Florida’s chief justice hunts for goof-off judges

Florida Supreme Court Justice Jorge Labarga - Florida Supreme Court

Florida’s chief justice has ordered the state’s 20 chief judges to monitor the work of each judge in their circuit looking for goof-offs — a move that’s unnerved judges in South Florida and elsewhere.

In a Dec. 1 administrative order, Chief Justice Jorge Labarga directed each chief judge to “separately communicate” with each trial court judge in their circuit “the importance of a professional work ethic and accountability to the judiciary as a full-time commitment.”

“Neglect of duty” offenses “shall be reported by the chief judge to the chief justice of this court,” Labarga’s order says.

Labarga turned down an interview request to discuss what prompted the order.

“The Chief Justice simply wants to make sure that the chief judges and the judges they supervise understand that there are consequences for violations of the public trust,” Supreme Court spokesman Craig Waters said. “We certainly realize that most of our judges honor their duties, but we feel it is a healthy thing to remind everyone of their ethical obligations.”

Broward, where judicial misbehavior has made national headlines and County Court Judge Gisele Pollack and Circuit Judge Laura Marie Watson are defending ethics charges brought against them by the Judicial Qualifications Commission (JQC), is among a number of circuits thought to have motivated Labarga’s order.

“The Supreme Court has to have a statewide perspective,” Waters said. “The people in the 18th Circuit [Brevard and Seminole counties] are convinced that the order is aimed at them.” Three judges from the 18th Circuit have disciplinary cases pending before the JQC.

Still, over the years Broward has had its fair share of concern about judges allegedly shirking their duty.

Larry Seidlin, the weepy probate judge who gained notoriety presiding over the high-profile Anna Nicole Smith case, had a reputation for paying more attention to his backhand than his caseload before his 2007 retirement. And this fall’s election included allegations that defeated incumbent Judge Stephen Feren was frequently absent from the courthouse.

Chief judges are elected to two-year terms by their fellow judges and serve as the administrative officer in their circuit, with supervisory authority over all judges and court personnel.

The new administrative order obliges chiefs to ensure accountability by the judges they oversee.

“Until this order came out, the chief judge, at least in Broward, was largely a ceremonial title where you went to rubber chicken lunches and you cut ribbons at the courthouse,” said Broward Public Defender Howard Finkelstein. “I was told by at least four chief judges that, whether a judge was intoxicated on the bench or was violating people’s rights by not following the law, they had no authority to do anything. … This order, as I read it, puts it clearly on the chief judges.”

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Florida’s chief justice hunts for goof-off judges

 

Death in Bronx Shows Vulnerability of State’s Nursing Home Residents

University Nursing Home in the Bronx is part of a large consortium of rehabilitation and home health companies called Centers Health Care. Credit Edwin J. Torres for The New York Times

Unable to see clearly and afflicted with dementia, Frank Mercado, 77, depended completely on the care provided by the small nursing home in the Bronx where he had lived for four years. But last Monday, as Mr. Mercado cried for help, a veteran employee beat him to the ground, where he was impaled on a sharp metal protrusion from an overturned table, according to prosecutors.

Mr. Mercado died hours after the beating, and on Monday, the Bronx district attorney’s office said the employee, Cherrylee Young, 41, had been charged with negligent homicide, fatal assault and endangering the welfare of an adult.

The death, which was ruled a homicide by the medical examiner, underscores the vulnerability of frail nursing home residents in New York State, where rates of substandard care, neglect and abuse are high, according to national studies. Advocates for elderly and disabled residents complain that state enforcement has dwindled in recent years, even as private companies have been on a buying spree, acquiring nonprofit facilities and often cutting staff to enhance profit margins.

The nursing home, University Nursing Home on Grand Avenue, is small, with only 46 beds, but it is part of a large consortium of rehabilitation and home health companies called Centers Health Care.

