Monday, June 25, 2018

This Kansas nursing home had high rates of mind-altering meds. Today, that has changed

Dorothy "Dottie" Morgan gets assistance from her daughter, Deanna Seimsen, middle, and her husband, Ted Morgan, inside the Kearny County Hospital's assisted living facility in Lakin

Read more here: http://www.kansas.com/news/state/article212842959.html#storylink=cpy

  When Dorothy “Dottie” Morgan entered High Plains Retirement Village in Lakin, she was already on at least one anti-psychotic medication. 

Risperdal — and the other anti-psychotic medications she received on an as needed basis — has a “black box” warning for elders, the strictest warning from the U.S. Food and Drug Administration.

In 2016, 20 percent of all Kansas long-term nursing home residents had an anti-psychotic medication at some point in the year. That tied Kansas for the highest rate with Oklahoma and Mississippi.

Those medications, which are intended for serious mental health issues such as psychosis and schizophrenia, can increase the risk of falls, heart attacks, strokes and more, particularly for the elderly. They are not recommended for someone with dementia, like Morgan.

Today, those rates have declined across the country, throughout Kansas and at High Plains Retirement Village, which is located at Kearny County Hospital.

‘Zombie like’


As Morgan’s dementia worsened, it was hard for family to know whether the medicine or her disease was changing her. She was lethargic, “kind of zombie like,” uninterested in anything, said Ted Morgan, her husband. She had difficulty moving and hardly seemed to notice when people walked by. 

For years, prescribing anti-psychotics for nursing home residents who were difficult to control was common practice, said Mary Chipley, director of nursing at the hospital. When physical restraints ceased to be used in the late 80s and early 90s, nursing homes moved to chemical restraints.

Chipley first learned that the hospital had high rates of anti-psychotic usage shortly after becoming the new director of nursing. In a short period of time, she received a state survey, heard from the Kansas Partnership to Improve Dementia Care and was surveyed by federal regulators.

With 38 percent of residents on anti-psychotics, Kearny County had the second highest rate in Kansas — a state that, at the time, had the highest rates in the nation. (Nursing home advocates point out that Kansas has nine designated Nursing Facilities for Mental Health, which are unique to Kansas and make up nine of the top 10 homes in the state for anti-psychotic use. That has raised Kansas’ ranking). 

In just 18 months, rates at Kearny County Hospital have dropped from 38.2 percent to 8 percent. The one resident remaining on anti-psychotic medications has a psychiatric diagnosis for which the medications are approved. 

With the physicians on board, they began to gradually reduce the medications. Chipley required nurses to receive approval from her before asking a physician for anti-psychotic medications for a resident. Consultants came in to offer training on how to handle difficult behaviors without medication.

One of the most important elements was completing a “life story” for each resident. In it, staff met with family members to find out about the resident’s personality, history, comfort foods and more. 

That allows staff to better manage behaviors if they know the root cause. Perhaps a favorite comfort food can be used to help someone calm down. When a resident tries to get out of the locked area, staff might take him for a walk rather than making him immediately return indoors. 

Siemsen, the Morgans’ daughter, said one of the greatest successes was explaining to the staff that her mother didn’t like being ordered around. 

“If you ask her, ‘Hey Miss Dottie, would you like to go have an ice cream?’ if you ask Miss Dottie and approach it that way, she’s much, much more receptive than if you just tell her it’s time for lunch,” Siemsen said.

It can be hard to understand the needs and desires of someone with dementia, Chipley said. Knowing their histories helps people to understand how they think and behave.

“A please and a thank you go a long way with her (Miss Dottie),” Chipley said. “That’s still there. She still wants you to use your manners.”

Another resident was a homemaker. In the past, if she had become upset after lunch, staff might not have known why and opted for anti-psychotic medication. Now, they know she wants to wash dishes every day, so they let her.

Changing mindset


No nursing home wants to put their residents on these medications, said Benjamin Anderson, CEO of the hospital, but they sometimes don’t have the tools to do otherwise. 

“The difference (here) has been a nurse leader who was willing to say there’s another way,” Anderson said. 

It takes a while for people to change the mindset of “that’s just the way they’ve always done it,” said Tim Keck, secretary of the Kansas Department for Aging and Disability Services. 

“It really starts with focusing on the person, person-centered care, and thinking about what would you want for yourself or your family member,” Keck said. “You start there.” 

Debra Zehr, CEO of LeadingAge Kansas, the statewide association of nonprofit long term and aging care providers, also referenced creating “a person centered place for people to call home” when she recognized Kearny County Hospital for the decrease in medications last week.

What’s being done at the hospital is also happening around the state as people become better educated, Zehr said.

Data from the Centers for Medicare & Medicaid Services shows that anti-psychotic use for long-term nursing home residents has declined in Kansas from about 26 percent when the rate was first measured in 2011 to 18.4 percent in the fourth quarter of 2017, moving Kansas to 45th in the country.

Ted Morgan said he’s seen a world of difference in his wife since she stopped taking the anti-psychotic medications.

On Tuesday, “Miss Dottie” was alert, curious about a Wichita Eagle photographer’s camera and eager to show off her pastel pink fingernails.

She might not know who residents, staff and visitors are, said Ted Morgan, but she pays attention to them once again. Before the medications, she loved the outdoors, flowers, grass, books, reading, family photos, pictures and paintings. Those interests have returned, her family say. 

“If she can be off the antipsychotic medication and function fine in her environment and have a little more response to her environment, then absolutely, why wouldn’t you do that?” Ted Morgan asked.

Chipley says others have had similar reactions to being taken off their medications. At first there was some resistance among staff, but they came on board when they noticed the change.

“It was like they were coming alive again,” Chipley said. “It wasn’t just people sitting in recliners anymore sleeping. It was going outside. It was doing an activity. It was being up and moving around, having a conversation. It was almost becoming a person again.”
d more here: http://www.kansas.com/news/state/article212842959.html#storylink=cpy


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This Kansas nursing home had high rates of mind-altering meds. Today, that has changed

Sunday, June 24, 2018

Legendary astronaut Buzz Aldrin sues his family alleging fraud

© JP Yim, Getty Images for Nick Graham
MELBOURNE, Fla. — Apollo 11 moonwalker Buzz Aldrin has launched a legal battle against his children and family foundation, accusing them of abusing his trust and finances nearly 50 years after his historic moon landing.

The 88-year-old Aldrin's children, in turn, say they fear he is a victim of manipulation by parties seeking to take advantage of his money and reputation.

In a civil suit filed this month in Brevard County Circuit Court, Aldrin, a Satellite Beach resident, claims his son, daughter and a former manager have misused credit cards, refused to disclose financial information and mismanaged social media accounts and other media obligations.

Aldrin further says they have slandered him, telling others that he has dementia and Alzheimer’s disease, and have refused to let him marry and undermined romantic relationships.

The family and Buzz Aldrin Space Foundation “have used this tactic to gain further control over (Buzz Aldrin’s) personal relationships, business contacts, and assets,” the lawsuit states.

Aldrin also seeks to remove his son, Andy Aldrin, as the controlling trustee of his estate that oversees memorabilia worth millions of dollars.

Andy Aldrin is a former rocket company executive who also serves as the foundation’s president and director of the Aldrin Institute based at the Florida Institute of Technology in Melbourne. Buzz Aldrin's daughter, Jan Aldrin, is a foundation board member. Buzz Aldrin is the foundation’s chairman, but does not oversee day-to-day operations.

The foundation, which is gearing up for an annual gala fundraiser July 21 at Kennedy Space Center, did not comment directly on the lawsuit Friday.

However, the foundation said in a statement that it has “concerns for (Buzz Aldrin’s) vulnerability to manipulation by other parties seeking to gain access to and control of foundation and personal resources.”

Those concerns were expressed this week after public questions arose about a surge of activity on Aldrin’s official Twitter account, after it had been dormant for six weeks.

One of the messages personally attacked Aldrin’s longtime manager, Christina Korp, of Winter Park, accusing her of “using Buzz’s voice and brand to self-promote/ promote her clients.”

Echoing the lawsuit filed June 7, the tweet said Aldrin had fired Korp, whom the lawsuit also accuses of fraud and other exploitation.

The family foundation said that was not true, and that Korp remains a board member with its full support.

The foundation also said someone else appeared to be speaking for Aldrin on his official Twitter account, @TheRealBuzz.

“We are not sure who is responsible for the tweet regarding Christina Korp, but we are confident Buzz did not write this," the foundation said in a statement.

Florida Tech, which houses the Aldrin Space Institute and Aldrin Center for Entrepreneurship in Space, also is a defendant in the case.

Identifying Buzz Aldrin as a “vulnerable adult” under Florida law, the lawsuit accuses Andy Aldrin of making “large sums of transactions monthly” from Buzz Aldrin’s accounts.

