caregivers to insert themselves into that hiring pool. 

After all, if you fill your staffing positions with undedicated, uneducated or unqualified individuals, then you are not helping the situation. As Simpkins said, we need to address programs that will bring workers — good workers — back to assisted living environments. Simpkins commented that addressing caregiver shortages through workforce programs could make a difference.

In all, a fix to this elopement problem may not be as simple as federal regulation. Maybe the better intervention is to help improve staffing, allow states to further crack down on poor-performing assisted living communities, and see how that goes before instituting federal regulation. Otherwise, federal regulation could make the situation worse. 

Neville M. Bilimoria is a partner in the Chicago office of the Health Law Practice Group and member of the Post-Acute Care and Senior Services Subgroup at Duane Morris LLP.

The opinions expressed in each McKnight’s Senior Living guest column are those of the author and are not necessarily those of McKnight’s Senior Living.

Full Article & Source:
Assisted living’s real problem: Staffing and acuity, not lack of regulation

Misericordia faculty member testifies to the Senate Special Committee on Aging

1/25/2024 11:35 AM

Misericordia faculty member testifies to the Senate Special Committee on Aging

William Stauffer, LSW, CCS, CADC, adjunct professor of Social Work at Misericordia University, addressed the U.S. Senate Special Committee on Aging's hearing on the topic "Understanding a Growing Crisis: Substance Use Disorder Among Older Adults," held on December 14 in Washington, D.C. Senator Bob Casey (D-PA) serves as chairman of the committee and conducted the hearing.

Stauffer, who is also the executive director of The Pennsylvania Recovery Organizations - Alliance, returned to speak to the Special Committee following his testimony during a 2018 hearing on the growing need for Opioid Use Disorder (OUD) services for older Americans.

The topic of Stauffer's testimony during the committee's December hearing focused on the stigma in healthcare and our communities regarding older adults with Substance Use Disorder (SUD).

"Stigma is a huge issue; it keeps things invisible. When a loved one dies from an alcohol-related fall, the underlying issue doesn't get reported. When someone dies from SUD, the root cause doesn't get reported," said Stauffer. "One in three healthcare providers believes that people can and do recover from SUD. If only one in three providers think people recover, people won't go to them for help. Research shows that people who get help, treatment, and the support they need will recover."

This is particularly true, according to Stauffer, for our older adult community members.

"We ignore them when they are suffering. Stigma prevents older patients from reporting they have a problem, the medical community in asking patients questions about substance use, and it even prevents family members from seeking help for their loved ones. As a result of these dynamics, perhaps the most significant fact is that we do not know the true prevalence of SUDs in the older population," he testified to the committee.

The young adults from 1978 who are turning 75 this year, had the highest level of substance use over their lifetime than those before them. According to U.S. Census Bureau data, the median age in the U.S. last year was 38.9 years. In Pennsylvania, the median age was 40.9 years, the oldest of any state in the nation. Pennsylvania currently ranks fifth in the nation when it comes to the size of its population aged 65 and older (2.2 million).

The demographics reveal that our population of older adults will be increasing over the next 20 years. "We will need to think more critically about what we do concerning older adults. There are going to be even more of us in the coming years; we cannot afford to ignore their needs any longer," he said. 

The trends for substance use, dependence, and addiction mortality trends in older adults are alarming. The rate of drug use in people over 40 is increasing faster than it is among younger age groups. Drug-related deaths for users over 50 increase by 3% annually. Seventy-five percent of deaths from SUDs among users aged 50 and older are caused by opioids. In 2020, alcohol-induced causes were recorded as the underlying cause of death for 11,616 adults aged 65 and over, and age-related death rates for alcohol-induced causes have been increasing since 2011.

"We need to get ahead of this curve by providing prevention, treatment, and recovery community support for older adults," said Stauffer during his testimony.

The question then becomes, what can we do the help older adults with SUD in our communities?

Stauffer encourages the entire community — friends and loved ones of older adults with SUD, as well as medical professionals — to think about SUD in a different way; to provide care and support to these individuals the way we do with other chronic conditions like cancer, diabetes or high blood pressure.

"Older adults are looking for a purpose; let's use the talents and skills they have and support them. I've never met a person who has talents and skills that they don't want to share. We could develop an older Adult Recovery Community Corps for older adults looking for a purpose; to pair them with others to share their talents and skills while providing hope, purpose, and connection," he said.