Kenneth Rozenberg, the consortium’s chief executive, is an owner or director of 17 nursing homes, including University. It has scored high in federal rankings, though the integrity of those rankings was called into question in a recent investigation by The New York Times, and in recent years state officials found numerous violations there.

Thomas McCartin, a spokesman for Centers Health Care, said Ms. Young, who has worked at the nursing home for 14 years, had been suspended. A lawyer for Ms. Young, Jacob Lemon-Strauss, could not be reached for comment.

Mr. McCartin said University Nursing Home had an exemplary health care history, including a five-star rating from Medicare.gov. He said the company was assisting the Police Department in its investigation but declined to comment further.

Only one-fifth of the country’s 15,000 nursing homes have received the top rating from Medicare, but The Times this year reported that the ratings rely heavily on self-reported data from nursing homes that the government does not verify, and that can be incomplete and misleading. Medicare has since made changes to its rating system, which will take effect in January.

Over the last four years, the state has found 19 life safety code deficiencies at University, compared with a statewide average of 11 over the same period. A State Health Department inspection in 2011 cited the nursing home for filthy rooms, for broken equipment — including over-the-bed meal tables — and for failing to properly report or investigate resident injuries for possible abuse.

In one case, an 86-year-old woman’s hand was lacerated on nails sticking out from a wardrobe; in another, an 81-year-old man with dementia complained of shoulder pain and then developed large bruises on his arm that went uninvestigated.

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Death in Bronx Shows Vulnerability of State’s Nursing Home Residents

Eleven Texas lawyers & four judges disciplined

Disciplinary Actions — December 2014 State Bar list (verbatim from the State Bar of Texas)

General questions regarding attorney discipline should be directed to the Chief Disciplinary Counsel’s Office, toll-free (877) 953-5535 or (512) 453-5535. The Board of Disciplinary Appeals may be reached at (512) 475-1578. Information and copies of actual orders are available at www.txboda.org. The State Commission on Judicial Conduct may be contacted toll-free, (877) 228-5750 or (512) 463-5533. Please note that persons disciplined by the Commission on Judicial Conduct are not necessarily licensed attorneys.

Houston area discipline:

JUDICIAL ACTION
On Sept. 4, 2014, the Hon. Denise Pratt [#16238500], former judge of the 311th District Court, Houston, Harris County, was issued a public reprimand by the State Commission on Judicial Conduct for failing to be diligent and failing to timely execute the business of the court in violation of Article V, Section 1-a(6)A of the Texas Constitution. The commission found that Judge Pratt’s decisional delays, which inclu-ded a failure to timely issue orders, renditions, and findings of fact in numerous family law cases pending before her court, were unreasonable and unjustified; that Judge Pratt’s frequent tardiness and cancelation of hearings and trials contributed to the court’s enormous backlog; and that her dismissal for want of prosecution of more than 600 cases on Dec. 30-31, 2013, without notice to the parties or their attorneys, failed to comply with the law under Canon 2A, demonstrated a lack of professional competence in the law under Canon 3B(2), and deprived litigants of their right to be heard under Canon 3B(8). The commission noted that prompt disposition of cases is critical to the parties appearing in court, especially when vulnerable children are involved, and necessary to prevent backlogs that interfere with the administration of justice. The commission also noted that a judge who fails to show up for court hearings, appears late to court, or delays making decisions and signing orders in cases involving the rights of parents and the best interests of children, causes harm and a great disservice to parties, lawyers, witnesses, jurors, and other judges.

