Saturday, July 1, 2017

111 people have killed themselves under California’s new right-to-die law

The mother of Brittany Maynard
Tom House was about as robust and independent as anyone could hope to be as an octogenarian. A former Marine, private pilot and insurance broker, he was still chopping wood and going on miles-long jogs at his retirement home in Sonoma, Calif., long after his 80th birthday, relatives told the Sacramento Bee.

But last year, congenital heart disease and colon cancer took a toll on his body. Given just months to live, the 94-year-old decided to end his life on his own terms.

On a Monday last August, he spent the morning sharing memories with family and friends, according to NBC Bay Area. Then, with a doctor’s prescription, he drank a fatal dose of barbiturates from his favorite coffee mug and chased it with a martini. Less than an hour later, he was dead.

“He did it his way,” his daughter-in-law Esther House told NBC, choking back tears. “He went out his way. He really did.”

House was one of 111 people in California who took their own lives in the first six months of the state’s new right-to-die law, which allows terminally ill adults to request life-ending drugs from their doctors, according to a state health department report released Tuesday. The report offers the first snapshot of Californians who sought to end their lives under the legislation.

California enacted the End of Life Option Act on June 9 of last year amid heated debate over the ethics of permitting physicians to give lethal medications to patients suffering from malignant cancers and other terminal diseases. It is the fifth state in the country to enact right-to-die legislation, which was first adopted by Oregon in 1997.

Between the day California’s law took effect and Dec. 31, 2016, more than 250 people started what the law calls the “end-of-life option process,” making two verbal requests for aid-in-dying drugs, according to the report by the California Department of Public Health. Of those people, 191 received prescriptions written by 173 different physicians.

Health officials said 111 people ingested the drugs, killing themselves. Another 21 died of natural causes before taking the medication. It’s not clear what happened to the remaining 59 people who received prescriptions, the report said.

Those who ingested aid-in-dying drugs were mostly white, college-educated seniors who were receiving hospice or palliative care, according to the report. A little more than half were women.

Sixty-five people were suffering from malignant cancers, while 20 had neuromuscular disorders such as Parkinson’s or Lou Gehrig’s disease. Smaller numbers had heart or lung diseases, or other unspecified maladies.

There were six Asians, three blacks and three Hispanics, who ingested aid-in-dying drugs. The remaining 102 patients were white. Nearly all of them had insurance, most through Medicare or California’s Medi-Cal program. The median age was 73. Nearly three-quarters of patients had received at least some college education, according to the report.

The report’s findings mirror some statistics from Oregon, where the majority of patients last year were older than 65 and had terminal cancer. Although California is more racially diverse than Oregon, the vast majority of patients who took their own lives there last year were white, according to Oregon’s 2016 report on the state’s Death With Dignity Act.

California’s law was passed last year in a special session of the state assembly after a campaign driven by stories of terminally ill patients who were unable to access aid-in-dying drugs in the state. One such patient was Brittany Maynard, a 29-year-old with stage 4 brain cancer who moved to Oregon in 2014 to end her life.

Compassion and Choices, a leading right-to-die advocacy group, said California’s findings were good news for the law’s supporters.

“The state’s data show that even during the early months of the law’s implementation, the law was working well and terminally ill Californians were able to take comfort in knowing that they had this option to peacefully end intolerable suffering,” Matt Whitaker, the group’s California director, said in a statement Tuesday.

Critics of the law argue it is unethical for physicians to hasten death in anyone, and warn that it is virtually impossible to tell if drugs were prescribed to a depressed or unwilling patient. The Life Legal Defense Foundation, American Academy of Medical Ethics and a group of doctors have sued in federal court to overturn the law, arguing it violates Californians’ civil rights by stripping terminally ill patients of certain legal protections and treating them differently than other patients.

“It’s really tragic that doctors are now thinking that the best they can do for a patient is to give them a handful of barbiturates and leave them to their own devices,” Alexandra Snyder, an attorney with Life Legal Defense Foundation, told the Los Angeles Times on Tuesday.

John Minor, a retired psychologist from Manhattan Beach, Calif., was among those who killed themselves under the new law. He was an avid cyclist, runner and hiker until he was diagnosed with pulmonary fibrosis, a lung disease, in his late 70s, as NPR reported earlier this month.

As Minor’s body deteriorated to the point where he struggled to eat or speak, he asked for aid-in-dying drugs. But his doctors refused.

“I started cold-calling — like, just different hospitals and different departments within different hospitals,” Jackie Minor, his daughter, told NPR.