“The amounts are unknown in amount but substantial, potentially hundreds of thousands of dollars,” the suit states.

Robert Tourtelot, Buzz Aldrin’s lawyer, did not immediately respond to a call for comment.

The lawsuit reflects a rift that has divided the Apollo astronaut — who this week visited the White House for a National Space Council meeting — from his family in favor of a different management team.

The new team last month promised to unveil a new Aldrin initiative, the Human Spaceflight Institute, at Spaceport Houston located at Ellington Airport.

The planned May 22 press event was canceled without explanation. But on Friday, its spokesperson, Beverly Hills-based Edward Lozzi of Lozzi Media Services, said to stay tuned.

“We are going to be making a major announcement in the near future,” Lozzi told Florida Today.

Lozzi previously has represented celebrity clients, including Lou Ferrigno and Jon Voight, and served as a White House press aide under President George H.W. Bush, according to his website.

Aldrin’s new advisers have established a Los Angeles-based entity, Buzz Aldrin Ventures, that they say now represents his business interests.

The organization’s website says it is “Buzz’s overarching holding company charged with developing strategic projects and international joint ventures that further Buzz’s vision and legacy in addition to activities formerly undertaken by Buzz Aldrin Enterprises.”

The venture’s chief operating officer is Linn LeBlanc,who had previously worked as executive director for Buzz Aldrin’s Share Space Foundation, a major educational initiative run by the family foundation. Her involvement with Share Space ended in February 2017, according to LeBlanc’s LinkedIn page.

LeBlanc also previously served as executive director for more than a decade of the then Kennedy Space Center-based Astronaut Scholarship Foundation.

Also involved with Aldrin, according to the online news site NASA Watch, is Lisa LaBonte, who once served as CEO of the United Arab Emirates-based Arab Youth Venture Foundation, which partnered with NASA on some education projects.

Aldrin’s family foundation says its mission is to promote STEM education, space exploration and Aldrin’s legacy. It reported net assets of about $240,000 in 2016, according to IRS documents.

“We are determined to protect Buzz’s personal reputation and professional legacy, while also protecting his ability to remain self-sustaining financially,” the foundation said.

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Legendary astronaut Buzz Aldrin sues his family alleging fraud

Deputies: Hospice aide stole from elderly couple

Nekeya Denise Jenkins
TARBORO — A Wilson woman is accused of swindling an elderly Edgecombe County couple out of more than $13,000 while working as an in-home hospice aide.

Edgecombe County sheriff's deputies say 36-year-old Nekeya Denise Jenkins of 905 Macon St. S. was hired to provide hospice care in the couple's home May 26. After six to seven home visits, she allegedly began stealing the patients' personal checks and debit cards.

Jenkins spent $13,596.28 of the couple's money on herself without authorization, according to the sheriff's office. Deputies said the male patient has died due to a terminal illness.

Deputies said Jenkins was employed as a hospice nurse, but the exact nature of her job is unclear. The North Carolina Board of Nursing's online database does not list Jenkins as a registered nurse, licensed practical nurse or Level II nurse aide. The N.C. Division of Health Service Regulation registers Level I nurse aides but requires the last four digits of a person's Social Security number to search its registry.

If Jenkins is a licensed or registered health care worker, the allegations she faces could cause her to lose required state credentials to work in that capacity.

The Edgecombe County Sheriff's Office on Friday credited Wilson police and Wilson County deputies with assisting in the case and helping to locate Jenkins in her Wilson home. She was jailed in Edgeconbe County under a $40,000 secured bond.

Jenkins is charged with exploitation of an elder adult, identity theft and two counts each of obtaining property by false pretense and financial card fraud - all felony counts. She also has a pending charge of felony larceny by employee in Wilson County.

Records show Jenkins is due in Edgecombe County District Court on Wednesday.

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Deputies: Hospice aide stole from elderly couple

Breathing Tubes Fail to Save Many Older Patients

One-third of patients over age 65 die in the hospital after they are put on ventilators. Doctors are beginning to wonder if the procedure should be used so often. 


David Plunkert
Earlier this year, an ambulance brought a man in his 80s to the emergency room at Brigham and Women’s Hospital in Boston. He had metastatic lung cancer; his family had arranged for hospice care at home. 

But when he grew less alert and began struggling to breathe, his son tearfully called 911.

“As soon as I met them, his son said, ‘Put him on a breathing machine,’” recalled Dr. Kei Ouchi, an emergency physician and researcher at the hospital. 

Hospice patients know that they’re close to death; they and their families have also been instructed that most distressing symptoms, like shortness of breath, can be eased at home.

But the son kept insisting, “Why can’t you put him on a breathing machine?”

Dr. Ouchi, lead author of a new study of how older people fare after emergency room intubation, knew this would be no simple decision. 

“I went into emergency medicine thinking I’d be saving lives. I used to be very satisfied putting patients on a ventilator,” he told me in an interview. 

But he began to realize that while intubation is indeed lifesaving, most older patients came to the E.R. with serious illnesses. “They sometimes have values and preferences beyond just prolonging their lives,” he said.

Often, he’d see the same people he’d intubated days later, still in the hospital, very ill, even unresponsive. “Many times, a daughter would say, ‘She would never have wanted this.’”

Like all emergency doctors, he’d been trained to perform the procedure — sedating the patient, putting a plastic tube down his throat and then attaching him to a ventilator that would breathe for him.

But, he said, “I was never trained to talk to patients or their families about what this means.”

His study, published in the Journal of the American Geriatrics Society, reveals more about that. 

Analyzing 35,000 intubations of adults over age 65, data gathered from 262 hospitals between 2008 and 2015, Dr. Ouchi and his colleagues found that a third of those patients die in the hospital despite intubation (also called “mechanical ventilation”).

Of potentially greater importance to elderly patients — who so often declare they’d rather die than spend their lives in nursing homes — are the discharge statistics. 

Only a quarter of intubated patients go home from the hospital. Most survivors, 63 percent, go elsewhere, presumably to nursing facilities. The study doesn’t address whether they face short rehab stays or become permanent residents.

But it does document the crucial role that age plays.

After intubation, 31 percent of patients ages 65 to 74 survive the hospitalization and return home. But for 80- to 84-year-olds, that figure drops to 19 percent; for those over age 90, it slides to 14 percent.

At the same time, the mortality rate climbs sharply, to 50 percent in the eldest cohort from 29 percent in the youngest.

All intubated patients proceed to intensive care, most remaining sedated because intubation is uncomfortable. If they were conscious, patients might try to pull out the tubes or the I.V.’s delivering nutrition and medications. They cannot speak. 

Intubation “is not a walk in the park,” Dr. Ouchi said. “This is a significant event for older adults. It can really change your life, if you survive.”

A study at Yale University in 2015 following older adults before and after an I.C.U. stay (average age: 83) confirmed what many geriatricians already understood. Depending on how disabled patients are before a critical illness, they’re likely to see a decline in their function afterward, or to die within a year. 

Those who underwent intubation had more than twice the mortality risk of other I.C.U. patients. “You don’t get better, most of the time,” said Dr. Ouchi. While outcomes remain hard to predict, “a lot of times, you get worse.”

Intubation rates are projected to increase. But so has the use of alternatives known as “noninvasive ventilation” — primarily the bipap device, short for bi-level positive airway pressure. 

A tightfitting mask over the nose and mouth helps patients with certain conditions breathe nearly as well as intubation does. But they remain conscious and can have the mask removed briefly for a sip of water or a short conversation.

When researchers at the Mayo Clinic undertook an analysis of the technique, reviewing 27 studies of noninvasive ventilation in patients with do-not-intubate or comfort-care-only orders, they found that most survived to discharge. Many, treated on ordinary hospital floors, avoided intensive care.

“There are cases where noninvasive ventilation is comparable or even superior to mechanical ventilation,” said Dr. Douglas White, a critical care physician and ethicist at the University of Pittsburgh School of Medicine. 

Dr. Ouchi, for instance, explained to his patient’s distraught son that intubation would thwart his father’s desire to remain communicative. The patient, able to see though not to say much, died four days later in a hospital room with bipap and morphine to reduce his “air hunger.”

Most patients in the Mayo review died within a year, too. But bipap may provide an interim option, giving families and physicians time to decide together whether to intubate an ailing older patient, who at this point probably can’t direct his own care.

The harried emergency room environment, after all, hardly encourages thoughtful discussions about patients’ prognoses and wishes. Those can become fraught conversations anyway, as Dr. White’s previous research has demonstrated.

His 2016 study showed that when physicians and surrogate decision makers have very different expectations about a critically ill patient’s odds of recovery, it’s not merely because family members fail to grasp what the physician explained

“Other things get in the way of making good decisions,” Dr. White pointed out. “A lot of this has to do with psychological and emotional factors” — like “optimism bias” (Most people with this condition will die, but not my mom) or “performative optimism” (If we maintain hope, our mom will get better). 