Pennsylvania is already heading in this direction. Governor Shapiro signed an executive order last year to develop a Master Plan for Older Adults, a 10-year strategic plan designed to transform the infrastructure and coordination of services for older Pennsylvanians. It includes a focus on SUD treatment and recovery needs.

"This is a vital step to identifying not only the challenges our older adult community members face, but also their inherent strengths and talents that they offer to our society," said Stauffer.

In addition to community support, the focus of healthcare needs to change. "We need to shift our SUD service system to focus beyond acute stabilization; we do not cover all of the treatment services older adults require to sustain recovery from an SUD. Roughly 85% of people who sustain five years of recovery remain in recovery for life, but older adults don’t get a full continuum of support, because we do not fund it," he testified.

The work of the committee is far from over. Stauffer has already been contacted with additional questions from Senator Casey's staff, who are scheduling a follow-up meeting with Stauffer at his Harrisburg offices.

To watch Stauffer's testimony, click here. For more information about Misericordia's Social Work Program, click here. 

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Misericordia faculty member testifies to the Senate Special Committee on Aging

“Gravely Disabled” — How I Narrowly Escaped a Conservatorship

By Susan Stebbins Standen 

I travel up through translucent layers of reality. They lift one by one, slowly, imperceptibly, like filmy veils unwrapping a cocoon. A few faces, a garbled attempt to communicate a message from the afterlife, a sharp pain in the back of my hand and the dull ache that lingers. When I finally wake, the room is empty.

I really suck at killing myself.

My first conscious thought is followed by an awareness of my complete relaxation, body and soul. Despite the unexpected awakening, I am still cocooned. I did not know a bed could be so comfortable. It conforms to every bend of my bones, cushions every potential arch of neck or knee or back. I’m untroubled—delighted, even—by the tubes in my arms and groin. I am being fed and drained. There is no need to get up, no need to take care of myself. It is all being done for me, like a child in the womb. I cannot think of a better way to be.

“Inner Moonscape” by Susan Stebbins Standen

The curtain at the end of my bed is partially open and without moving my head I see a sign that reads “Cardiac Care Unit.” I know cardiac means the heart. Did my heart stop? It seems fine, beating slowly and reliably in my chest. I follow the beat, feeling the blood pushing through arteries out to my hands and feet. The pulse in my big toe is apparent to me. All my other toes, my fingertips, my scalp, even the tip of my nose. I have never been so conscious of my body.

This is life, I think.

The next time I wake I have a few more thoughts about life and death. Despite my very best effort to leave it, I am still in the world. I had given up, given it all up, the hopes, the dreams, the pain, and the fear.

I am empty of all that, now, I realized. Who cares if I never do anything but lie in this bed for the rest of my life? It is enough that I am breathing. That’s the important part. All the rest is small potatoes.

Why did I ever think I needed to fulfill anyone’s expectations? What is success, anyway? I need to do nothing more to be worthy of life. I have no price to pay, nothing to prove. I realize that having given up all hope of being what others wanted me to be, I am now free to live however I want.

Or so I thought.

* * *

Two days later I am sitting in a chilly room on a flat bed with leather handcuffs, reconsidering that thought. I am not free. No one wants to hear that I want to live, except Renae.

“Do you believe me?” I asked my partner of fifteen years as she watched me being unhooked from all my tubes in the Cardiac Unit. The doctors were removing me from my blissful cocoon and getting me prepared to be ambulanced to the psychiatric hospital across town.

Renae had tears in her eyes. “Yes, I believe you. You sound like the old Susan, the real one. I thought I’d lost her.”

I hang on to that thought. I am not exactly the “old Susan,” but I am the real one. What had it done to my brain, to take so many lethal pills and yet live? Some kind of giant chemical shock had jolted me right out of suicidal depression. I feel clearer than I ever have in my life. I feel renewed. I feel triumphant.

Triumphant, but frustrated and afraid as well. The handcuffs, currently dangling at the sides of the wooden bed, are a clear sign that I am not out of this yet. Of course they have to put me on a psych hold, I tell myself. Twenty-four hours, or seventy-two at the most, just to make sure I’m not going to try it again. It seems a long wait in some ways; in other ways, it’s just a hiccup on the way to my new life. Surely they’ll see, like Renae does, that my mind has changed, that I am free of depression.

