Abused Adults

By Attorney David Engler

Adult Protective Services (APS) is responsible for investigating reports of suspected abuse, neglect, or exploitation of Ohioans aged 60 and older. Similar agencies exist in every state. APS is part of each Ohio County Department of Job & Family Services (CDJFS). The Ohio Revised Code defines “abuse” as infliction upon an adult by self or others of injury, unreasonable confinement, intimidation or cruel punishment with resulting physical harm, pain, or mental anguish. “Neglect” is defined as the failure of an adult to provide for self the goods or services necessary to avoid physical harm, mental anguish, or mental illness or the failure of a caretaker to provide such goods or services. “Exploitation” means the unlawful or improper act of a caretaker using an adult or an adult’s resources for their monetary or personal benefit, profit or gain.

APS can petition Probate Court for a temporary restraining order to prevent interference or obstruction of its investigation by any person, including the abused adult. The court must find (a) that there is reasonable cause to believe the adult is being or has been abused, neglected, or exploited, and (b) that access to the adult’s residence has been obstructed. APS can also petition the court to approve a service plan providing involuntary services. The adult must receive a notice describing his or her rights and the consequences of a court order at least five working days before a hearing on the petition. An indigent adult has the right to a court-appointed attorney. Notice of the hearing must also be sent to the adult’s guardian, attorney, caretaker and spouse.
The court must find by clear and convincing evidence that (a) the adult has been abused, neglected, or exploited; (b) the adult is in need of protective services; (c) the adult is incapacitated; and (d) no other person authorized by law is available to give consent. If the court so finds, it must issue an order requiring protective services for up to six months, but can be re-authorized for up to a year.

But like with any governmental organization, APS can be too intrusive. Before they act there needs to be clear authority that an adult can be removed.

Recently, I met a distressed couple who had their Mother literally yanked from their home in the final months of her life. An anonymous tip was given by the Mother’s long time “friend” that she wanted to go back to the care-takers residence. The mother was in full scale dementia and would answer a few questions correctly and if asked would parrot the name of the “friend.” In horror the family of the elderly woman watched as APS took the mother from their home and moved her back to the friend’s house. After the Mother was there the friend arranged for her entire estate to pass to him. An attorney helped in the sham transfer.

In a matter of months the family desperate for help asks the Probate Judge to order an evaluation of the Mother. She had dementia for at least a year and was unable to make any decisions on her own. Be careful when a governmental agency says that it knows best. Hold on to your liberty because they are about to snatch it from you.

Probate Court acted quickly but it was too late. The Mother died a few days after the mental health assessment. Her possessions real and personal would have passed to the children, but for the friend getting everything transferred.

More than the money the family loss the beauty of being with their parent as she lived her final months. All they are left with is bitterness towards a government going too far and a scrapbook of memories.

Attorney David Engler
Phone: 330-729-9777
http://www.DavidEngler.com Attorney Engler’s website

Areas of Practice: Family Law, Elder Law, Domestic Relations, Bankruptcy, Criminal Law

Also published on eGuardianship.com on April 3, 2012 http://eguardianship.wordpress.com// and Family Fault Lines Blog http://familyfaultlines.com//

Brains Shrink, Heads Grow!

By Attorney David Engler

The terrible irony of getting older is that the physical size of our head gets bigger as the size of our brain decreases. I have seen pictures taken 20 years ago and I can hardly recognize myself. The hair has fallen out, grayed and my eyelids droop. I have not invested in plastic surgery but will do so as soon as it is offered inside a Wal-Mart store, like it’s eyeglass center or banking services.

A new study in the Proceedings of the National Academy of Sciences states that human brains are unique in that they can shrink up to 15% in a lifetime. Before this study it was assumed that all primate brains had shrinkage. Turns out it is only us.

By 2030 about 1 in every 5 people in the United States will be over the age of 65. This is twice the number of elderly than just a decade ago according to the U.S. Administration on Aging.