In their most recent study, he and his colleagues experimented with a support program for families with relatives in I.C.U.s., nearly all intubated.

When a specially-trained nurse checked in daily to explain developments and answer questions, families rated their communications more highly and felt more satisfied with their loved ones’ care

The University of Pittsburgh Medical Center’s health system has begun adopting the program in its 40 I.C.U.s. 

But discussing how aggressively an older person wants to be treated remains a conversation — probably a series of them — best held before a crisis.

Intubation, for instance, is often something a physician can foresee. Older patients who have cardio-respiratory conditions (emphysema, lung cancer, heart failure), or who are prone to pneumonia, or who have entered the later stages of Alzheimer's or Parkinson's disease — any of them may be nearing this crossroads. 

When they do, Dr. Michael Wilson, a critical care physician at the Mayo Clinic, opts for a particularly humane approach. 

As he recently described in JAMA Internal Medicine, before he inserts the tube, he explains to the patient and family that while he and the staff will do everything they can, people in this circumstance may die

“You may later wake up and do fine,” he tells his patient. “Or this may be the last time to communicate with your family,” because intubated patients can’t talk.

Since setting up intubation generally takes a few minutes, he encourages people to spend them sharing words of comfort, reassurance and affection. Without that pause, “I have stolen the last words from patients,” he told me. 

His editorial has drawn attention from critical care physicians around the world.

Dr. Wilson has used this approach about 50 times in his I.C.U., so he has learned what patients and families, given this opportunity, tell one another. 

“It’s nearly always, ‘I love you,’” he said. “‘I hope you do well.’”

Full Article & Source: 
Breathing Tubes Fail to Save Many Older Patients

Saturday, June 23, 2018

Couple sentenced for financially exploiting elderly man locked in room

Kevin Miller and Janice Miller
PINEVILLE, Mo. — A husband and wife from southwestern Missouri have been ordered to pay $5,000 in restitution for cashing government checks intended for an elderly man who was found padlocked in a bedroom in their home.

The Joplin Globe reports that 47-year-old Kevin Miller and 50-year-old Janice Miller of Goodman pleaded guilty Tuesday to financial exploitation of an elderly person. The plea deal dismissed kidnapping and armed criminal action charges. The couple received a suspended sentence.

The Millers were arrested after a McDonald County deputy, acting on an anonymous tip, found 79-year-old Herbert Spell inside a padlocked bedroom of the Millers’ home. Spell told the deputy he had been locked in the room for six months, fed “sporadically,” and rarely allowed to shower.
 
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Couple sentenced for financially exploiting elderly man locked in room

Moving an Aging or Disabled Parent Into Your Home: 4 Things You Should Know

It’s every adult child’s nightmare: getting a phone call in the middle of the night from an aging parent, or worse, the hospital. Maybe there’s been a fall or a medical emergency. Perhaps the early stages of dementia have advanced more quickly than anticipated, and there’s been an incident. Either way, one thing is clear in this situation — it is no longer safe for the parent to live alone.

Deciding to move an aging parent — especially one who is disabled — into your home isn’t a decision anyone makes lightly, but it’s often the most affordable option. One out of every four caregivers lives with the person they are caring for. While this can be very rewarding to both the son or daughter and the aging parent, there are several important pros and cons to this arrangement. On one hand, if the parent is mentally and physically sound, they can help in small ways with the kids, housework or finances. On the other hand, if they require constant care due to a disability or illness, the entire family might experience moments of added stress, anxiety and frustration.

That’s why you need to weigh options and considerations when an elderly parent moves in with you. Though there might be heavy emotions surrounding the decision, it could still be the right choice. This guide will help you make that decision by giving you some insight on:

  • Understanding how to give the right kind of care.
  • Estimating the costs associated with assisted living facilities versus in-home care.
  • Making your home elderly-friendly.
  • Adjusting the whole household to the lifestyle changes.

Giving the right kind of care


Being the child of a senior who needs more vigilant care means you have your heart in the right place — your parent’s health and well-being is your priority However, that doesn’t necessarily mean you are as qualified as an expert to give the best care.

If Mom or Dad is still relatively healthy and independent, moving him or her in will be much simpler and smoother. However, most people don’t get to the point where they consider moving a parent into their own home unless in response to a specific health crisis. In that case, it’s important that you know your parent’s illness or limitations very well. Consider where this health situation is likely to go. How will a chronic illness, a broken hip or mental illness progress one, two or fives years from now? You may be prepared today, but you also need to think about how prepared you will be later on.

If the health situation is serious or extreme, you may not be capable of giving the best quality of care. Living with you might only be a temporary solution. This could help ease the transition to a nursing facility, or you could hire an in-home professional to support your caregiving responsibilities. However, if their health requires 24/7 monitoring, specialized care or equipment, it may be best to to move them to a nearby nursing home or assisted living facility.

Estimating the associated costs


Sometimes the decision to move in an elderly parent comes down to cost. On average, a nursing home can run about $80,000 per year and an assisted living facility costs roughly $43,000 per year.

However, there are also care costs to consider when moving Mom or Dad in. Things may be easy now, but the amount of assistance needed will most likely increase as they age. That means that sooner or later you might consider finding an in-home aide. A caregiver hired to help with self-care tasks like bathing, feeding and chaperoning activities can cost about $20,000 per year for full-time help.

For other tasks around the house, you may want to consider hiring an errand runner or personal assistant to ease the burden on both you and your loved one. These services can cost about $25 per hour, and may come in handy in a pinch. If you’re reacting to a recent health crisis, you may need to hire a caregiver with specific medical training, which can double, or even triple, the cost of care.

Providing full-time care may entitle you to financial or other forms of assistance. Do thorough research to help you prepare and budget for the many facets of care giving.

Making your home ready for care


Moving in a parent who is aging or disabled is, in all probability, the most cost-effective solution for many people. However, that doesn’t mean that there won’t be some expenses associated with renovating areas of your home to make it safe and secure for senior care. Some common remodeling projects include:
  • Installing an automatic lift to help the senior navigate flights of stairs ($1,500 – $3,000).
  • Building a ramp in addition to your front steps if the senior needs wheelchair access ($400 and up).
  • Widening doorways for wheelchair and walker access ($500 – $1,000).
  • Converting an attic, basement or den into a bedroom, possibly for you or your children. You’ll want your senior to be comfortable, and usually, a first-floor bedroom without stairs is the safest place for them to reside ($1,500 – $5,000).
  • Adding a new bedroom or suite for your aging parent, especially if there is no other room to renovate ($100,000).
  • Adding handrails and modifications to the bathroom to prevent slips and falls ($40 per foot).
  • Covering prescription medication costs and healthcare copays.
  • Paying additional bills for electricity, groceries and water.

The National Alliance for Caregiving (NAC) released a study stating that out-of-pocket caregiving costs can run about $5,500, but other studies have shown the costs may be much higher, topping at around $15,000 per year for care.

While these renovations are less of a financial burden than a nursing home or assisted living facility, not planning for any costs can creep up on your finances. To avoid problems or roadblocks later, talk to your parent and family members about this up front.

Adjusting to the lifestyle changes


There are going to be more sacrifices than just finances and space when you move in an elderly parent. Will your child’s music disturb your aging parent? Is your elderly housemate as clean and tidy as you expect the rest of your family to be?

Instead of focusing on the potential issues, think about this as an opportunity for everyone to grow. Creating room for your parents in your home can help your children learn how compassion leads to joyful compromise. It also empowers everyone to try out critical thinking and conflict resolution skills. If your mom or dad is uncomfortable with your teen’s loud music, ask your child to use headphones after a certain hour, or pick up a pair of noise cancelling ones for your parent.

When you bring a senior who needs extra care into your home, some of your vacation plans will likely have to change. You may have to put off some vacations, while others may just need to be modified or adjusted to accommodate for accessibility. Again, get the whole family involved in the decision-making process, especially if you feel like resentment is building.

Caring for an aging or disabled parent can help you give back some of the love and devotion they gave to you when you were young or going through challenging changes. There will certainly be stressful times, and not everyone will be satisfied with each compromise or outcome. However, if you feel in your heart that this is the right decision, the relief you feel being able to keep your aging loved one safe will override most tense and stressful moments. Remember, you are one of many to make the choice to have your parent live with you; there are others out there, in groups online or in person, who can provide emotional support when you need it.

Full Article & Source:
Moving an Aging or Disabled Parent Into Your Home: 4 Things You Should Know

Fort Myers man found guilty of exploitation of an elderly person

John James Dunn
A Lee County court found a man guilty of exploitation of an elderly person or a disabled adult for a 2016 incident where he scammed $2,000 from an 80-year-old woman under the guise of a fake air conditioning service contract.