* * *

Three days later, it is clear that no one else sees me like Renae does. The walls are closing in. My family members have called the hospital and were given all my information. “Your father was so concerned,” the nurse tells me. I remind her of my HIPAA rights, of the large sign I myself had put on the nurses’ desk specifying that no one but Renae and Patricia, my therapist, be allowed to know I was here.

It does not matter. I have no rights. I laugh to myself as I walk away from the desk past the huge poster called “Patients’ Rights,” a glaring piece of fiction written by people who were never in my position.

I am forced to take medication that makes me fall over constantly. The tiled floor is like the deck of a ship, constantly tilting side to side. I stagger and slam against walls. I speak to the nurse who hands out the meds but she glares at me. “Do you really want to be non-compliant?” she asks. I take the comment as it is meant: a threat.

I take another dose, and prepare for rough seas.

Time passes like jam spilling through a screen. No movement for a long time, and then splat, it’s afternoon. The weight of gravity is the only clock I can measure by.

They can imprison my body, but not my mind. If I can get through this, I can get through anything.

Every other morning I see people lined up in wheelchairs to go get shock therapy. ECT by assembly line. This can’t be happening, I think. It’s 2010, not the nineteen fifties. But every evening the nurses or psychiatrist present me with a piece of paper. They put a pen in my hand. Sign it, they say. It’s an agreement for electro-convulsive treatment. Every evening I put the pen down next to the unsigned paper. I do have this right, at least, but the cost is dear.

“You don’t want to get well,” my shrink admonishes me. “You know there’s nothing more to be done with you: You’re medication-resistant and a danger to yourself. The procedure is safe. Research has proven it. If you don’t agree to ECT I assume you don’t want to feel better.”

“I’m not a danger to myself,” I explain. “I’m glad to be alive, I want to live.”

“That’s not what your family says. They say you’re a liar.”

“You’ve been talking to my family?”

He looks at me like I’m stupid.

* * *

I finally decide to take my father’s call on the patient phone, just to find out what’s going on.

“We can’t let you do this anymore,” says Dad.

“I’m fine now, Dad, I just want to go home.”

“We tried that.” His voice is rough. “You need a safer facility.”

“Safer? What do you mean?”

“There’s a great place right here in Massachusetts, beautiful grounds, a really excellent program.”

“I can’t go to Massachusetts, Dad. I live in California, remember.”

“You’ll live where I decide.”

“Did I wake up in Russia this morning?” I ask sarcastically. “Because I think I have a right to live where I want after I get out.”

“Not if you’re judged to be ‘gravely disabled.’”

“Gravely… Dad, you’re kidding, right? That’s for people who can’t feed or dress themselves, not someone like me who owns a home and pays their bills. Not to mention a fifteen-year stable relationship.”

“You’ve tried to kill yourself twice this year. We can’t allow this to go on. I will be your legal guardian from now on.”

“There’s no judge in this world that will say that I’m gravely disabled under the law.”

“Enough money will get a judge to say whatever I want.”

“You bastard! You f       controlling a      , you are doing this for yourself, not me!”

“Think what you like.”

Shaking, I slam down the phone and wobble over to the nurses’ station. “Can I talk to someone, please?”

The nurse hears me out. She shakes her head. “You have to convince them that you have a plan for treatment after the hospital. If they see you are intending to go into a voluntary program, maybe they will re-think putting you on conservatorship.”

I call Renae. She finds me phone numbers of outpatient treatment programs in Sonoma County. I call them all, trying to sound both urgent and sane at the same time. One calls me back, saying that Dr. B. told them not to accept me. When did I give my former psychiatrist the right to talk to anyone about me? Never. I start to seethe, but control myself. I need my mind to stay clear; I need to find my way out of this.

But no one will take me. I contact my therapist, whom I’ve seen every week for the last seven years.

“I can’t be your only support anymore,” she tells me. “If you go into a residential program, I will agree to see you, but only then.”

I feel stabs of pain in my belly and chest. Patricia, how could you desert me?

“No one will take me,” I whisper.

“Then there’s nothing I can do. I’m sorry, Susan.”

She refuses to refer me to another therapist, and hangs up.

I go to bed and cry and cry. I try to be quiet because how will they believe I’m not depressed if they see me bawling my eyes out? Tears and mucus and snot run all over my pillowcase. I turn it over and drench the other side. This isn’t depression. This is grief, and betrayal, with a mix of terror. I still want to live, want to be free. But it hurts. How it hurts. Patricia was in my heart closer than anyone but Renae. Now I only have Renae.