Finally, the family found him a health plan that would write him a prescription. Last September, at the age of 80, he drank a cup of apple juice mixed with a fatal dose of the pills and died quietly, surrounded by his relatives.

“John did what was right for him,” his wife, Sherry Minor, told the Los Angeles Times. “He died peacefully, rather than in agony, and he was in control. He didn’t feel afraid or helpless.”

Full Article & Source:
111 people have killed themselves under California’s new right-to-die law

What to Do When Siblings Can't Agree on a Parent's Care Needs

Siblings! For some lucky families, having a bunch of adult siblings gather around and plan how to take care of Mom and Dad as their parents' health begins to fail is a great comfort. For some families, siblings who never got along as kids and have had little to do with each other as adults being thrown together to make touchy decisions is disastrous.

For most families, the journey through the mine of elder care decisions falls somewhere between the two extremes. Elder care has a way of sneaking up on people. Generally, if there is an adult child living in the same town as the aging parents, it is this child who becomes, at the first sign of need, the default caregiver. That usually makes sense. You live in town. Your folks need some help with their Medicare forms, so you stop over. They need help with the yard, so you start taking time away from your family to help out. Then its grocery shopping and then, well, you're on your way to taking on a second job.

Ideally, before things get to this stage, you've had conversations with your parents about how they want their needs met during their later years. They've made out the papers naming a Power of Attorney for Health Care (a health directive indicating who will make health decisions if they can't and detailing their preferences for treatment) and a Power of Attorney for financial affairs. A will should be part of this, as well as other personal papers. Ideally, as well, all siblings are aware of these papers, what they contain and all are in agreement. Ideally – taking care of the elders becomes a family affair. However, life is seldom ideal.

Even in seemingly harmonious families, the person who slowly became a default caregiver can start to feel resentful. The out-of-town siblings can conveniently slide into denial. They aren't around to see how much help is needed. They see Mom and Dad occasionally, talk to them on the phone, and all seems well. The fact that you, the in-town sibling, are the reason everything is going so smoothly doesn't really register with them.

This is a red flag for you. It's time to stop and consider how you are, as a family, going to handle the spiraling needs of aging parents. Most experts would suggest a family meeting. I agree. You, the hands-on caregiver, would explain all you do and give your siblings a chance to help.

You'd find each other's strengths and weaknesses and work with those. You'd regularly check in with each other and update the whole family as needed. I would suggest this, because it is ideal, and many families can do this with a little work. If this works for your family, congratulations and you can quit reading here.

Those of you who read questions and answers in the family and relationships support group will see the cold hard facts. You will see that, for many, the chances of a civil family meeting where you hash out the needs of your elders and agree who does what are, well, nil. You will see caregivers stressing over siblings accusing them of spending too much of their parents money to care for their parents. You will read the pleas for help from the one sibling who has quit his or her job to care full time for an ailing parent being either ignored by siblings, or worse, being accused of predatory intentions because they are "running the show."

Option 1: Geriatric Care Manager


When these ugly scenes pop up, there's usually no way to go but through a third party. It's nice if you can agree on hiring a geriatric care manager, if you can find one in your area. This person would do the managing, get the help set up, and offer a cool head to work out problems, since the manager is not emotionally involved and doesn't carry family baggage.

Geriatric care managers are not available in every part of the country, and there is no over-reaching licensing, so you will want to do your homework. But sometimes, these people can make siblings see the light. They can help the ones in denial realize that the one doing hands-on care is "really working."

Option 2: Counseling


Family counseling is also a good route, if siblings are willing to work on sibling relationships for the sake of their parents. Talking through the issue with an objective third party, who can guide the conversation and keep it civil, can help families work through the challenges associated with caring for an elderly parent. It helps everyone involved to better understand the other family member's views, frustrations and challenges, and can sometimes offer a fresh perspective.

Option 3: Elder Care Mediation


Unfortunately, many family relationships are beyond that point. This is where elder care mediators come in. These people are trained to mediate family disputes. Likely you can find one through your local court system or in the phone book.

Two online places to search for elder care mediation services are Eldercare Mediators at http://www.eldercaremediators.com/ and the Association for Conflict Resolution at http://www.acrnet.org/.

This is certainly worth trying before going to court over guardianship rights, which some families end up doing. It would be lovely if people didn't bring their baggage from childhood into adulthood, but we all do to some extent. If people could at least put sibling rivalry, greed and other undesirable behaviors aside for the sake of their elders, that would also be lovely.