DISBARMENT
On Sept. 15, 2014, Melonie Dwan Jones [#24032483], 49, of Sugar Land, was disbarred in three separate disciplinary actions composed of multiple cases. An evidentiary panel of the District 5 Grievance Committee found that in all three disciplinary matters, Jones failed to keep her clients reasonably informed about the status of their legal matters; failed to promptly comply with reasonable requests for information from the clients about their legal matters; failed to explain the status of the legal matters to the extent reasonably necessary to permit the clients to make informed decisions regarding the representation; engaged in conduct involving dishonesty, fraud, deceit, or misrepresentation; failed to timely furnish to the Office of Chief Disciplinary Counsel a response or other information as required by the Texas Rules of Disciplinary Procedure; and engaged in the practice of law when her right to practice had been administratively suspended for failure to timely pay required fees and assessments or for failure to comply with Article XII of the State Bar rules relating to mandatory continuing legal education. The panel found that, upon receiving funds in which some of the clients had an interest, Jones failed to promptly notify the clients; failed to promptly deliver to the clients funds that they were entitled to receive; failed to hold funds, belonging at least in part to the clients, that were in Jones’s possession in connection with the representation separate from her own property; and distributed funds, belonging at least in part to the clients, that were in Jones’s possession in connection with the representation to persons or entities who were not entitled to receive them by virtue of the representation or by law. The panel found that Jones failed to abide by some clients’ decisions of whether to accept an offer to settle the clients’ legal matters and that she knowingly disobeyed a ruling by a tribunal and committed a serious crime or other criminal act that reflects adversely on her honesty, trustworthiness, or fitness as a lawyer. Jones violated Rules 1.01(b)(1), 1.02(a)(2), 1.03(a), 1.03(b), 1.14(a), 1.14(b), 1.14(c), 3.04(d), 8.04(a)(2), 8.04(a)(3), 8.04(a)(8), and 8.04(a)(11). She was ordered to pay $60,955 in restitution and $3,944.99 in attorneys’ fees and direct expenses.

SUSPENSIONS
On Oct. 9, 2014, Ty Alexander Gibson [#24083069], 28, of Houston, agreed to a 28-month, 15-day partially probated suspension effective Nov. 1, 2014, with the first four months and 15 days actively suspended and the remainder probated. An evidentiary panel of the District 4 Grievance Committee found that Gibson ordered, encouraged, or permitted conduct by a non-lawyer that would have been a violation of the Texas Disciplinary Rules of Professional Conduct if engaged in by Gibson; paid a non-lawyer to solicit and refer prospective clients; accepted or continued employment in a matter when that employment was procured in a manner contrary to the disciplinary rules; committed a criminal act that reflects adversely on his honesty, trustworthiness, or fitness as a lawyer; and engaged in conduct that involves dishonesty, fraud, deceit, or misrepresentation and that constitutes barratry as defined by the law of this state. Gibson violated Rules 5.03(b)(1), 7.03(b), 7.06(a), 8.04(a)(2), 8.04(a)(3), and 8.04(a)(9). He agreed to pay $2,000 in attorneys’ fees and $620.80 in direct expenses.

On Sept. 15, 2014, Charles L. Thorn [#19963700], 61, of Webster, received a two-year probated suspension effective Oct. 1, 2014. An evidentiary panel of the District 7 Grievance Committee found that complainant hired Thorn for representation regarding two traffic citations. In representing complainant, Thorn neglected the legal matters entrusted to him by failing to provide legal services for complainant and failing to keep complainant reasonably informed about the status of the legal matters. Thorn violated Rules 1.01(b)(1) and 1.03(a). He was ordered to pay $100 in restitution and $1,300 in attorneys’ fees and direct expenses.

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Eleven Texas lawyers & four judges disciplined

Another ward speaks out after spending nine years in Florida's professional guardianship system

The I-Team has been exposing issues with Florida's professional guardianship system for more than a year, leading to changes in the law and helping one man get his freedom back.

 

Now another ward is speaking out about her own experience with the program.

 

Litta Flynn, who has no family in Florida, was taken into guardianship nearly a decade ago when the state became concerned she might be financially exploited.

 

“I'm not entitled to have anything I want and that I need,” Flynn said when she first met with the I-Team in July.

 

Flynn, who is now 86, was once a glamorous fashion model and a world traveler.

 

She reached out to the I-Team asking for help in replacing her court-appointed guardian, who she said denied her the ability to purchase basic necessities like fresh food, toiletries, eyeglasses and even a new mattress.