The brain shrinking conditions that affect the elderly can be depression and Alzheimer’s disease. These diseases of course can be a by-product of the shrinking brain. In a terrible commentary on most of us over 50; poor memory may stem from a fractional shrinkage in the hippocampus. This is when you forget a friend’s name or forget an appointment. My brother believes he has CRS. When I asked him what that diagnosis was he said, “Can’t Remember Shit.”. My mother firmly believes that it might have had something to do with pot smoking during the seventies. I knew nothing about these claims and the statutes have long passed.

So we live twice as long as chimps and this might explain why our brains start to shrivel. They only live into their 40’s. A shrinking brain is the neural equivalent of sore knees and stiff fingers. Perhaps we need to forward this blog post to our children so they can be patient with us. (if you can remember)

Attorney David Engler
Phone: 330-729-9777
http://www.DavidEngler.com Attorney Engler’s website
Areas of Practice: Family Law, Elder Law, Domestic Relations, Bankruptcy, Criminal

Two Stories of Abused Adults – Women and Sex & Disabled Adults, both exploited in the City of Brotherly Love

By Attorney David Engler

Two stories from this week’s pages of The Philadelphia Inquirer:

13 arrested in prostitution raid at Philly Mummers club

One night a month, police say, the inside of the modest Mummers’ Downtowners Fancy Brigade clubhouse in South Philadelphia transformed into a bacchanalian free-for-all where dozens of men ate, drank, and had sex with prostitutes in full view of each other.

For a $30 cover charge, attendees got one free beer from the cash bar, food, and access to the women at the party. The women, police said, walked around scantily clad or naked, charging from $30 to $100 for sex.
This past week, the festivities came to an abrupt end when police officers swarmed the two-story building near Second Street and Snyder Avenue.

About 50 men and 10 ‘working’ women were inside……

Police find four adults chained in Northeast Philadelphia apartment

Three people were arrested and charged with kidnapping, assault and other crimes after Philadelphia police found four mentally handicapped adults shackled in “deplorable conditions” in a basement storage closet of a Northeast apartment building Saturday.

The three men and a woman were found by a janitor chained to a water heater, in a 15-by-15-foot room, locked behind a steel door. All were malnourished, said a police spokeswoman.

The female victim is 29, the men 31, 35 and 41; each has the mental capacity of a 10-year-old, police said.

Police said the room included buckets for urine and feces……

Here in the “City of Brotherly Love”, not twenty minutes from each other, in tough pockets of Philadelphia, four mentally disabled forty-something adults were being held in a chained room as a paid sex party was happening not too many blocks away at a Mummers Club.

The Mummers Club puts on an annual New Year’s Parade each year and dates back to the days of Benjamin Franklin’s Philadelphia. The MUMMERS Club said they did not know about a sex party and were only renting it out once per month to help the not-for-profit.

The four disabled adults were found alone in an apartment building nearby. It was in the basement of a building in a semi-industrial section of town. You would drive by and wonder if anybody actually lives there. They were wards of someone. Their social security money funded this “care”. It was a group home of sorts. Each of the four was malnourished and taken to a hospital. No one took responsibility.

The fifty men present paid $30 to get into the party which included a free beer ticket and access to the women. It was a wide open sex party. The women would then negotiate an extra charge for sex with men at the party. The women were busted for prostitution and the two bartenders who were club officials as well, and managed the monthly brothel were charged with criminal conspiracy. The Johns were let go since the police did not know if compensation was exchanged before the sex. The women apparently approached the undercover cops to negotiate.

The disabled adults were used for their benefit money. They will be on record with some court or social security as being wards of someone or some agency. The conduct was criminal. But there is also criminal conduct in the gross negligence of a guardian or agency charged with making sure disabled adults are not abused. They all had the mentality of 10 year olds. No one has yet to be charged.

Same night and it was the same story. Men are pimping out vulnerable addicted women for quick cash. A sleazy “group home” is pimping out the weakest among us for some quick cash. Both of these dirty secrets were taking place at the same time, in the same City. The celebrated Mummers Club claimed not to know anything about a group that had monthly pay-for-sex orgies at their building. The local government and courts knew nothing about tax dollars supposedly used for the humane care of people being misspent and the people becoming prisoners in filth.