But sharing the care of elderly parents doesn't always bring out the best in people. Add to that hopes of inheriting something from the estate, and it gets worse. This is when third party help is often a good option. For, if the hands-on caregiver doesn't get help somewhere, the damage done can reach far beyond the elders. Resentments nurtured at this time can poison family relationships for generations. If you are the default family caregiver, ask siblings for help early on. Let them know they are wanted (drop the martyr act).

If they have been given a chance and they refuse, try an agency designed to solve family issues. It could be one of the best investments you've ever made.

Full Article & Source:
What to Do When Siblings Can't Agree on a Parent's Care Needs

Mother, son arrested for stealing $200,000 from elderly relative

Ansonia police arrested a mother and son for allegedly stealing tens of thousands of dollars from an elderly relative’s investment accounts.

Kristina Ukanowicz
Kristina, 62, and Joseph Ukanowicz, 29, of 195 Canal Street in Shelton are mother and son. They were both arrested on warrants following a two year investigation conducted by Detective Stephen Adcox into the theft of “tens of thousands of dollars” from Kristina’s mother while she was power of attorney over her mother’s finances.

According to police, the theft took place over a three-year period while the victim was in her eighties.

The victim’s bank and investment accounts went from having combined balances of over $200,000 to having a negative balance of over $1,000 during the time Kristina was power of attorney.

Through his investigation, Det. Adcox showed a pattern of spending and withdrawals that increased “disproportionately” from the time period before Kristina took over as power of attorney to her time as power of attorney.
Joseph Ukanowicz

Det. Adcox’s investigation also identified Joseph as being involved in the theft.

During interviews with both Kristina and Joseph, each admitted to a role in the theft but blamed each other for the majority of the theft.

On June 16, Joseph was arrested by warrant for first degree larceny and conspiracy to commit first degree larceny.

10 days later, Kristina was arrested by warrant for first degree larceny and conspiracy to commit first degree larceny.

Joseph appeared in court on June 19, was held on $50,000 bond and is currently incarcerated at the Bridgeport Correctional Center.

Kristina was held on a $35,000 bond and is scheduled to be arraigned in court today, June 27.

Full Article & Source:
Mother, son arrested for stealing $200,000 from elderly relative

Friday, June 30, 2017

Former wards, victims of attorney, awarded total of $200,000

Paul S. Kormanik
Financial relief is finally coming for some of the victims of a former Columbus attorney who stole money from his court-appointed wards.

More than $200,000 is being awarded collectively to 35 former wards of Paul S. Kormanik, who was the subject of a five-part Dispatch investigative series that prompted changes in the state’s guardianship system. If dispersed evenly, each former ward would receive a touch over $5,700.

The money will be paid out of the Lawyer’s Fund for Client Protection, which was established in 1985 to protect clients from potentially exploitative practices of attorneys. All active attorneys pay into the fund through various fees associated with the profession. Previously, two claims brought forward by Kormanik wards were reimbursed a total of $28,057.11 by the board.

“These situations can chip away at the public’s faith in the fiduciary responsibilities that wards entrust to their guardians, some of whom are attorneys,” said Janet Green Marbley, administrator of the fund. “It’s important for the public to understand that the fund can help rebuild that trust by reimbursing wards affected by the dishonest conduct of an attorney.”

The Columbus Bar Association brought 15 charges of misconduct against Kormanik, who forfeited his law license. Over the years he amassed about 400 probate court-appointed wards.

In court proceedings, Kormanik pleaded guilty to four counts of theft from an elderly or disabled person, one count of theft and five counts of tampering with records.

Kormanik was found dead in 2015 of apparent suicide. He was set to appear in court later that day to face contempt of court charges after failing to pay back one of his wards.

The Dispatch series invoked sweeping changes in the state’s guardianship system. The “Unguarded” series caused probate judges who award guardianship, state legislators and the Ohio Supreme Court to enact reforms.

Additionally, Attorney General Mike DeWine issued guidelines in a handbook that is required to be available to every guardian in Ohio.

A guardian is appointed by a probate court to manage care for the affairs of a minor or incompetent adult. Being designated a guardian or ward is “one of the most restrictive protective services available under Ohio law,” according to DeWine’s handbook.

Full Article & Source:
Former wards, victims of attorney, awarded total of $200,000

See Also:
Lawyer charged with stealing from wards, bilking burial fund

Jay Evensen: What is the solution for an incapacitated politician?

Gary Ott
The heart-wrenching case of Salt Lake County Recorder Gary Ott could be worse. He could be a judge.