 

“I shouldn't have to live my life this way. It really isn't living. I'm just vegetating,” she said at the time.

 

Her guardian was appointed in 2005 after Flynn's bank called the Florida Department of Children and Families when Flynn tried to cash out a CD following her husband's death.

 

“I just wanted to consolidate my money into one bank. I had several at the time,” Flynn said. “And I didn't want these statements from all these banks coming in.”

 

Flynn was evaluated by a psychiatrist and found to be incapacitated by the court.

 

In the psychiatrists’ report, he references the fact that he has spoken to her court appointed temporary guardian, who told him Flynn was vulnerable to exploitation.

 

According to Flynn, the doctor spent just a few minutes examining her.

 

Flynn denies that she has ever been incapacitated.

 

"I know what I want and what I'm doing,” she told us in July.

 

Flynn originally approached a volunteer at her assisted living facility about her situation.

 

That person called us after seeing our stories about guardianship issues, specifically the case of Willi Berchau , who was wrongly placed in an Alzheimer's unit at the age of 99.

 

“You see nobody. You have no contact with anybody. It's no socialization,” Berchau told us at the time.

 

Berchau was moved to a less restrictive unit after we started asking questions.

 

He later petitioned the court for another capacity hearing.

 

Berchau was evaluated by another doctor, had all of his rights restored and was released from the guardianship program.

 

Litta Flynn also felt alone.

 

“There was nobody to help me. I was all by myself and had nobody to turn to,” said Flynn, who told us that letters she wrote to her guardian were mostly unanswered.

 

She said her guardian only met with her in person a few times during her nine years under court appointed guardianship.

 

After meeting with us, and turning to Willi for advice, Flynn also wrote to the court.

 

Her guardian resigned. Flynn's capacity was restored after she was evaluated by another doctor and she recently went back to court, where she got back most of her rights.

 

“I feel wonderful. I'm so happy that everything is over with, completely over with. I couldn't be happier,” she said coming out of the courthouse.

 

She's now speaking out about a system she said left her feeling helpless for nine years.

 

“It definitely shouldn't be that way, but that's the way it is when you don't have somebody to stick up for you. You need someone to help you,” Flynn said.

 

Flynn hopes the state will give more power to the Department of Elder Affairs to take enforcement action when they identify cases of guardianship neglect or abuse.

 

Currently, it is largely up to courts to police themselves and the guardians they appoint.

Source:
Another ward speaks out after spending nine years in Florida's professional guardianship system

Muncie judge accused of abusing her powers, faces 13 misconduct charges

MUNCIE, Ind (Dec. 11, 2014)–The Judicial Qualifications Commission filed 13 charges of misconduct against a Muncie City Court judge.

Judge Dianna Bennington is accused of abusing her judicial power and committing ethical violations while in public.

“This commission is essentially the investigatory as well as the prosecutory body that looks into whether a judge in our state has committed misconduct,” said Kathryn Dolan, chief public information officer for the Indiana Supreme Court.

The seven-member qualifications commission says Judge Bennington breached her judicial power by sentencing a man without telling him when he would be released. That same sentencing hearing was also held without a prosecutor present.

The Honorable Dianna Bennington is accused of violating statutes and court rules. Court documents show that the judge did not comply with contempt procedures. The commission also cites the Judge for using a racial slur in public.

“Judges are held to this code of conduct, judicial ethics, that require judges to act in a manner at all times that promotes confidence in the judiciary​,” said Dolan.

Bennington is also facing a misconduct charge for a comment she wrote on Facebook to the father of her children.

“Must be nice to be able to take such an expensive trip but not pay your bills. Just sayin’.”

‘I’m here now because of Judge Bennington,” said John Ewing, a Delaware County inmate.

Ewing was sentenced by Judge Bennington, and so was his father, who is also named John Ewing.

Judge Bennington is accused of sentencing the elder Ewing of contempt of court without due process, or a prosecutor present.

Court documents reveal that Bennington hasn’t been cooperative. She has 20 days to file a response.