We have a special responsibility to protect these wards, if we are in a position to know. It goes beyond the bewilderment we all sense when driving though a bad section of town and worrying if anyone cares. It is not enough to claim ignorance of what happens in a building you own when you are collecting rent as a social hall. It is also wrong to ignore where your ward is living if you are the guardian. We all rely in good faith that others feel a sense of accountability for the way they make money. It did not happen that way on an early fall day in Philly. If a social club looks the other way while sex is sold or a court or government responsible for paying benefits to a “caretaker” turned torturer never asks questions, then the bond between us in society is broken.

The whole idea of this City was one of ‘brotherly love’. There is no greater love than treating a stranger as your brother. It is the Golden Rule. Those in a position to know, allowed gold to rule them and allowed the weakest of our brothers and sisters to be exploited and abused. That’s a criminal shame.

Attorney David Engler
Phone: 330-729-9777
http://www.DavidEngler.com Attorney Engler’s website
Areas of Practice: Family Law, Elder Law, Domestic Relations, Bankruptcy, Criminal

The Power of Attorney Abused

By Attorney David Engler

Aside from flat-out driving an incompetent victim to their bank and taking their money, the first choice of the thief is the power of attorney.

A Power of attorneys is recognized in every state and there is little to no regulation of its use. In most states the only time it is recorded is when real estate is being transferred. There should be extreme caution given by any professional who drafts a power of attorney. Care should be taken to truly understand not only if the signer is competent, but is the person being coerced even if subtly.

As a lawyer I have seen power of attorneys given to care givers who might have come into the elderly person’s life because they were hired. The constant contact with the person presents an opportunity for the caretaker to overstep their role. This is yet another good reason why family members should choose a person who is a registered guardian. It is a far better course of action to choose a stranger who is trained and bonded than checking the inventory at death to find out all the assets were depleted.

The power of attorney most often survives incompetency if it was drafted within the last 20 years. It is true that there is plenty of case-law indicating that a person cannot use a power of attorney for their own benefit, but self-dealing is usually not detected or discovered too late. By then assets are gone and usually unrecoverable.

As part of planning for the care of your mother or father or other person who seems unable to handle their own finances because of mental or physical reasons, a good start is to ask if there are any power of attorneys out there and better yet send a notice of revocation to all the banks with which the person might be doing business.

Attorney David Engler
Phone: 330-729-9777
http://www.DavidEngler.com Attorney Engler’s website
Areas of Practice: Family Law, Elder Law, Domestic Relations, Bankruptcy, Criminal

Keeping Track of Your On-Site Visits

By Attorney David Engler

One of the most important jobs of a guardian is to keep track of the times you visited your ward at a nursing or group home. Just last night I was visiting my own mother at a rehabilitation facility. Now while she seems to be completely competent at age 82, I can see the difference in treatment because the staff knows I am a lawyer and involved in the guardianship business. Most importantly I am keeping track of what I am seeing and letting them know that I am. My mom has complained about not getting her medications at the right times and about rude treatment by an aide. Her roommate confirmed the complaints.

It is remarkable how some staff that work at nursing homes do not seem to like their jobs and treat all patients like unruly children.

Well, they should be listing the complaints they receive directly from the patients on their charts. They do not! It is information that might show a pattern of neglect and therefore better not to list. But the fear of litigation is a powerful deterrent and if you demand that your complaints on behalf of your ward be documented and that you are recording the same, your client will get better care.

My Mom hit the nurse’s button and was not supposed to use the rest room without assistance. The response took more than 20 minutes. Now she is on a diuretic and it is hard to wait. The aide finally showed up and said, well just do it in your bed. You have to be kidding! She wasn’t! Believe me, these understaffed and under trained statements are coming out every day to our wards who find themselves relying on the care of others. Let the facility know up front that you will document the issue in your own case notes.

Our software (www.eguardianship.com) allows the guardian to keep track of case notes and these notes are searchable. Contemporaneous notes are admissible as business records if litigation is needed in the future. We have to put the pressure on the residential care-givers to keep them honest and accountable.