A few years ago, at a federal court in New York, attorneys were astounded when an 84-year-old judge asked someone to explain the concept of email.

As quoted in Pro Publica, he said to no one in particular in the courtroom, “It pops up in a machine in some administrative office, and is somebody there with a duty to take it around and give it to whoever it’s named to?”

Email may be a difficult concept for many older people, but this particular judge had at one time competently presided over cases involving an investment banker and the information contained in a single email. Now he acted as if he had never heard of such a thing.

But was he suddenly incompetent, or merely having a bad day? And if we make it too easy to remove someone who is losing it, do we provide another tool in the never-ending blood sport that is politics?

I’ve encountered politicians who are nutty enough when competent that it would be hard to tell the difference.

That said, the anecdotal evidence surrounding Ott is becoming overwhelming. So are the suggestions his close aides are covering for him, and perhaps even taking advantage of him financially.

But we have to be careful not to make the cure for this problem worse than the problem itself.

Judges make life-or-death decisions. County recorders preside.

Sure, their offices record real estate transactions, liens, leases, mortgage transactions and subdivision plats, but the recorder has a competent staff to do all that. Ott presides, and if things are working well, you hardly need to be conscious to preside (insert a joke about your boss here).

We elect recorders because all those duties I just mentioned have to be a step removed from political influences. An appointed recorder might be pressured by a politically connected boss to fudge a record. An independently elected one gets to answer all by himself for what gets recorded.

Which is a problem, of course, if he can’t answer simple questions posed by a Deseret News reporter.

Utah law can’t help here. It contains no provision for removing someone who is incapacitated.

On the one hand, this is an indication of how rare such problems are. If the state has gone 121 years without having to confront such a challenge, do we really need to over-react to one highly publicized, agonizing example?

But on the other hand, who doesn’t know someone with dementia?

The Alzheimer’s Association reports someone acquires that degenerative brain disease every 66 seconds in this country, and Alzheimer’s is just one of several diseases that affect memory and cognitive skills. And while deaths from heart disease are down 14 percent since 2000, deaths from Alzheimer’s are up 89 percent.

The tricky intersection between competency and dementia seems destined to become more crowded and difficult to maneuver in the future.

So what is the remedy?

State lawmakers tried to find one during the 2017 session. Rep. Rebecca Chavez-Houck, D-Salt Lake, sponsored a bill that would have allowed someone to be removed from office for mental incapacity through a petition signed by a percentage of voters, a unanimous vote from a “local legislative body” and a ruling in a state district court.

The bill never advanced. At a hearing, it was opposed by advocates for the disabled, as well as the Utah Association of Counties.

The problem is, people might use such a process either to destroy the reputation of a politician or to remove that person for political reasons. Determining competency is no simple thing. It’s hard enough when it plays out within the private confines of a family.

Which is where Ott’s case ultimately belongs. His brother and sister have begun court proceedings to obtain guardianship. That may be the most logical and humane end game.

Meanwhile, we may be indeed grateful Ott isn’t a judge, or a governor or mayor.

That doesn’t mean such a thing won’t happen some day. It does mean we should take the time to craft a safe remedy.

Full Article & Source:
Jay Evensen: What is the solution for an incapacitated politician?

See Also:
Sister, brother file for legal guardianship of embattled county recorder

Workers charged in Boardman nursing home death


BOARDMAN, Ohio (WKBN) –Prosecutors in Boardman say three nursing home workers made a mistake with drugs and a patient died because of it.

The death at the center of the case happened in 2015 at Greenbriar Healthcare Center in Boardman.

It took the Ohio Attorney General’s Office the next two years to put together its case, and now investigators are charging those that they say are responsible.

Assistant Mahoning County Prosecutor Michael McBride said the Greenbriar patient died after the employees gave him the wrong drug and then tried to treat his overdose on their own.

“We believe, and actually the coroner’s report indicates, it actually caused the death of this gentleman,” McBride said.

Johonna Hull, 28, of East Liverpool, was arrested and charged with abuse of a patient and tampering with medical records.

Brenda Lamancusa is also charged with patient abuse. Another person, who hasn’t yet been arrested, also faces charges.

The victim’s identity is being protected under privacy laws.

Complaints from nursing home deaths are investigated by the Attorney General’s Office. McBride said this case involved extensive medical review.

In November of 2015, just after the death, Greenbriar Health Care was placed on a Medicaid “worst of the worst” watch list.

The state noted several problems with prescription protocols and other issues.

The facility improved enough to be taken off that watch list in February of this year.