During 2013-1014, there were 435 grievances filed against judges in Indiana. Only one judge received formal disciplinary charges.

The court has a variety of options when it comes to handing down discipline in this case.

The case can be dropped, fines and sanctions can be imposed or Judge Bennington could be stripped of her powers.

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Muncie judge accused of abusing her powers, faces 13 misconduct charges

Bank employees help catch suspected scammer

William E. Riley

Quick thinking by employees at a pair of Regions Bank locations led to the arrest of a Hannibal, Missouri, man accused of scamming older adults in two Southeast Missouri counties.

William E. Riley, 50, faces a Scott County charge of attempted financial exploitation of the elderly and a Perry County, Missouri, charge of resisting arrest.

On Dec. 1, Riley went to the home of an 88-year-old woman in rural Scott City, showed her some certification papers and said he needed to check the lightning rods on her home, according to a probable-cause affidavit filed by Capt. Jerry Bledsoe of the Scott County Sheriff's Department.

"After the inspection, Riley informed [the victim] that her lightning rods needed repair and she owed him $4,500," Bledsoe wrote. "[The victim] reportedly thought the repair price was too high but felt intimidated when Riley would not leave, so she issued a check to him in the amount of $4,500."

When Riley attempted to cash the check at Regions Bank in Scott City, bank officials became suspicious and called the victim, who asked them not to cash the check and said she had just written it so Riley would leave, Bledsoe wrote.

Reached by telephone Friday, Bledsoe said trying to cash a large check in a small town was a critical mistake by Riley.

"Typically, [scammers] want to get the money as quickly as possible, but on the flip side, when they are working in a smaller city, the banks know their customers," he said. "Bank officials find it questionable when someone from another area wants to draw a large sum of money."

Riley left the bank before officers could arrest him, but authorities caught up to him a few days later at the Regions Bank branch in Perryville.

"Initially, we had his name," Bledsoe said. "It was odd he used his real name. We thought it was fictitious at first, but we put out a statewide broadcast of the name used and Hannibal address."

A probation officer in Charleston, Missouri, responded to the broadcast, and Scott County officers were able to get a photo of Riley, which two bank employees picked out of a lineup, Bledsoe said.

Riley was arrested Wednesday in Perry County, Missouri, after a Regions Bank employee in Perryville called police to report another possible scam, according to a probable-cause affidavit filed by Sgt. Jason D. Kelley of the Perry County Sheriff's Department.

The bank employee said a paving company had given his client a quote of $3,000 to do some work at his home, but as soon as they finished the job, company employees told him the total cost would be $16,500, Kelley wrote in the affidavit.

The bank employee said when the client questioned the amount, one of the paving company employees, later identified as Riley, reduced the amount by $2,000 and accompanied the client to the bank, Kelley wrote.

Reached by telephone Friday, Perry County Sheriff Gary Schaaf said that's when officers discovered Riley and a man who was working with him, George Fogle Sr., both had warrants.

Fogle, 67, was arrested on an outstanding warrant out of Texas for scamming, Schaaf said.

When Kelley and Detective Jason Klaus responded to the call from the bank, Riley ran from them, Kelley wrote.

Kelley and Klaus caught up to Riley, who was charged with resisting arrest.

Bledsoe said Riley is part of a group of people who are suspected of running home-repair scams in Warren, Montgomery, Cape Girardeau and Audrain counties in Missouri and in Iowa, Kentucky, Texas and possibly Kansas.

"My investigation revealed he is part of a fairly organized group of people involved in scams involving lightning rods, paving blacktops, roofing repairs and cleaning gutters on homes," Bledsoe said.

He estimated the group is responsible for "thousands and thousands of dollars'" worth of scams.

Bledsoe said he's worked similar cases in the past, but the culprits usually are long gone before police are notified, making it difficult to find out who they were.

Schaaf said homeowners often sign contracts with the scammers, making it difficult -- if not impossible -- for police to run interference.