John James Dunn, 37, went to the woman's Fort Myers home to sell her air conditioning services. She agreed to pay $3,000 through financing to have her air conditioner refurbished. The owner of the company Dunn worked for went to the woman's home and discovered that she didn't fully understand the contract, so he canceled the contract and did not charge her, authorities said.

The company owner told Dunn he had canceled the contract. Dunn proceeded to create a fake contract using letterhead from an air conditioning company that previously employed him. He convinced the woman to go to the bank and withdraw $2,000 to pay for the fake contract.

A month later, Dunn returned to the home while a well-being check was being done at her home. Dunn told the person checking on the woman that he worked for the air conditioning company on the letterhead, which was untrue, and introduced himself using his deceased father's name, authorities said.

He is then said to have aggressively demanded that the woman pay an outstanding balance of $1,000.

Dunn left the home without getting the money and was reported to law enforcement. The Lee County Sheriff's Office investigated and then turned the case over to the state attorney's office.

Dunn faces up to ten years in jail. His sentencing is scheduled for July 24.

Full Article & Source:
Fort Myers man found guilty of exploitation of an elderly person

Friday, June 22, 2018

Guardians from Hell

The completely legal, utterly grotesque system for undermining the rights of the elderly 


By Gretchen Rachel Hammond

At 92-years-old,Virginia Jean Wahab hadn’t lost any of the vitality and health she maintained throughout her life. She raised two daughters as a single mom and made a home for them in the Detroit, Michigan suburb of Oak Park. Wahab worked on her feet and didn’t retire from her job at a local family restaurant until she was 88.

Fiercely independent, Wahab was quite happy living at home after retirement. She had a healthy social life. She did her own grocery shopping and chores. She so rarely needed to pay a visit to a hospital that her health insurance was barely touched.

Her eldest daughter Mimi Brun converted to Judaism at the age of 18. She went on to become a prolific Jewish artist, who sold her work all over the world. In 2010, she began to establish art schools for children under 12 in France and then Chicago. Although Brun was estranged from her younger sister, she and her mother were extremely close. Wahab was Catholic, but Brun noted that she had the fastidious nature of a Jewish mother.

Wahab’s legal affairs were in order including a durable power of attorney she had signed in January, 2016 which named Brun as a patient advocate (the handler of her medical needs) as well as giving her daughter charge of her financial affairs should she ever become incapacitated. Wahab’s home was also registered in Brun’s name in a quit claim deed signed by Wahab on December 29, 2014.

The two talked on the phone every day. Brun particularly relished visits with her mother during which she would gift her a piece of art. Wahab was an eager collector of Brun’s work.

That was two years ago. Everything has changed since then.

In 2016, after a fall at her home, Wahab was diagnosed with a slight cognitive problem but otherwise deemed healthy. Wahab’s doctor recommended that Brun find her a short-term rehab facility.

“I looked for a Jewish one,” Brun said. “They were all full. I found Lourdes because it had a five-star reputation.”

On February 23, that year, with the approval of her HMO, Wahab was admitted for short-term rehabilitation at Lourdes Senior Community in Waterford, Michigan—a nonprofit elder care facility founded by Dominican nuns in 1948. According to the organization’s 2016 I-990s, Lourdes listed end of year assets of $22,096,166.00. Expenses totaled $14,476,851.00

Brun said she made her mother’s meals and went to each of her physical and occupational therapy sessions.

“The insurance granted her up to 120 days,” Brun remembered. “She was excelling like a champ but the therapist at Lourdes started telling me she suspected Mom should not live alone. Mom and I decided that I was going to go back to France and Chicago, put my businesses on hold, rent out my homes and move my work and studio to Mom’s. It was what she had dreamed about—to spend the end of her life living with me.”

Brun left for France, placing her aunt and sister in charge of caring for Wahab while she was in rehab.

“I called Lourdes every day,” Brun said. “Then the insurance cut off.”

Brun asserted that she spoke to Lourdes social worker Sara Van Acker and pledged that she would enter into a payment plan. Shortly thereafter, however, she received an email from a Lourdes administrator which stated “Your payment plan with Sara Van Acker was not approved by me. I cannot receive partial payment nor be patient for your payment plan time frame.”

On June 6, Lourdes filed a petition for guardianship on the grounds of a $31,416.65 past-due bill. Brun said that the petition notice was sent to an address that was not hers. The petition shows that the address used to serve Brun belongs to an apartment complex in Harper Woods Michigan—one hour’s drive from Lourdes and 30 minutes from Oak Park. On the address, no apartment number is listed. It is also not the address listed on the Power of Attorney paperwork Brun says she provided to Lourdes.

Brun rushed back to Michigan. On the morning of June 29, 2016, she attended a hearing presided over by Oakland County Probate Judge Linda Hallmark, one of four judges serving there. Hallmark vacated Wahab’s power of attorney and appointed a local attorney Jon Munger as Wahab’s guardian. According to Brun, neither she nor her mother ever requested Munger’s services.

Also appointed by the court was a man named Matthew Jason Brown, another local lawyer. Brown was named as Wahab’s guardian ad litem (GAL)—a person entrusted with investigating what course of action is in the best interest of a person unable to care for themselves. The June 29 hearing was also attended by two representatives from Lourdes: Van Acker and Lisa Hibbert from the organization’s accounts receivable department.

According to court transcripts from that morning, Van Acker stated that she had filed the petition for guardianship because “there’s a concern about the nursing home being paid.”

Brown wanted to know if an application for Medicare benefits for Wahab had been made.

“Not to my knowledge,” Van Acker replied.

“Are you familiar with [Wahab’s] medical condition?” Brown wondered, to which Van Acker answered “slightly.”

When Brown asked Brun if she had any objection to the petition, Brun replied “I am contesting this hearing because I was not served. I’ve had no time to get a lawyer.”

“Well, you’re here Ma’am,” Hallmark replied, “and it’s a guardianship so there is some urgency about it, so we’re going to proceed.”

When Brun protested that she had been appointed as Wahab’s guardian through a power of attorney, Hallmark quickly rebuked her.

“That’s different than an appointment by the court,” Hallmark said. “Has any court appointed you guardian?”

“No, but I haven’t applied for it yet,” Brun replied. “I’d like to petition for it, but I need time.”

Hallmark did not respond to this request.

In delivering his report to the court, Brown went on to state that he had visited Wahab at Lourdes only two days earlier. During that visit, he said, he “explained to Wahab her rights and gave her a copy of [the petition].”

“She didn’t have any objection to the appointment of a public administrator at that time,” he added. “But I would note that she was not oriented to date, time, and place.”

Brown also stated that he “went over [Wahab’s] medical condition with Ms. Van Acker and she went over with me sheets that said she was suffering from dementia, unspecified lack of coordination, osteoarthritis, two…type two diabetes, muscle weakness and hypertension.”

Transcripts from that day indicate that Hallmark never asked for medical reports to prove Brown’s assertions.

Brun told Hallmark that she had witnesses who would speak on her and Wahab’s behalf. Those witnesses, however, were never called.

“My Mom needs love,” Brun went on to tell Hallmark. “No one loves my Mom more than me. When I asked my mom ‘what’s your greatest desire?’ she said ‘I want to go home. I want to go home with you.’”

“I want to take her home,” Brun begged Hallmark.

“I’m going to grant the petition,” Hallmark said. “I would like to appoint Mr. Munger [as guardian]. If he thinks that an independent medical or some other action is required that’s fine. I’m also going to appoint [Munger] as special fiduciary to make sure we have the Medicaid application on track. I’ll revoke the power of attorney today. If it’s appropriate that [Brun] should serve, if you want to get counsel and bring the matter in, we’ll consider that.”

“She hasn’t lost any of her rights…” Hallmark added, speaking of Wahab. “She has a guardian and it’s Mr. Munger…”

Brun made one last desperate plea. “Is there a reason why?”

“Yes,” Hallmark replied. “Because she’s in need of a guardian and I’m appointing Mr. Munger. That’s why.”

Hallmark never mentioned the grounds by which she was revoking the power of attorney.

The court adjourned.

Brun’s fight to have her mom released from Lourdes would eventually result in Hallmark issuing an injunction restraining her from entering Lourdes premises, denial of her visitation rights (even when chaperoned by a nun and a locally renowned, retired judge) and a bench warrant from Hallmark’s court for Brun’s arrest.

Two days after Munger had been assigned, Brun received an email from his office which stated “It will be necessary to close [Wahab’s] bank accounts and locate all assets in order to apply for Medicaid. I understand that there is at least one account at ****** Bank with both of your names on it. It would be more efficient if you cooperate with the closing of the account(s). I will need proof of closure for the Medicaid application. I will then open a guardianship account at ******** for your mother, pay her bills, and apply for Medicaid.”