Renae is holding strong for me. She exhausts herself driving back and forth a hundred miles to see me almost every night. She smiles and hugs me and says she believes me. Her trust is golden. It is the most precious thing in my life. The only sweet thing in my life.

My determination will not let me despair. I have met with the so-called Patients’ Rights Advocate, a young man who seems both uneducated and apathetic. He sat through my 5250-hearing, which extended my 5150 (3-day hold) for another two weeks, without saying a thing. Now there’s a new code to learn.

* * *

“What’s a fifty-two sixty?”

The shrink looks oddly uncomfortable. “Thirty-day hold. That will keep you here through your conservatorship hearing.”

“You can’t possibly think I’m gravely disabled. You’ve talked to me almost every day for two weeks. You’ve heard reports from the nurses. Do you really think I’m still a danger to myself? That I need to be in the hospital?”

His answer surprises me. “No, I don’t.”

“You think I’m well enough to leave?”

“Yes, but it’s not up to me.”

I’m puzzled. “Who is it up to?” Even as I ask the question, the answer comes to me.

“Your family.”

“Since when has my family been psychiatrically trained? This doesn’t make sense. You are the one that signs the discharge papers!”

“Not in this case.”

“Why not? What’s going on? Is the idea for me to live in a locked facility forever?” A silent wail of despair wells up inside me. I fight it down.

“That’s the general idea, yes.” He sounds disinterested and looks down at his desk.

I can’t speak. The room wobbles and it’s not just the meds. What’s happening to my life?

The doctor looks up and sees something in my face that makes his tone kinder.

“Susan, if it were up to me you would have been out of here a week ago. But I’m not going to have my children go to community college because of you.”

It takes me several moments to process his meaning. “You’ve been threatened with a lawsuit?”

He gives a curt nod, his face expressionless now. “A psychotherapist and an MD, I believe.”

“My brothers?” Outrage swamps my terror.

The doctor shrugs.

* * *

“Mom, mom. Tell me you’re not part of this.” I grip the phone in my fist.

“What do you want me to say?” She sounds oddly smug. No wonder; she holds all the cards. Now it’s my turn to feel as helpless as she has. I have a feeling she’s enjoying this.

“I want you to tell me you’re on my side. I want you to say you believe me, like Renae does.”

“I’m not as easy to fool as Renae. I see right through you, Susan. And so yes, I’m on your father’s side. You need help.”

I let out a breath I didn’t know I was holding. Mom’s attitude hurts less than Patricia’s. Perhaps so many losses have dulled my senses.

“Then it will be a long time before I’m ready to speak with you again,” I say.

I hang up.

There’s a woman here on the ward who says she’s had sixty ECT treatments over the years. Her voice is shaky, her eyes are oddly blank. But she does speak, and she tells me her story. Twenty years ago her husband left her. She tried suicide. She was hospitalized and given ECT. She was put on conservatorship. She was told where to live, had no access to her money, and was threatened with the hospital if she didn’t take the meds they gave her.

Round and round she had gone. To dingy, one-roomed apartments, group homes, board-and-cares. Back to the hospital. More shock treatment and more meds. Twenty years.

I might have been inclined to disbelieve her but for the line of wheelchairs that paraded shock victims back from the medical unit. Slumping, drooling, wide-eyed and pale. Not me, I thought, grateful that they were still allowing me to put the pen down before signing.

How long will I last? Will I give in, or will they sign my name for me and say I lost my memory of it? The only thing I have going for me is my brain. And Renae. I’ve got to keep the one, and get back to the other.

It’s always cold here. This unit is brand new, they say, and the air conditioning doesn’t work right. The other patients and I walk around or sit with layers of flimsy cotton blankets wrapped around us. There is a sort-of porch, on which people can go out at certain times. It’s covered and screened in, and I refuse to let myself go out there. The next time I breathe fresh air, I promise myself, will be when I’m free.

“Take your pills,” says the meds nurse.

“They make me dizzy. I’m getting bruises on my elbows and shoulder from hitting the walls.” I hold out my arm to let her see.

“What’s that?” She takes my arm, but not to see the latest bruise. There’s a rash underneath my wristband. “Why didn’t you tell us you’re allergic to latex?”

“I didn’t know.” I forbear to tell her that I’ve never worn a hospital band for so long.

The nurse cuts off the wristband, scans the bar code and hands me the dangling plastic strip and my cup of pills.