Vary the times you come to visit so your schedule is not predictable. If they know you show only at 4 P.M. then maybe they will not bathe your ward until that time. Do not be shy about letting the residential care facility know that your job is as an advocate on behalf of your ward. Let them know that you keep electronic records even if they do not.

Attorney David Engler
Phone: 330-729-9777
http://www.DavidEngler.com Attorney Engler’s website
Areas of Practice: Family Law, Elder Law, Domestic Relations, Bankruptcy, Criminal

Why Guardians Matter

By Attorney David Engler

At our affiliated company, eGuardianship.com, our clients who are guardians are people who take care of other people. There is no higher calling. The genesis of this profession can be found in the founding principle of every religion. And as our world moves us faster and faster and with greater and greater distance between us – technology can be part of the fabric that holds us together. It can be the means of communication that allows us to make sure our mother is getting the best care or that a veteran is sure to have a home. Reporting on visits or reporting to a court are all done with binary precision.

I have had this debate over many years with friends. Some believe that as the world ages we grow apart. They see the world as tribal warfare, disconnected crimes and people simply tuned out. I believe the opposite. If we can find more common languages, our world shrinks. Math is universal. It is the basis for technology. It allows the foundation of the explosion of social networking. It allows a guardian in Alaska to check the medical records of her ward in a flash who was treated in Texas. It allows this blog. Technology is a unifying force. And the people who are engaged in the most noble of professions will use it to bring their care closer to those who need it.

Attorney David Engler
Phone: 330-729-9777
http://www.DavidEngler.com Attorney Engler’s website
Areas of Practice: Family Law, Elder Law, Domestic Relations, Bankruptcy, Criminal

Let Grandma Facebook

By Attorney David Engler

Five years ago at this time Facebook had 12 million users. At the beginning of 2009 it had 150 million users. Today, Facebook has over 750 million users. The fastest growing demographic is users over 35. It’s time to put grandma and grandpa on Facebook.

We need to teach them the skills and create applications for ease of use. At first they might not understand what a Wall might be and perplexed if someone asks them to accept ‘chickens for their farm’. But the one thing Facebook can do for seniors is allow them to socialize.

There is nothing more important in maintaining a healthy lifestyle than continuing to socialize. Too many of our wards, our parents, aunts and uncles become isolated by physical immobility and the loss of friends to death and the movement of families from home communities.

The lack of socialization can slowly give way to earlier onset of dementia and Alzheimer’s. Studies have shown that the healthiest seniors are those that continue to lead busy and interacted lives. It’s not on Facebook yet but we can create social groups built around military units or ships or graduating nursing classes from the 40’s and 50’s.

A welcome expenditure is to buy your mom a laptop and set her up on Facebook, Also if the grandkids accept her as a friend, then maybe they will be less likely to post compromising pictures of themselves that they would regret later.

Attorney David Engler
Phone: 330-729-9777
http://www.DavidEngler.com Attorney Engler’s website
Areas of Practice: Family Law, Elder Law, Domestic Relations, Bankruptcy, Criminal

Who You Calling Sweetie?

By Attorney David Engler

Have you ever taken an aged client or your parent to the Doctor’s office and the doctor or nurse refers them as sweetie or sugar or some other term of endearment?

I know the doctor is trying to show compassion and connection but the opposite often occurs. It is a way of saying I don’t take you all that seriously and need to address you in a patronizing way; seniors get offended by health care professionals who treat them like children. A male doctor would not refer to a 36-year-old female client as sweetie and he should not refer to an 83-year-old female any differently. It is the subtle use of words that convey a relationship that is not equal.

The people we bring to their doctors might be frail and fearful but most are of sound mind and understand that they are being talked about in their presence.

I am suggesting to all well-intentioned professionals to refer to the elderly in the more respectful manner of Mr., or Mrs. or by their first name if they have a solid relationship.

Never ask the son in the room if the Mom is acting confused when the Mom is sitting right there. It feeds into their sense of hopelessness that their guardian or child is the only one that can be trusted with medical questions. There may be a time for such questions but they should be done outside of the presence of the patient.