Even though Wahab was originally admitted for a short-term rehab at Lourdes, on July 1, 2016, according to his own accounting, Munger completed a long-term medical assistance application that entitled Lourdes to three months of retroactive disbursement, faxing the application to Michigan State’s Department of Human Services. Five days later, Munger completed and mailed another admissions packet to Lourdes for Wahab.

A July 17, 2016 affidavit, signed by Wahab and filed in court, read “I want to go home with my daughter Mimi.”

On August 15, 2016 Brun’s then-attorney sent a letter to Lourdes CEO Sr. Maureen Comer stating “Ms. Brun has not and has never been opposed to negotiating the payment of the outstanding bill. Ms. Brun has made arrangements to take Ms. Wahab home and Ms. Wahab has even signed an affidavit stating she wants to return home.”

Two days later, Brun, her attorney and Lourdes received an email from Munger which stated that he was clarifying “for both Lourdes and for yourself, that I am not authorizing either Mimi Brun or yourself to discuss, negotiate or otherwise become involved in any potential discharge plan nor payment.”

Munger also went on to say “there have already been repeated complaints about your client’s behavior while at Lourdes facility. I have not yet taken full steps to curtail your client’s visitation, but we may need to revisit that issue.”

In a subsequent series of emails Brun’s then-attorney called Munger’s actions “highly inappropriate. You are needlessly dragging on this litigation so you can keep billing and billing.”

Munger replied “You and your client will cease any communication with Lourdes administration or management.  Your failure to abide by this requirement will simply force me to place the matter before Judge Hallmark, where I will ask that both you and your client be sanctioned for this grossly unprofessional, abusive and threatening behavior.  I simply will not allow either of you to interfere with Virginia’s care.”

On August 18, 2016, Munger billed Wahab $245 for his drafting “of a petition to limit visitation.”

An email that day from Munger to Brun’s attorney stated that it was “due to your attempts to pay Lourdes.” It makes no mention of any complaints about Brun’s behavior.

Because he was Wahab’s guardian, Munger was legally permitted to bill his ward for any work on her behalf. A 2017 statement of other fees and services billed to Wahab by Munger and Associates shows that in little over a three-month span, Munger billed Wahab a total of $6,097.00 in fees and services.

Brun filed an emergency petition to have Wahab released from Lourdes. In an October 5 hearing in Hallmark’s courtroom, Munger was represented by attorney Joseph Ehrlich.

Munger billed Wahab $450 to “attend hearing on court motions and “[a] conference with judicial staff attorney.”

Following the hearing, Ehrlich secured an order from Hallmark compelling Brun to pay $25,000 to Lourdes and gave her 25 days to come up with the cash.

Brun told me that, because it did not include the provision for her mother to be released, she refused to pay it.

A subsequent motion Brun filed to vacate the order stated that “upon review of the transcript of this hearing, at no point did Brun ever agree to pay $25,000 to Lourdes. It does not comport with the settlement placed on record.”

Lourdes retained attorney Mary Lyneis to represent them.

A November 2016 letter from Lyneis to Brun accused her of violating “Court Orders entered into the Probate Court.”

While it did not mention which of those orders Brun was supposed to have violated, it went on to accuse her of “Threatening conduct toward the staff at Lourdes. In addition, you upset your mother with unfounded allegations the staff at Lourdes. As a result, you are hereby notified that you are no longer permitted on the premises. Should you attempt to enter the premises, appropriate law enforcement will be contacted.”

The letter offered no evidence of any court order sanctioning a decision to bar Brun from the premises.

In a February 2, 2017 email, Lyneis told Brun “We want to be paid. You cannot expect to show up to see your mother when you have not paid for the privilege and you have disappeared since November.”

A subsequent email from Munger to Brun stated “If you want to visit your mother and or even remain in contact with her, you would be better served by complying with the existing court order than by continuing to harass everyone trying to see your mother.  In particular, pay the $25,000.”

Concerned about being able to pay her legal fees, Brun sold her and her mother’s home to Michigan banker Bradley Silverstein on the proviso that he draft a lease for her and Wahab to live there. A lease with that condition was drafted on February 28, 2017.

Two days later on March 1, 2017, Ehrlich, Lyneis, and Munger appeared before Hallmark and asked for a series of ex parte orders against Brun.

Ex parte orders are issued without the presence of or even notification of the parties it affects. Since due process is Constitutionally guaranteed, these orders are supposed to be temporary while allowing ample room for them to be contested.

Brun was not present at the hearing when the ex parte orders were issued. At the time, with the support of her doctor and with his medical order in the court file, she had requested a two-month medical leave from the court.

Hallmark also issued a permanent injunction against Brun restraining her from entering Lourdes premises, and a bench warrant for arrest alleging that her refusal to pay the $25,000.00 was in contempt of court.Regardless, Munger and Ehrlich requested that the house be transferred back to Wahab’s name “and then [to] permit Jon Munger to sell the house in order to pay for her care, so that [Wahab] would then qualify for needs-based benefits.” The court issued this order on June 28, 2016.

Brun told me that, in the months that followed, Munger attempted to force his way into the house. On August 8, 2017, she filed a police report, complaining that Munger had attempted to enter the house on three separate occasions.

When Brun replied that she had never received such an order, Munger wrote “A hearing was held on June 21 in front of Judge Linda Hallmark, and you received notice of that. I have every legal right to enter your mother’s home, and I have done so.”A June 30 email from Munger to Brun read “As you are aware, Judge Hallmark entered an order in the eviction case requiring you to vacate your mother’s home by Wednesday, June 28th 2017.  I went to the home with several others on the following day, June 29th, and it was apparent that no one was residing in the home.  Accordingly, we had the locks changed and the home secured. Upon our entry into the home, it was apparent that you had left a great deal of valuable personal property behind, including artwork.  We deem this to be abandoned property under the law.  For the time being, we are holding that personal property and artwork as security for repayment of the $25,000 you were ordered to pay on October 5.”

Brun has filed criminal police reports for larceny home invasion and theft against Munger with the Oak Park Police. The police took no subsequent action.

On August 30, Munger billed Wahab $245 for “a hearing to set aside deed” and $119 for calls to the real estate agent and the locksmith.

Brun said she was not present at any such hearing.

Brun’s attorney Phillip Strehle would later tell Hallmark “In October ’16 [Munger] filed a forwarding address card with the post office which has Mimi’s name on top and Munger’s address on it. So, he already knew, as of October ’16, that whatever mail he sent to the house, she would never get, because he sent it to himself. Mr. Ehrlich told me out in the hall that the order of August 30 was entered because it was uncontested. There’s a reason why it was uncontested; because Ms. Brun was not properly served.”

Brun finally got a break in October 2017 when attorney Lisa Orlando became Wahab’s new Guardian ad Litem.

In two reports Orlando submitted to Hallmark in 2018, she wrote “I visited [Wahab] at Lourdes Senior Community first on November 16, 2017 and then again more recently, on February 28, 2018, at which time I again served her a copy of the petition, notice of hearing and the order appointing a Guardian ad Litem. I don’t believe that Virginia was able to understand the information being presented, however she did clearly say that she did not want to go to court. I then asked her if she wanted Mimi to be her guardian and she said ‘of course!’”

“In the opinion of this GAL, it is Virginia Wahab a 94-year-old woman, who is paying the price of these ongoing legal disputes and suffering harm by not being able to see her daughter for more than 17 months,” Orlando added. “To isolate and prohibit an aging Mother from seeing her daughter is heartbreaking to this GAL. Mimi Brun has priority under the statute and is Virginia’s choice to be her Guardian.”

An affidavit signed by Wahab’s sister Sr. Helen Essa reads “Mimi is a devoted daughter and attended to every detail of her mother’s care not ever putting her own needs first. I know how desperate my sister is to go home with Mimi and have Mimi care for her. I pray, as we all do, that my sister will not die in a nursing home.”

In concluding her report, Orlando cited Michigan statutes.

“Under MCL 700.5313(3)(b), [Brun] has priority over a professional guardian,” she wrote. “’If suitable and willing to serve as guardian, the court shall appoint, an adult child of the legally incapacitated individual.’” Under MCL 700.5313(2)(b), [Brun] is Virginia’s choice to serve as her guardian. I discovered no clear and convincing evidence why the Petition should not be granted.”

Yet, Munger still remains as the sole guardian for Wahab who is still at Lourdes. Despite her best hopes, Brun has yet to see her and bring her home

The question remains as to why the Oakland County Probate Court effectively became a debt collector for a nursing facility and why the now 95-year-old Wahab is still held there despite her own Guardian ad Litem opinion that Brun replace Munger as guardian and family members’ pleas to Hallmark that Wahab be allowed to go home with her daughter.