“I want to go home,” I murmur.

“It’s your own fault you’re here.”

* * *

There’s a new patient, a woman who came in last night. She is loud at dinner and when I ask her to be “a little quieter” she screams at me and calls me a bitch. The confrontation scares me.

The next morning the same woman appears stumbling out of her room, like me with my off-center gravity, but worse. Her eyes are glazed and she cannot speak at all. I look at her face, but no one is home. Seeing this scares me worse. I’d rather have her yell at me than lose her identity altogether.

By this time all the patients who’d been here before me are gone, as are almost all those who had been admitted after me. I talk to the people who seem nice and hear their stories and feel burgeoning friendships begin. They seem to like me. They all wonder why I’m here. Then they are discharged while I remain.

I ask one nurse who’s been nice to me about the 5260 order that my doctor has made. She looks surprised. “I’ve been here twenty years and I’ve only seen one other 30-day hold.”

“What was the other person like?”

She shakes her head. “Not like you. Who did you piss off?”

“Everyone. Almost. Particularly a very rich father and two professional a      brothers with no scruples. They threatened the doctor with a lawsuit if he lets me go, and my dad’s bribing a judge to conserve me.” I think about how insane this sounds. Why would she believe me?

The nurse widens her eyes. It seems that she believes me. “Which doctor?” Her voice is very low and secretive.

I tell her. She purses her lips and nods. I can see she’s distressed about something. So upset that I don’t want to make it worse by asking her what it is. She answers me anyway.

“It’s my job,” she whispers. Then she walks away.

I puzzle it through. What did she mean, it’s her job? Her job is to follow doctor’s orders. If she believes something is hinky with the doctor, she can’t say anything or she might lose her job. That’s what she means. She’s afraid to put her job on the line for me. I know what this means.

She’s going to help me.

* * *

At the end of her shift, right before visiting hours, the same nurse comes to me and slips something in my hand. A scrap of paper. I start to open it but she hisses at me to stop.

“Don’t put it anywhere,” she whispers.

“My lockbox?” That’s where my shoes and purse are.

“Don’t be silly, that’s not private.” Which is news to me. I thought it was private. I think of my journal, where I’ve been keeping my notes, and I’m glad that I carry it everywhere and sleep with it in my bed.

“Don’t look at it. Give it to the one who visits you,” she whispers. She must mean Renae. “Don’t let anyone see you give it.” The nurse turns around and walks away as if we’d never spoken.

I disobey her almost at once. The handwritten note, folded three times, has my doctor’s full name and medical license number on it. When will I have the freedom to use this information? I sigh.

More important than the possibility of filing a complaint someday, she’s given me something more. She’s given me courage.

I speak again to the Patients’ Rights Advocate. He has tousled hair and his young face looks sleepy. I tell him about my father’s threats to bribe the judge to conserve me, and about my brothers’ threat to sue my psychiatrist. The advocate just stares at me. I don’t know if he doesn’t believe me or just doesn’t care. He lets me know that an ambulance will take me to court for my next hearing.

“That’s a lot of money to waste on one nut,” I tell him.

The irony escapes him.

Renae is excited when she comes to see me. After a faux-casual hug in which I slip her the nurse’s note and tell her what’s on it, Renae tells me her news. “They can’t conserve you from San Mateo County,” she says. “Because only a judge in the county where you have a legal address can hear your case.”

A reprieve. It feels as though the heavens have opened up. They still can chase me when I get home, but maybe I will get home after all.

* * *

I’ve been here twenty days now, and one of the nurses hands me a letter. It’s from my insurance company. It seems they also think they’re spending a lot of money on one nut. The letter begins, “You’re clearly not benefiting from your hospitalization…”

No shit, I think.

It takes me another minute or two to untangle the bureaucratese and discover that the letter is in response to my doctor’s request for a 30-day hold. More importantly, it is a denial of the request. They will no longer pay for my hospital stay.

I get on the phone. “Get here now,” I tell Renae. “Do not pass go, do not collect two hundred dollars; it’s time to bust me out of here.” She can barely contain her delight and I hear her rushing feet and slamming doors as she prepares for the fastest drive of her life.

I double-check with the nurse on duty. Is this right? I ask her. Can I just leave? She looks a bit bewildered but says “yes.” It’s the weekend, so my doctor’s not here, but she contacts his on-call person to double-check. Yes, my insurance is gone. And so will I be – if I can just get out of this building.