McBride said this is the only criminal abuse case that he has handled from the nursing home over the past several years.

Editor’s note: This story is corrected to show that Hull is 28 years old, according to court records and the Licensing Bureau. A police report listed Hull’s age and birthdate, indicating she was 18.

Full Article & Source:
Workers charged in Boardman nursing home death

Thursday, June 29, 2017

Terri Schiavo’s Brother on Protecting the Medically Vulnerable



Published on Jun 23, 2017
With the rise of assisted suicide, the spotlight is on the need to protect the medically vulnerable. Bobby Schindler, the brother of Terri Schiavo, joins us as we look back on her life and discuss how we can care for our loved ones.

 Source:
 Terri Schiavo’s Brother on Protecting the Medically Vulnerable

N.H. becomes first state to give grandparents preference in guardianship cases

Gov. Chris Sununu
As the opioid crisis continues to devastate New Hampshire, grandparents will soon have an easier time getting guardianship of grandchildren whose parents are abusing drugs.

At a ceremony in the State House on Tuesday, Republican Gov. Chris Sununu signed House Bill 629 into law. The change will take effect in 2018 and make New Hampshire the first state in the country to give preference to grandparents in guardianship cases related to substance abuse, lawmakers said.

Republican Rep. Mariellen MacKay filed the bill after hearing from grandparents that they weren’t getting a voice in the court process.

“That’s their child and their grandchild; who would know better?” asked MacKay of Nashua.

The state’s child protection division has recently seen a spike in abuse and neglect reports related to substance abuse. Nearly 470 babies were born exposed to drugs last year, slightly lower than the 2015 number, but still far above the 367 cases in 2014, according to the Division for Children, Youth and Families. Nearly 500 people died from drug overdoses in 2016, and experts say many were in their parenting years and may have left behind children.

Treatment providers say parents with drug addiction are sometimes reluctant to seek treatment out of fear the state will take away their children. MacKay hopes the bill helps address that issue by ensuring the child can remain in the family, but under the grandparents’ care.

“If you are the adult with the substance abuse issue, you want to be free to take care of yourself and not have to worry, ‘Am I going to lose the right to my child?’ ” she said.

It’s not clear exactly how many grandparents in the state are raising their grandchildren, but estimates put the number at around 10,000.

Denis and Rosemary Nugent of Antrim became guardians for their grandson after their son was incarcerated when his drug and alcohol use got “out of hand.” Though they didn’t have trouble in court, they said they support the bill to make it easier in the future for families like theirs.

“These children are like the forgotten victims of the opioid crisis,” Denis Nugent said. The couple’s grandson, also named Denis, stood at Sununu’s right side as the first-term governor signed the bill.

Later, the boy proudly showed his grandparents a blue pen commemorating the occasion.

In addition to the bill related to guardianship, Sununu signed into law a study committee to look at grandfamilies in the state. The group, including legislators, child protection workers and advocates, will seek to gather data on the number of New Hampshire grandfamilies, barriers they face and actions that could improve their situations. A report is due in November.

Full Article & Source:
N.H. becomes first state to give grandparents preference in guardianship cases

Many elderly are ashamed to speak of abuse

Abuse is a word that most people do not like to talk about. Abuse happens all over the world, which is scary in itself. It has been reported that thousands of adult Oklahomans suffer Abuse, Neglect, and Exploitation by family members and other caregivers each year. Many of the victims are elderly, and possibly frail and vulnerable. They are unable to help themselves and depend on others to meet their basic needs.

Many older people are too ashamed to speak of abuse of any kind. This is why most abuse occurs without being reported. The abuse may occur in their own home, in relatives’ homes, and even in a long term care facility that is responsible for their care.

Abuse does not happen in every long term care facility. Many long term care facilities provide quality care, but even one allegation of abuse is one too many. Visiting our elderly in the long term care facilities is very important. By visiting we can be the eyes and ears that they need to help stop abuse.

Become an Ombudsman Volunteer, you can help make sure that the elderly in the long term care facilities are being treated with respect and dignity they deserve. To learn more about Elderly Abuse, the Ombudsman Program or to become an Ombudsman Volunteer, contact Tiffany Wingfield or Rebekah Williams at SODA Area Agency on Aging at 580-920-1388 or Senior Info. Line 1-800-211-2116 or write to them at P.O. Box 709 Durant, OK. 74702. Ombudsman Supervisors are available to speak to your group or organization upon request. Flexible training schedules are available.

Full Article & Source:
Many elderly are ashamed to speak of abuse