On May 25, 2018 Hallmark vacated the order to pay $25,000.00. Hallmark also found Brun not guilty of contempt of court.

Brun does not believe the petitions she filed in October to have Munger removed as guardian will even be heard until July.

“I have been offering to pay Lourdes the money to let my mother go but Munger refuses to accept my working with the facility,” she said. “I promised Mom that her last chapter would be her best. But I think my mom will die before Munger ever lets her go.”

Strehle, who has been Brun’s attorney since October, 2017, told me that he felt the entire case against Brun was “bizarre.”

“The transcript of June 29, 2016 does not comply with the statute or the court rules,” he said. “There’s not a single bit of evidence to support even the creation of a guardianship; not one iota of evidence.”

He added that for a nursing home to present a petition for guardianship based on a past-due bill is something “I’ve never seen in all my years of doing probate. Ever.”

In the [June 29, 2016] transcript, the guardian ad litem [Brown] is the one that’s asking the questions,” he added. “Not Munger. Not an attorney for Lourdes. That’s even more bizarre. Usually, the person asking the questions is the petitioner not the guardian at litem. The court grated it because of an overdue bill. That’s not a basis for getting even a limited guardianship.”

Strehle also addressed the March 1, 2017 subsequent bench warrant and injunction issued against Brun.

“In my view, the bench warrant against Mimi was entered improperly because of the $25,000 provision which the court recently vacated,” he said in an interview with me. “In her petition Lyneis was seeking a restraining order against Mimi. A restraining order lapses on its own in 14 days. That’s not what she got. The court granted her a broad injunction. Lyneis had a huge burden of proof to get the restraining order. After that, she was supposed to notify us of a hearing within 14 days. She didn’t do that. It was based on no evidence whatsoever.”

“After all this time, I still have not seen any evidence to support [Munger’s] guardianship,” he concluded. “I have emails from Lourdes saying ‘we don’t want [Wahab] here.’”

“Twice on the record now in open court Ehrlich has said he wants to get the house to pay fees,” [referring to both his and Munger’s legal fees]. “I don’t see how that’s a basis for keeping this poor woman in this location, isolated, with no visitation. I’ve never seen it before in 31 years of doing this.”

I reached out to both Lourdes CEO Sr. Maureen Comer and Lyneis. In a series of email responses, Lyneis requested my “credentials” in the form of a “CV”. When I refused to provide her with a resume, Lyneis declined to confirm or deny any of the emails or statements on court transcripts made by her or Lourdes staff members. She also refused to answer a long list of questions pertaining to everything from Wahab’s initial medical diagnosis to why a petition for guardianship was filed over a past-due bill.

I also reached out to Hallmark via email and telephone and was told by a staff member in her office that, since she had not responded to my email, it was an indication that she had no comment.

An Oakland County Probate Court Administrator later replied, “In the interest of fairness to those involved, it is this court’s policy not to comment on pending litigation.”

Wahab’s first GAL, Brown, however, did respond. “As I stated in my report, Ms. Wahab consented to the guardianship,” he wrote. “I also felt, after interviewing Ms. Wahab, that she needed a guardian to be appointed. The information regarding the medicals was given to me by the nursing home regarding Ms. Wahab’s medical condition and are consistent with my report and testimony.”

This is not a story drawn from a dystopian fantasy. It is happening today all over America, where Probate Courts employ an exponentially growing network of professional, for-profit guardians.

I talked at length to six other families—in Michigan, Arizona, New York and Illinois respectively about their experiences with predatory guardians; some are court appointed professionals, others are family members granted leave by Probate Courts to cut their siblings out of a ward’s life.

The tapestry of each story was as complicated as it was heartbreaking. Each narrator pulled on the memory of each thread of that tapestry and found tears, despair, rage and frustration behind it.

In October, 2017 WXYZ television in Lansing, Michigan launched an investigation into the Oakland County Probate Court and its court appointed guardians Barbara Andruccioli and Thomas Brennan Frasier whom a family member accused of neglecting and financially exploiting her parents Lorrie and Sandy Kapp.

Andruccioli and Brennan have yet to respond to these allegations.

The Oakland County Probate Court judge in the case, Daniel A. O’Brien, issued an ex parte order denying WXYZ the ability to show the Kapp’s faces.

Andruccioli was subsequently fired as a public administrator and has become part of a still ongoing criminal investigation by both the Oakland County Prosecutor’s Office and the Sherriff’s office yet she still remains conservator and guardian for cases at the Oakland County Probate Court.

According to court documents from the Michigan Court of Appeals, in 2011, Hallmark appointed Munger as guardian to Angela M. Robinson who had been declared legally incapacitated. In 2012, her parents Remo and Marie Marzella petitioned Hallmark to remove Munger as guardian and transfer her to their care. They claimed Munger “had not investigated Angela’s best interests or made proper decisions regarding her future care.”

Following an evidentiary hearing, Hallmark denied the petition.

“I am not going to remove Mr. Munger at this point,” she said. “I don’t find that Mr. Munger did anything wrong.”

In a subsequent 2014 lawsuit, the Marzellas accused Munger of committing legal malpractice. Among the complaint’s allegations, Munger “failed to investigate and ascertain Angela’s best interests with respect to her living arrangements, advocated for Angela to live in an institution instead of with her family” and “failed to foster Angela’s family relationships and family involvement in her care and life.”

“Angela and her special needs trust were subsequently shorted and she and her family suffered economic and non-economic damages,” the complaint added.

Munger claimed that, because Hallmark had already ruled he “did nothing wrong” during the petition for his removal, the Marzellas were barred by “collateral estoppel” (preventing an issue from being relitigated.)

In 2016, the Michigan Court of Appeals found that “no discovery was even conducted before [the evidentiary] hearing. Simply stated, the probate court’s decision not to remove Munger as Angela’s guardian was not tantamount to a finding that Munger did not commit legal malpractice or breach fiduciary duties owed to Angela.”

It concluded that the Marzellas “never had a full and fair opportunity to litigate the issues underlying their claims.”

The same court dealt with the 2007 case of Brenda Cupp—who suffered head injuries after a car accident. According to court documents, her sister Dana Browning had been appointed as guardian. After Cupp’s attorney contested the case, Munger was appointed co-guardian and co-conservator of Cupp’s special needs trust.

Five weeks later, Munger petitioned the probate court for Browning’s removal as co-conservator “on the basis that she acted erratically during Cupp’s independent medical examination [IME] and Munger heard second-hand that Browning intended that the money in Cupp’s estate would not be used to pay legal fees.”

The petition was granted.

In 2010, the Michigan Court of Appeals ruled “the IME incident was not sufficient good cause to remove Browning from her co-conservatorship position a mere five weeks after her appointment” and that “the probate court abused its discretion in finding that good cause existed to remove Browning as co-conservator.”

In 2002, Joseph Ehrlich, was sanctioned over $113,000 by a Michigan Court for “pursuing frivolous litigation” in a case disputing the estate of John J. Fannon, Jr.

Ehrlich appealed in 2005 and, in denying that appeal, the court stated that “The record reflects that, when they joined the case, Ehrlich and his firm continued to file pleadings and documents that lacked factual and legal support. The record clearly reflects that Ehrlich failed to make reasonable inquiry into the factual and legal merit of the claims he asserted on behalf of plaintiff when he knew or should have known that they lacked such support.”

On his website, Munger claims to be an Oakland County Public Administrator although an email from State Public Administrator Michael Moody reads “Mr. Munger’s appointment as an Oakland County Public Administrator was terminated on October 6, 2017.” Munger is also not among the Oakland County Probate Court’s list of Public Administrators.

Between June 29, 2016 and September 19, 2017 Munger’s statement of fees and services billed for his guardianship of Wahab totaled $12,282.

I reached out to Munger by email and telephone and was told by his office secretary that he had no comment.

I reached out to Ehrlich via email and telephone. His office secretary responded that Ehrlich had never received the email. When I asked to speak to him in person, she concluded the conversation.

There are also a number of cases involving Holocaust survivors.

Al Katz barely escaped numerous Nazi camps, including Dachau, only to become the ward of guardians in Florida at the age of 89, as court documents show.

“My father came to the United States in 1946,” his daughter, Dr. Beverly Newman, told me.

“His mommy, daddy, little brother, older sister, her husband and their one-month-old baby had all been murdered. He was a walking skeleton with no money, no job and didn’t know the English language. He felt very alone.”

Nevertheless, Newman remembered that her father never lost a wonderful sense of humor while he lived by the motto “Never forget, never forgive and never be bitter.”

It was at a Purim ball in Indianapolis that Katz met Sophia Passo.

“He was stricken with love,” Newman laughed. “He asked her over and over again to marry him. She just would not do it.”