I request my shoes and purse. The nurse hands them over. She brings me papers to sign; I read them as carefully as I can in my excitement, and sign them. I grab my little comforter from home, my journal, and the puzzle books Renae brought me.

I don’t have a bag: it’s all piled in my arms. I don’t have meds ordered anywhere. I do not have a psychiatrist or a therapist anymore. All that stuff about not letting me go without an aftercare plan was just bull     after all. It was just about the money.

I’m about to jump out of my skin, worrying that my dad or someone will get wind of my exodus and stop me. But doors are unlocked before my eyes and I am ushered out. I stand outside the hospital in the cold December afternoon, feeling eyes on my back, wondering if and when someone will grab me and lock me back up again. Then I look up, and there is Renae, honking at me from the curb. I dive in with my pile of belongings like I am escaping a bank heist.

“Drive!” I yell, frissoning with fear and giggling at the same time. “Drive, baby! I’m free!”

“We’re together, and that’s all that matters,” says Renae.

I lean over and kiss her hands as we drive away.

***

Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

Full Article & Source:
“Gravely Disabled” — How I Narrowly Escaped a Conservatorship

Girardi Fraud Case: Ex-Celebrity Attorney’s Mental Competence Challenged in Court

By Rihem Akkouche

In a courtroom drama reminiscent of a Hollywood blockbuster, former A-list attorney Tom Girardi finds himself in the spotlight again, but this time not for defending a celebrity client. Instead, he faces questions of his own mental fitness to stand trial over charges of stealing a staggering amount from his firm’s clientele.

Girardi Fraud Case: Judge’s Latest Verdict

U.S. District Judge Josephine Staton, who seems to have become Girardi’s biggest courtroom adversary in this saga, ruled that he must appear in a Los Angeles court on Aug. 23. Echoing a crescendo in a thriller, this order comes on the heels of Girardi’s failed attempt to postpone the hearing, and the judge dismissing one of his key expert witnesses, pushing the narrative closer to its climax.

Girardi Fraud Case:  A Battle of Claims

Amidst the mounting tension, Girardi’s defense team paints a poignant image: an 84-year-old disbarred lawyer, battling Alzheimer’s, unfit for the pressures of a trial. Yet, prosecutors aren’t buying the emotional subplot. They argue he’s feigning his condition to dodge the limelight of what’s being touted as one of California’s most infamous legal debacles.

Girardi Fraud Case : Alzheimer’s & Conservatorship

It’s a plot twist that could be straight out of a script – Girardi, diagnosed with Alzheimer’s, was placed under the conservatorship of his brother, Robert Girardi, in 2021. This happened right after the dramatic crumble of Girardi Keese. Subsequent acts saw federal grand juries from Los Angeles to Chicago indicting him with 13 counts of wire fraud and four instances of criminal contempt.

The Trial Before the Trial

Before the main act can commence, Judge Staton is set to assess evidence concerning Girardi’s mental capacity. The climax of this prelude? Determining whether Girardi can grasp the gravity of the allegations against him and play an active role in his defense. Should he be deemed incompetent, the entire case could take an unexpected detour, potentially impeding the government’s quest for justice.

Full Article & Source:
Girardi Fraud Case: Ex-Celebrity Attorney’s Mental Competence Challenged in Court

See Also:
Tom Girardi

The US Senate Special Committee on Aging Seeks Citizen Input on Guardianship/Conservatorship

THE US SENATE SPECIAL COMMITTEE ON AGING is planning to have a future hearing (specific date unknown at this time) on guardianship, conservatorships, protective arrangements, and alternatives to guardianship/conservatorship.

The Committee is asking for the following citizen input:
*Stories and examples of problems with guardianships;
*Stories and examples of alternatives to guardianships; and
*Suggestions for protecting the rights of people being considered for or currently covered by guardianships, conservatorships, or other protective arrangements.

Anyone can submit a statement for the record to: guardianships@aging.senate.gov. The Committee requests statements be brief --- no longer than five pages.

Statements must be submitted by March 23, 2023

Please remember, the Committee cannot get involved in any case in any way. The purpose of the hearing will be to document problems related to protective arrangements and to identify potential solutions.