"We are familiar with it," he said. "We see it sometimes around here and in surrounding counties as well. They come to people's houses and do a substandard job and then charge three times what they told you before, and next thing you know, you're being ripped off."

Online court records show Riley has a long history of financial exploitation charges.

In 2009, he pleaded guilty to two counts each of theft and financial exploitation of the elderly in Pettis County, Missouri, and was placed on five years of supervised probation.

Riley successfully completed his probation in that case in January.

Also in 2009, he pleaded guilty to financial exploitation of the elderly in St. Charles County, Missouri, and was sentenced to three years in prison, online court records show.

At the time of his arrest Wednesday, he was wanted by the Missouri Board of Probation and Parole for a parole violation on an original charge of financial exploitation, and he also had a 2008 conviction for theft by deception in Marshall County, Kentucky, according to the Scott County probable-cause affidavit.

His bond was set at $25,000 cash only in the Scott County case.

Regions Bank spokeswoman Evelyn Mitchell said bank employees are encouraged to get to know their customers.

"We train our associates to look for unusual patterns," she said in a telephone interview Friday. "... Regardless of the market size, one of the things our associates do focus on is knowing their customers."

In an email message to the Southeast Missourian, Mitchell said employees are trained to spot potential financial exploitation cases.

"Regions Bank has procedures and processes in place to identify, investigate and report financial exploitation of older adults. This includes training associates to recognize potential elder financial exploitation," she wrote. "Our associates put their training to good use in this case to protect Regions customers and, hopefully, prevent future incidents."

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Bank employees help catch suspected scammer

Alaska Supreme Court disbars Palmer attorney for taking dead client's money

The office of Palmer attorney Melinda Miles on Friday afternoon. The Alaska Supreme Court disbarred Miles on Friday over claims she misappropriated a deceased client's funds. Zaz Hollander / Alaska Dispatch News

PALMER -- The Alaska Supreme Court has disbarred a Palmer civil attorney with a dog mushing background for misappropriating more than $20,000 from a dead client and hiding it from his family.

The state’s highest court on Friday issued a ruling that upholds an earlier recommendation from the Alaska Bar Association’s Disciplinary Board and refers to attorney Melinda Miles' action as "duplicitous" -- one that "damages the reputation of the legal profession and the legal system at large."

Miles moved money out of a dead client’s bank accounts and into her own, according to the opinion written by Justice Daniel E. Winfree. Then she told relatives the dead man “gifted” the money to her and she was following his wishes in deceiving relatives over more than three years of disciplinary proceedings.

“Given the egregiousness of Miles’ conduct and the aggravating factors involved, we agree with the board that disbarment is appropriate in this case,” Winfree wrote.

The disbarment is effective 30 days from Friday. Miles is not allowed to take on new clients and must transfer open matters to other attorneys. She can petition for rehearing.

Miles could not be reached Friday. A man who answered the phone at her downtown Palmer office Friday morning said “no comment” before abruptly hanging up.

The lawyer who represented her before the Supreme Court -- John Murtagh-- did not return a call for comment.

Miles was admitted to the Alaska Bar in 1989 and has handled matters ranging from divorces and landlord-tenant disputes to will preparation and other estate planning and probate services.

She also has a history as an avid dog musher, establishing a kennel in Chugiak in 2000 and completing her first race, the 2001 Denali 300, the next year in 11th place, according to an Iditarod Trail Sled Dog Race bio.

According to her professional bio, Miles started her own business in 1994, “taking a short break from practicing law to run the Iditarod” in 2004.

She scratched that year but finished other races, including the Yukon Quest 250 -- a quarter-length of the famously grueling 1,000-mile race -- in which she placed seventh in 2003.

Her law office in a two-story building on South Bailey Street near Palmer’s Fred Meyer was open but quiet early Friday afternoon. The office door was shut but not locked. Inside, an assistant looked through a file folder at his desk; a woman could be heard on the phone in an inner office behind a closed door. No clients sat in a small waiting room with magazines on a coffee table.