Katz started to work in bakery and then a packing house where he was injured twice. It was when Sophia was visiting him in the hospital that she relented.

He and Sophia were married in 1947. Katz began a successful insurance career. The couple had two children, Newman and her younger brother, and were inseparable for over thirty years until Sophia passed away in 1977.

The devastation Katz felt remained with him the rest of his life.

After retirement, Newman said that her father became a snowbird, spending winters in Florida.

In 2009, concerned for his health, one of Katz’s doctors contacted a public guardian.

That individual was M. Ashley Butler who worked in the Office of Public Guardian for three Florida counties since 2006 together with a partner, Jo Eisch, under the business name Aging Safely, Inc.
Newman maintained that the first she heard about it was when she was told by Katz’s Indianapolis attorney that “there are people poking around about putting your father into guardianship. That was August of 2009.

Newman added that hospital records she obtained from the time include numerous orders made by the guardians not to inform her of any medical decisions or procedures.

“On Rosh Hashanah, September 18, [Butler and Eisch] filed papers to put my dad into Emergency Temporary Guardianship,” Newman said, adding that neither guardian had ever met her father. “They didn’t even know him. I have the transcripts of the hearing. The judge knew that I had not been contacted and went ahead and approved it anyway. Things then moved very quickly.”

A 2011 Florida Supreme Court complaint filed by Newman and her husband noted that Bradenton attorney Ernie Lisch was appointed by the court to act as Al’s counsel.

“Despite many irregularities at the hearing, Lisch took no steps to advocate for or protect the rights of his client,” the complaint reads. Lisch contested these allegations, and the Florida Appellate Court ruled in his favor.

Newman discovered that Katz had been placed in Casa Mora Nursing Home in Bradenton.

In 2015, the Bradenton Herald reported that the facility was one of three on a Florida watch list “due to prior problems or deficiencies.”

The Herald noted, among those deficiencies, “A 58-year-old Casa Mora resident and the resident’s representative had requested in a resuscitate order that the resident receive CPR if she was ever found unresponsive. This procedure was not followed when she fell unresponsive. She was pronounced deceased after not receiving CPR.”

According to the article, these deficiencies have since been corrected.

Casa Mora is no longer on the state’s watch list.

Newman and her husband Larry immediately drove from their home in Indianapolis down to Florida.

She asserted that, shortly before they arrived on September 20, Butler utilized the Florida Baker Act—which allows for involuntary commitment—in order to place Katz in Manatee Memorial Hospital.

“They said that he had taken his walker and bumped it into someone at the nursing home,” Newman said. “But my Dad was barely able to use a walker. He was in very poor physical condition and not a danger to anyone else. They never told him anything. Not what was going on, nothing. We arrived while daddy was in the Manatee Hospital emergency room. It was horrifying. My dad just wanted to go home. A psychiatrist chosen by Butler and Eisch made a No-Contact order. The hospital kept my daddy in an underground unit, like a dungeon. There were armed guards and these huge electronic doors. A nurse told us he was pacing the halls like a caged animal. It was traumatizing.”

She added that Katz was there for three weeks.

Newman remembered Katz calling Butler and Eisch “Nazis” to their faces.

Meanwhile, like the family members in Michigan, Newman launched a fight to have Butler’s guardianship removed and her father returned to her care, as court documents show.

Opposed by Lisch, the case was heard on October 26, 28, and 30, 2009 in Florida’s Twelfth Judicial Circuit Court.

“In the intervening three weeks, Katz was repeatedly hospitalized and near death,” the 2011 complaint noted.

“Guardianship in Florida is a very lucrative industry,” Newman said. “People who go into guardianship lose every cent they ever had. Their families are wrecked.”

She stated that the guardians even took control over her father’s Holocaust Survivor Compensation checks as part of their oversight of her father’s assets.

I attempted to track down Butler. The telephone numbers for Aging Safely have been disconnected. Email addresses for Butler have been shut down. The last I-990 tax return filed by the organization in 2014 listed bet assets of $1,767.00.

As of publication, Eisch had not returned phone calls or email requests for comment.

In Newman’s case, Florida Circuit Court Judge Paul E. Logan (now retired) restricted visits to her father to only three hours-per-day. “He said I could never tell my daddy that I was fighting in court to get him home or that he was under guardianship,” Newman asserted. “If I did, I would lose visitation completely. Daddy was crying and saying, ‘Take me home!’ ‘Why do you have to leave me?’ ‘Why can’t I go home with you?’ and I was prohibited by court order from telling him the truth.”

On November 23, 2009 Newman won her petition for guardianship of her father but not his property.
“I didn’t care,” she said. “I just wanted to get daddy out of the nursing home and hospitals and give him a real life. It was such a relief that I couldn’t stop crying.”

However, by then, Katz was extremely ill and in the hospital.

“I spent Thanksgiving that year with my daddy and in the hospital,” Newman said. “In some ways, that as the best and worst Thanksgiving of my life. At least I could shower him with love and attention.”

By the time Newman and her husband got Katz home, it was Hannukah.

“He was finally smiling,” she said. “By New Year’s Eve, he was able to eat and talk. We took him to a restaurant that he liked. We got him all dressed up. He wanted us to take pictures of us celebrating New Year’s Eve. It was a happy time.”

Their time was all too short. Katz passed away on July 11, 2010.

“He had no catheters or feeding tubes in him,” Newman said. “He was just as normal as you could be at 90-years-old.”

In January that same year, Lisch filed a petition for $24,354.15 in attorney’s fees and expenses.
“For doing essentially nothing,” Newman asserted.

She opposed it and took the case all the way to Florida’s and then the United States Supreme Court, the latter of which declined to hear the case. Ultimately, Lisch prevailed in his original petition.

Even nine-years after her father’s death, Newman said she is still subjected to verbal abuse and numerous accusations from those with a vested interest in a system against which she has actively taken a stand. Meanwhile, she continues to fight in Indianapolis to settle her father’s estate and to remove liens on Katz’s properties.

In 2006, in the case of Marshall v. Marshall, the USSC determined that issues dealing with Probate Courts are “reserved to state probate courts” and “also precludes federal courts from disposing of property that is in the custody of a state probate court.”

In memory of her father, the Newmans founded the Al Katz Center for Holocaust Survivors and Jewish Learning in Bradenton.

“We serve many hundreds of persons every year through advocacy and programming open to the entire community,” the Center’s website reads, “and we are life-sustaining and life-saving to elders in peril and trauma.”

On the opposite side of the country, the probate and guardianship system created another activist and family advocate out of an individual who found herself opposing those who have successfully exploited it.

The Bradenton police department wouldn’t help Newman. Brun said that the police in her case were similarly unable to act, unless it was to prevent her from entering Lourdes to see her mother.

[T}here is an organization that advocates for those working in the profession.

The National Guardianship Association (NGA) was formed during a national conference in Chicago in 1988—one year after the AP’s article was released.

In the 30 years that followed, the NGA’s membership increased to over 1,000.

Sally Hurme is an attorney and member of the NGAs Board of Directors. She said that, while she is not and has never been a guardian, she has been involved in developing guardianship policy for decades.

“NGA does not have any mechanism by which to do anything other than to keep developing standards of practice and educating individuals who want to provide excellence in guardianship,” she said.

According to the NGA’s website, those standards of practice have increased from the original seven to their present number of 25. In 1997, the NGA voted to create an entirely separate entity,  the Center for Guardianship Certification (CGC) on whose board Hurme has also served.
It states its vision as one in which “every professional guardian will obtain and maintain CGC certification.”

“The CGC is the only national certifying body for guardians,” Hurme said. “Any guardian; professional, family, public or volunteer is welcome and encouraged to become certified.”

Among the five pillars Hurme listed as necessary to obtain certification is an examination.

To become a Nationally Certified Guardian (NCG), the $375 exam is scored on core competencies including professional practices, knowledge of person under guardianship, application of surrogate decision making, medical decision making and personal and financial management.

The competencies listed in the $525 examination to be certified as a National Master Guardian (NMG) are basically the same with the addition of “professional practices of a master guardian” and knowledge of the guardianship planning process.

Hurme stated that, at present, there are approximately 1,500 certified guardians.

“There is an agreement to a disciplinary process which receives grievances, determines whether there is probable cause to go forward with a professional review board,” she stated.

Ironically, according to Hurme, the professional review board is one in which “due process” is afforded to a certified guardian while a determination is made as to whether or not they have violated standards of practice.

“The professional review board has a range of sanctions from a letter of concern, to suspension, dismissal to decertification,” Hurme said. “The one problem with the CGC process is that we can only hear grievances if the individual is certified. If we receive a complaint about a guardian that is not certified, our hands are tied. There’s nothing the CHC can do.”