Pennsylvania: Joint Public Hearing on Strengthening Guardianship Laws and Preventing Elder Abuse

 

Agenda

11:00 a.m. Opening Remarks:
                  Senator Lisa Baker, Majority Chair, Judiciary Committee
                  Senator Judy Ward, Majority Chair, Aging & Youth Committee
                  Senator Steven Santarsiero, Minority Chair, Judiciary Committee
                  Senator Maria Collett, Minority Chair, Aging & Youth Committee

11:10 a.m. The Honorable Lois Murphy, Judge 
                 Court of Common Pleas, Montgomery County
                 Administrative Judge, Orphan’s Court Division – Testimony

11:30 a.m. Pam Walz, Esq., Chair
                  Elder Law Section, Pennsylvania Bar Association – Testimony

                 Sally L. Schoffstall, Esq., Certified Elder Law Attorney
                 Schoffstall Elder Law
                 Pennsylvania Association of Elder Law Attorneys – Testimony

11:50 a.m. Connie Brode, Executive Director
                  Huntingdon-Bedford-Fulton Area Agency on Aging – Testimony

                  Teresa Osborne, State Advocacy Director
                   AARP Pennsylvania – Testimony

12:10 p.m. Jennifer Garman, Esq., Director of Government Affairs
                  Disability Rights Pennsylvania – 
                   Testimony, Supporting Document 1, Supporting Document 2

12:30 p.m. Chelsea Robbins, Deputy District Attorney
                  Dauphin County District Attorney’s Office – Testimony

12:50 p.m. Closing Remarks

WATCH the hearing:
Joint Public Hearing on Strengthening Guardianship Laws and Preventing Elder Abuse

She Starved and Nearly Died on Guardian’s Watch, Family Says

Bonnie Lee Apple in 2016 with her friend Dr. Scot Silverstein, at her normal weight of about 140 pounds.

By Andy Newman

Bonnie Lee Apple’s family knew she was not well.

Her ex-husband had complained to Ms. Apple’s court-appointed guardian, who has been in charge of her care since a 2018 aneurysm left her moderately brain-damaged, that she had lost considerable weight.

Whenever her twin sister went to her apartment on the Upper East Side of Manhattan, Ms. Apple, 66, was covered in blankets or sheets. Health aides said she was sleeping. When Ms. Apple’s 18-year-old daughter visited in early February, she thought her mother was near death.

On Feb. 12, a longtime friend who happens to be a doctor called to say hello. “All she could say was, ‘I don’t feel good, I don’t feel good,’” said the friend, Scot Silverstein.

He asked Ms. Apple’s health aide what was wrong. The aide texted a photo.

“She looked like she had just walked out of a concentration camp,” Dr. Silverstein said.

Ms. Apple on Feb. 12 of this year. Minutes later, she was rushed to the hospital.

Ms. Apple’s emaciated face looked like skin pasted to bone; her arms were gaunt sticks.

Dr. Silverstein called Ms. Apple’s ex-husband. The ex-husband called the police. The police called an ambulance that took Ms. Apple to a hospital where she remains six weeks later, suffering from complications that Dr. Silverstein says were brought on by what was most likely months of near-starvation.

On Thursday, Dr. Silverstein and Ms. Apple’s sister, Amy Lee, are going to court to try to strip Ms. Apple’s caretakers, the Guardianship Project of the Vera Institute of Justice — a well-known legal-reform nonprofit — of control of her affairs.

The hospital, NewYork-Presbyterian/Weill Cornell, did not respond to a request for comment about Ms. Apple. But Dr. Silverstein, who said the hospital had shared limited information, said a doctor told him the day after Ms. Apple was admitted that she was suffering from severe malnutrition.

Since then, he said, batteries of tests and scans had found no underlying illness that could account for his friend having lost about 40 pounds since 2019. Medical records show that she weighed 135 in 2019 and 96 pounds in October 2021. Her weight upon admission remains unclear.

The Vera Institute, in a statement on Wednesday, said, “The medical reasons behind Ms. Apple’s weight loss are still being determined by medical professionals.”

While guardians are required to file annual reports on their wards’ health and financial status, Vera filed its most recent one, for 2019 — before Ms. Apple started losing weight — on Wednesday, after receiving inquiries from The New York Times. Vera declined to answer several other questions about her case.

Vera said that Ms. Apple’s care was now being overseen by Project Guardianship Inc., an independent entity spun off from Vera’s Guardianship Project last year, and that Project Guardianship was “investigating this matter internally.” Project Guardianship said in a statement on Wednesday, “We have worked closely with Ms. Apple’s physicians and the 24-hour home health aides who provide direct care and assistance to Ms. Apple to help her make decisions about her treatment and care.”