The 24-page Supreme Court opinion says the situation that led to the disbarment began in 2006. That’s when Miles met a man who built a fence for her. She claimed they were close friends and she occasionally did legal work for him.

The man in 2008 paid Miles to form a business for him, according to the opinion. Miles was authorized to sign for the account, as was the man. He died suddenly in 2009. He had no will but his mother was his sole heir and his brother had power of attorney to act on her behalf.

Miles didn’t know the man died until the brother contacted her, the opinion says. The next month, she withdrew $1,162 from the business's checking account and $20,072 from its savings account.

Miles claimed he’d told her he’d rather she got his money than his relatives, according to the document. She eventually transferred it into her own law office and personal accounts and began spending some of it, the document says.

The brother kept unsuccessfully pressing for details of the bank accounts, Winfree wrote, and eventually hired an attorney.

He filed a grievance against her with the Alaska Bar Association in July 2010. The man’s mother died a few months later. During a bar association hearing, friends of the man said he wasn't that close to Miles but friends of the attorney spoke of her regret and general truthfulness.

Miles eventually paid back all the money, said Steve Van Goor, counsel for the bar association, which has about 3,000 active members.

The bar recommended Miles be disbarred based on "reasonable doubt" that the man intended to make a gift of the funds and the fact Miles knew the business accounts were owned solely by the man when she withdrew the money, according to the state Supreme Court opinion. The one mitigating factor in her defense was her cooperation with the Bar.

The decision to disbar Miles ends her ability to practice law in Alaska or most likely anywhere in the United States for at least five years, Van Goor said. But getting reinstated is so rigorous that, until a year ago, the Alaska Supreme Court had never readmitted a disbarred lawyer.

“Theft, misappropriation or mishandling of a client’s money is a very serious offense,” he said. “It’s important not only that the public understand this but other lawyers understand this. There’s really no excuse for this kind of behavior. It’s such an important responsibility that when lawyers don’t meet that responsibility they should no longer practice law.”

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Alaska Supreme Court disbars Palmer attorney for taking dead client's money

This Nursing Home Calms Troubling Behavior Without Risky Drugs

Marian Grunwald (from left), Earl Elfstrom and Verna Matheson bounced a balloon back and forth with nursing assistant Rick Pavlisich on Dec. 13, 2013, at an Ecumen nursing home in Chisago City, Minn.

It's a sunny autumn afternoon and a good time to make apple crisp at Pathstone Living, a memory care facility and nursing home in Mankato, Minn. Activities staffer Jessica Abbott gathers half a dozen older women at a counter in the dining area, where the soundtrack is mostly music they could have fox-trotted to back in the day.

It seems residents can always find something to do around here. That can help to relieve the agitation common in some people with Alzheimer's or other forms of dementia — agitation that in other nursing homes might be managed with antipsychotic drugs.

Though antipsychotics are approved to treat serious mental illnesses like schizophrenia and bipolar disorder, the FDA says the drugs can increase the risk of death for people with dementia. Still, they're prescribed for nearly 300,000 nursing home residents nationally.

A few years ago, antipsychotics were used frequently at Pathstone, too.

"We saw these as medications that were supposed to help the patient and, of course, we gave them to them with the feeling that we were doing good," says Shelley Matthes, a registered nurse who is head of quality assurance for the nonprofit Ecumen, which runs Pathstone and about a dozen other nursing facilities in Minnesota.

Dr. Tracy Tomac is a psychiatrist and medical consultant at Pathstone. In the old days, a resident might have been started on antipsychotics to deal with an emergency, Tomac says, "but they would just stay on it. They would never be taken off for many months or even years."

So in 2009, she and a colleague at a small Ecumen nursing home near Duluth decided to see if they could reduce the use of antipsychotics there.

"At the end of six months or so," Tomac says, "we were able to get them all off any antipsychotics."
The next year they extended the policy to all of Ecumen's nursing homes. "Our goal, Matthes says, "was to reduce our antipsychotic use by 20 percent. And in the first year we reduced it by 97 percent."