You might order your eggs at a roadside diner and call the waitress sweetie, but you should never call an aged patient sweetie. They know as much about their condition as the doctor does and they have seen more of life, like the ravages of war, like raising a family, or making tough decisions at work. Always err on the side of treating our elders with respect.

Attorney David Engler
Phone: 330-729-9777
http://www.DavidEngler.com Attorney Engler’s website
Areas of Practice: Family Law, Elder Law, Domestic Relations, Bankruptcy, Criminal

Is That A Size 18 Dress You are Wearing?

By Attorney David Engler

Last week I saw an old friend who was wearing the stress of the morning on her face. Now my friend is a well-educated and savvy professional who rarely finds herself flummoxed. However, take this 60-year-old woman and have her Alzheimer’s-diagnosed mother ask her the same question everyday about her dress size and she gets reduced to a 12-year-old school girl remembering a disapproving mother.

It is remarkable how a parent who is ill from dementia or Alzheimer’s can cause such severe stress to the caregiver. All of the family fault lines are exposed. The siblings who live out-of-town can make a call and be seen as the good child and the parent will let you know it. Once the decision to move them from their home is made, the parent will hold the decision maker responsible. I asked her if her mother knew what day it was and she responded that she knew because a new day was every morning when she stopped at her care home before going to work. It takes true love and a sense of responsibility to shoulder this task.

Moreover, the family needs to understand the emotional and financial toll it takes on the family. It is exactly this toll that goes in to our change basket and adds up as we develop resentments for the other family members who we believe get off easy and do not understand the commitment.

In advance, if possible, or with the help of a neutral party like a family counselor or attorney experienced in elder law issues, a family should call for a retreat to strategize the needs of an aging parent. We come together to celebrate births and we should come together to celebrate and plan for the remaining years of our parents. There are many issues that need discussed, like the cost of care and what documents are necessary to provide for Medicaid eligibility.

The first meeting should be without the parent unless they are clearly competent and understand that the goal of the meeting is to plan for an uncertain future. All of the baggage needs to be checked at the door of the meeting room and fully examined for explosives (figuratively). The professional can help with the communication tools that seem to be so elusive when dealing with family.

The goals for all, needs to be focused. I like to start with a positive reinforcement of the 3 most beautiful things we can say about our parent. We then need to have everyone list what 3 goals they would like to take away from the retreat. In advance, an assessment of finances is prepared and an understanding of the condition faced by the parent.

Once again it does not seem to matter how many degrees a person has because when it comes to dealing with a person with Alzheimer’s, rationality goes out the window. When your 86-year-old mother says your butt looks big, we lose perspective. That is why it is important to create a situation where the family can seek an agreement with each other, understanding, and an appreciation for the caregiver at the bedside.

By the way my friend is half of a size 18 dress.

Attorney David Engler
Phone: 330-729-9777
http://www.DavidEngler.com Attorney Engler’s website
Areas of Practice: Family Law, Elder Law, Domestic Relations, Bankruptcy, Criminal

Divorce and Dementia

Having practiced law in the area of Domestic Relations I can attest that the divorce rate among the elderly is increasing. Divorce lawyers are seeing couples divorce after 30 years of marriage. In the past year I have seen divorce after 48 years and one after 39. In each instance the attorney and the family and possibly the guardian need to be aware of the effects of early dementia or early onset Alzheimer’s as causes for the break-up. It is popular for comedians to blame Viagra and it has come into play but most often it is the change in personalities that comes with the aging process that leads life partners to become unstable.

I actually filed a guardianship action that was thwarted by the wife when she hired an attorney who complained for divorce. The divorce action trumped the guardianship sought by the husband and the very adult children each took sides. The reality was a bitter fight disposing of a lifetime of assets.  Throughout the process the mental illness of the wife was present but divorce courts are reluctant to pursue a request for a competency exam. The facts must be extreme to derail a divorce by raising mental illness because of a stroke or dementia.

Attorney David Engler
Phone: 330-729-9777
http://www.DavidEngler.com Attorney Engler’s website
Areas of Practice: Family Law, Elder Law, Domestic Relations, Bankruptcy, Criminal