Guardians can be appointed by the court system when someone cannot care for themselves and no one else is both willing and able to do so; there are about 13,000 people under guardianship in New York City, the state court system said.

No city or state agency was able to provide statistics Wednesday on elder abuse complaints involving people under guardianship. But Elizabeth Valentin, a visiting associate professor at New York Law School who specializes in elder law, said that guardianship rules had “a number of gaps” in oversight mechanisms and that “opportunities exist for negligence.” She added: “You only need one or two people not doing their job and the whole thing falls apart.”

How Ms. Apple ended up starving under the care of a guardian does not matter, her family says. Ms. Apple’s case manager was supposed to visit every month. Home health aides were with her around the clock, at a cost to Ms. Apple, a former instructor at the Manhattanville College School of Education, of more than $20,000 a month.

Ms. Apple’s ex-husband, Gary Apple, said of the guardians, “If they looked in it’s tragic. If they didn’t look in, it’s tragic. It’s no excuse.”

Ms. Apple with her ex-husband, Gary Apple, last October. Mr. Apple wrote to Ms. Apple’s guardian that she seemed “horrifyingly thin.”

To this day, the family said, neither Vera nor Project Guardianship has offered an explanation for how Ms. Apple wound up in her condition. Vera remains legally in charge of both Ms. Apple’s personal care and her finances.

For the first week of her hospitalization, Dr. Silverstein said, the hospital refused to let Ms. Apple’s family visit her or even get information about her condition; he said the patient services department told him that was on orders of the guardian.

The lawyer Dr. Silverstein and Ms. Apple’s sister retained, Marcel Florestal, said that in a recent conference, Vera’s lawyer indicated that the organization would agree to step aside as Ms. Apple’s health guardian but that it would seek to remain the guardian of her assets, which as of 2019 amounted to more than $700,000, according to the report Vera filed on Wednesday. In 2019, Vera received $9,375 in commissions for managing Ms. Apple’s finances, the report said.

Vera founded its guardianship project in 2005, in partnership with the state court system, “in response to studies and news reports documenting abuses by guardians,” according to Vera’s website, which promotes the project’s “highly regarded holistic guardianship services model” that includes lawyers, social workers and finance associates.

Ms. Apple’s aneurysm left her with noticeable cognitive deficits and unable to care for herself. But she remained animated and able to carry on conversations, her family said.

By last June, her ex-husband was concerned about her weight. He wrote to Beth Williams, Project Guardianship’s main lawyer on Ms. Apple’s case, that she “seemed exceptionally thin and frail.” Ms. Williams thanked him for bringing the issue to her attention. On Wednesday, Ms. Williams, who left Project Guardianship in October, said by phone, “I really don’t remember having any correspondence with Gary about Bonnie’s doctors or any weight loss.”

Ms. Williams said that Vera had done a lot for Ms. Apple, including getting her piano lessons and buying her a computer (with her own money). “Whatever she wanted to do, we tried to use her resources to make her life as good as it could be,” she said.

A report by a court evaluator submitted Wednesday night in advance of Thursday’s hearing recommended that a new guardian be appointed “since the actions of the guardian” in managing Ms. Apple’s health “have been problematic.”

But it also stated that the hospital’s investigation of Ms. Apple’s medical and home care had found that “while certain decisions may have been done differently, they did not conclude that the guardian had neglected” Ms. Apple. It noted that Ms. Apple had been seen by a gastroenterologist in November, but that “there was no resolution” on why she was losing weight.

In early February, when Ms. Apple’s daughter Josette visited her, she stayed just a few minutes because it was so painful to see her mother so ill and disoriented.

“I’d say something and she wouldn’t respond,” or she would respond with gibberish, Josette said. “She was like mumbling and yelling at the same time.”

Josette added, “I knew that she wasn’t getting out and I knew that she wasn’t really eating, but I thought that had something to do with her condition, not the way she was being treated.”

Since she has been hospitalized, Ms. Apple has faced a series of problems, including blood clots, gastrointestinal bleeding, anemia and unstable blood pressure, Dr. Silverstein said.

Loss of appetite is not one of them.

“She’s like, ‘Where is my dinner’ when it’s breakfast time,” Ms. Apple’s sister said.

Full Article & Source:

She Starved and Nearly Died on Guardian’s Watch, Family Says