At Pathstone these days, around 5 to 7 percent of residents get antipsychotic drugs. Not all of the Ecumen nursing homes have numbers that low, but they're almost all well below the national average. And Matthes says the changes in the residents were as dramatic as the drop in the numbers.

"They started interacting," recalls Matthes, "and people who hadn't been speaking were speaking. They came alive and awakened."

Which is why they decided to call their program Awakenings.

A resident called Mac is definitely awake as he meanders around the skilled nursing wing at Pathstone.

"Yeah," he says with confidence to no one in particular. "I know what it is, where it is, what it is."

When he arrived at Pathstone, Mac was on antipsychotic drugs. He also had a tendency to fall, which meant he wasn't allowed to walk around on his own. That upset him. So, first the staff weaned him off the antipsychotics, which can increase the risk for falls. But they also needed to deal with what was making Mac unhappy. The answer was a device called a Merry Walker (sort of a walker on wheels, but with railings and a chair). It's given Mac some of his independence back, so he's happier and so is everyone around him.

Maria Reyes, who's in charge of the Awakenings program for all of Ecumen's nursing homes, says everyone on the staff is trained to know and understand the residents' likes, dislikes and life stories.

Whether working in dining services or maintenance, any staff member who spots a problem behavior by one of the residents is expected to try to figure out the rationale behind it, Reyes says.

"And once we figure that out, we can often times curb it," she says, "or eliminate it completely."

Ecumen doesn't take credit for inventing the techniques it uses. There's a lot of information out there on individualized care for people with dementia, and Reyes says the Awakenings program has borrowed something from just about all of them, including aromatherapy, white noise, pet therapy and validation.

Back in the dining room, apple crisp is still a work in progress. While utensils clatter, Shelly Cornish, director of the memory care unit, points out a vintage chest of drawers in the far corner.

"Every drawer you open," she says, "you're going to find a treasure."

They're treasures like an old-fashioned hat, for instance, or a book of recipes that hails from the days when meatloaf was king.

"The meaning behind that," Cornish explains, "is that people with dementia are frequently looking for something. But they don't necessarily know what they're looking for." (Read More)

Full Article & Source:
This Nursing Home Calms Troubling Behavior Without Risky Drugs

Alzheimer's patient with open wounds found suffering in blood, filth, police said

A Volusia County man was arrested Monday after his 82-year-old mother was found with open wounds, exposed bones and insects in a bed covered in blood and human waste.

Jeffrey Andrews, 44, told officers his mother suffered from Alzheimer's and he was her only caregiver, according to Daytona Beach Shores Public Safety officers.


Jeffrey Andrews

Andrews was charged with aggravated neglect of an elderly person causing great bodily harm — a second-degree felony.

He was being held today in the Volusia County Branch Jail in Daytona Beach, where he was being held on a $10,000 bond.

First responders were called to the Sage 'n Sand Motel on S. Atlantic Avenue in Daytona Beach Shores after getting a report of an elderly woman in need of medical assistance.

They found the woman in a bed covered in blood, urine and feces, according to a report from Sgt. Michael Fowler with the Daytona Beach Shores Department of Public Safety.

"She was suffering from multiple open wounds that were so severe her bones could be seen and flies were crawling through them," the report said.

Andrews said he had been treating the wounds with baby wipes and an antibacterial gel, but admitted he hadn't seen some of them for days, according to police.

"When asked how the wounds had been so neglected he said, "Give me a break, I've been looking online to see how to treat them,'" the report quoted him as saying.

He told officers he didn't immediately call for medical help because he wanted to clean her up first, the report added.

"The deplorable conditions worsened when the woman was removed from the bed,'' the report said.

"There was a permanent [indentation] in the mattress in the shape of her body and what appeared to be dried feces near where her face had laid."

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Alzheimer's patient with open wounds found suffering in blood, filth, police said