The CGC’s list of disciplined guardians posted on its website numbers 12 and includes April Parks alongside guardians from Oregon, Texas, Utah, Nevada, New Hampshire, New Mexico, Ohio, Oregon and Michigan.

The CGC lists 12 States that ask for mandatory CGC certification for its guardians or have their own State-specific licensing requirements. In the case of California, it’s a combination of the two. Michigan is not among them. Since 2016, Florida has employed The Office of Public and Professional Guardians (OPPG) to regulate “more than 550 professional guardians statewide, which includes investigating and, if deemed appropriate, the discipline of guardians in violation of the law.
“NGA and many of the other organizations such as those that are members of the National Guardianship Network are continually striving to make guardianship work better for those individuals who will need it,” Hurme said.

As an example of those efforts, Hurme noted the Uniform Guardianship, Conservatorship, and Other Protective Arrangements Act (UGCOPAA). The over 150-page document was drafted, over the course of two years, by a committee consisting of multiple stakeholders including representatives from the American Bar Association (ABA) and was approved and recommended for enactment in all US States at a July, 2017 meeting of the National Conference of Commissioners of Uniform State Laws.

Hurme stated that members of the NGA, herself included acted as technical advisors to the commission “in making sure that the new model; law addresses many of the issues that are floating around in guardianship; perhaps that there are too many guardianships and that there needs to be more emphasis in limiting the authority of the guardian, better recognition of the due process rights of the individual and a more person-centered focus of the individual in the hearing process that limits the authority of the guardian.”

American Association of Retired Persons (AARP) Senior Legislative Representative Diana Noel was part of the drafting committee.

“I felt as if it was a very thorough process that was very public,” she said. “There were a lot of people in the room. One of the things that is very important; that the drafting committee really wanted to come across, which is why the name is so long, is to recognize that guardianship was a system that was really not including the individual that it was about. One of the things the act did was to update terminology. Instead of using the term ‘ward’, it’s ‘individual’ so that the focus is on the individual and so that they have a say in their care.”

A Uniform Law Commission document encouraging States to adopt the UGCPOAA, declares that, under the act, “Each guardianship and conservatorship will have an individualized plan that considers the person’s preferences and values. Courts will monitor guardians and conservators to ensure compliance and approve updates to the plan in response to changing circumstances.”

It adds that “Without a court order, a guardian under UGCOPAA may not restrict a person under guardianship from receiving visits or communications from family and friends for more than seven days, or from anyone for more than sixty day” and that the act “prohibits courts from issuing guardianship or conservatorship orders when a less-restrictive alternative is available.”

These provisions and others in the UGCOPAA could have protected Brun and her mother had the act been adopted in Michigan.

It hasn’t.

As of the time of publication only Maine has adopted it. The New Mexico State Legislature introduced it this year and opened it up for public comment.

Hurme pledged that the NGA would direct its advocacy efforts to assisting States in understanding the importance of what she called “a forward-thinking law.”

“This isn’t a partisan issue,” [Noel] asserted. “This isn’t a caregiving and an aging issue. I don’t want you to think that, because States haven’t adopted it, that means that they are not looking at it. They may be looking at it. These things take time. They look at their current laws, they see what’s working and what’s not working and how things like the Uniform Act could help fix what’s not working or enhance what is.”

“As long as I’ve been here, I’ve been working on this issue,” she said. “States have been working on and updating their statutes because they are pretty outdated. They’ve been around for a very long time. It’s a very complicated system. What we’re doing and what states are doing is making sure that policy and practice meet and complement each other.”

The Elder Abuse and Prevention Act passed by the senate and signed into law by President Trump in 2017, charged the Department of Justice with establishing “best practices for data collection on elder abuse” and “in coordination with the Elder Justice Coordinating Council, [to] provide information, training, and technical assistance to help states and local governments investigate, prosecute, prevent, and mitigate the impact of elder abuse, exploitation, and neglect.”

“We have a real long history in combatting abuse and exploitation and ensuring that State laws address and prevent abuse by a guardian or a neighbor or whoever,” Noel said. “We’ve really been engaged in working not just with State legislators but State courts.”

Wondering about the laws in a State like Michigan and how far they extended in the protection of wards and their families from predatory guardians and the probate courts which employ them, I reached out to probate attorneys across the State.

Nathan R. Piwowarski is a highly respected lawyer and share-holder at the firm of McCurdy Wotila & Porteous, PC in Cadillac. He has been practicing trust, estate and elder law for ten years.

Ronald Dixon has practiced law since 1975 and served as a hearing panelist for Michigan’s Attorney Discipline Committee for approximately 25 years.

Neither Dixon nor Piwowarski were asked to comment on or given the details about any case pending or decided in Michigan Probate Courts.

“The problem is that when a person needs a guardian or conservator, frequently the family members are not worked with by the court or by the guardian appointed,” Dixon said. “The families are concerned, always, about the living conditions for the ward.”

He added that a conflict between a conservator and the family can be easily avoided with a durable power of attorney that specifically names a family member and an alternative as guardian and conservator “and none other.”

However, if judges arbitrarily strike down a durable power of attorney in favor of a court-appointed guardian, Dixon noted that “they should not do that. They should follow the family wishes. If that happens, it should be immediately appealed.”

He added that a judge needs to demonstrate sufficient grounds as to why a power of attorney listing a family member can be discarded.

“The record should be complete,” he said. “Showing the reasons why this person is not qualified or cannot maintain their position.”

Piwowarski noted that the issue “can get a little bit complicated” depending on whether the power of attorney is generic and related to financial transactions or whether it concerns healthcare and placement issues (a patient advocate designation.)

“In the case of the latter, unless the court specifically invalidates that document and removes the patient advocate, it remains in place,” he said. “The law presumes that the patient advocate would continue serving. That document should stay around unless there was some problem with it like there were not an adequate number of witnesses when it was signed. There are also situations where there is a valid document, but the patient advocate is not doing their job or honoring the person’s preferences.”

In terms of the Constitutional rights a participant in Michigan’s Probate Courts can expect, Piwowarski cited Michigan Compiled Law (MCL) 700.5304 (4) through (6) which addresses the rights of the individual who is allegedly incapacitated.

“They include the right to a jury trial [or] a closed hearing, if they request it, the right to be present at a hearing, the right to obtain an independent medical examination,” Piwowarski said. “There are other procedural rights and protections that are supposed to be afforded the individual who is the subject of a guardianship petition. For example, they’re entitled to personal notice in advance of the hearing. The minimum personal notice requirement is seven days. They are supposed to be given a visit by the Guardian ad Litem who is then supposed to report back to the court, in a timely manner, about whether that individual desires to contest any aspect of the petition or exercise any procedural rights such as the right to request something less intrusive than a full guardianship.”

According to Piwowarski, different rights are afforded to those who have an interest in the subject’s welfare.

“There are certain rights that they just don’t have,” he said. “They can’t demand a jury trial. But if there is a durable power of attorney, all of those individuals are entitled to notice and entitled to participate in the proceeding.”

“In terms of who should be serving as a guardian, the nominated patient advocate is right near the top of the list,” he added. “So, the court should be looking to the patient advocate before almost anyone else. The way the statute should work and the way that it’s written is that the court can only intervene in a person’s affairs if that person is legally incapacitated and if there’s an actual need for the court to intervene. The court should evaluate, on the record, why a patient advocate is inadequate. There are express provisions in the Estates and Protected Individuals Code that tell the petitioner and the judge that they have to identify why the court has to actually intervene alternatives short of guardianship can’t be used.”

The question of how much power a professional guardian in Michigan has Piwowarski noted both a statutory and political dynamic.

“In terms of the statue, a guardian has the right to set appropriate access and limit access for a protected individual,” he acknowledged. “That said, the guardian is specifically required by statute to do everything they can to have as full of a life and as high of a level of function as possible. In terms of financial transactions, the court can issue protective orders to remediate situations where a vulnerable person made a property transfer when they didn’t understand it or were under inappropriate influence. A conservator is not able to do something like that without a court order and there should be pretty significant showing before a court would reverse a transaction like that.”

“In my experience the court is typically appreciative of the willingness of a public fiduciary [guardian] to serve,” Piwowarski added. “There is such a need right now for a variety of reasons; families are smaller and more spread out. The public fiduciaries typically are overworked so I can certainly see a situation where a court adopts an overly deferential attitude because of the role that they serve in keeping the local legal system functioning.”

“Oakland County is the wealthiest county in Michigan bar none,” Dixon said. “Frequently estates are incredibly large. Public administrators can err on the side of greediness for him or herself. Frequently, because the judge trusts them to carry out their tasks properly and in good order and rely on them for accurate information.”

On a national level, the sheer power that has been extended by Probate Courts over wards and family members raises the question as to what the point is of making any kind of will when it can be rendered meaningless.

Full Article & Source:
Guardians from Hell