Before you read further, I ask you stop and imagine this for a moment: you are confined to a 10-by-12 foot room. Attendants bring you medications, but you don't know what they are or what they are for. You would like to take a walk outside, but an alarm goes off when you try to go out the door - and you can't go out anyway, because there are no clothes in the closet.
Not long ago, you lived in an apartment, had been there for many years, owned all the appropriate accoutrements of life, paid your bills and after what was expected to be a short period in a rehab hospital to help repair a broken ankle, you were never allowed to leave again.
It sounds like a gothic novel, but it is not. It is real.
This story is particular to the state of Massachusetts, but is likely a problem in some if not many of the other 49 states and perhaps elsewhere in the world.
“Dawn Cromwell dares not leave her building. If she tried, a device girding her ankle would sound an alarm. For over a year, she has had to use store-bought reading glasses because her pleas for a prescription pair have gone for naught. She is given medications, but, she says, no one will tell her what they are.”
- - Boston Globe, 13 January 2008
Ms. Cromwell, who is 73, has been confined to a nursing home where she has almost no clothes and has no idea what has become of her possessions or the apartment she lived in for many years – all because she suffered a broken ankle. After a short bit of rehab, she had expected to go home.
“But on the say-so of the nursing home’s doctor – a short, illegible diagnosis – a judge declared that Cromwell was mentally ill and handed all of her decision-making to a guardian. Cromwell lost all power over her own life, with no opportunity to object, no right to have a lawyer represent her, no chance to even be in a courtroom.” [emphasis added]
Someone has to give me more evidence than a broken ankle that a person is mentally ill, but that is not so, apparently, for judges to order guardianships and confinement in Massachusetts. And I thought, in the United States, we put ankle bracelets on criminals and people under house arrest, not old people. This is a nightmare.
Ms. Cromwell is able to be confined in this manner because she is what the State of Massachusetts designates an “unbefriended elder” – a person without relatives or friends to serve as her guardian. In that case, judges rely on petitioners – mostly hospitals and nursing homes – to decide a person is incapacitated.
The appointed guardians are unlicensed “professionals” who do this for a living and in the case of one guardian cited in the Boston Globe story, has possibly 70 clients and had not visited most of them in a year or more. In addition, guardians are required to file an inventory of a ward’s possessions within 90 days of taking on a guardianship, but this particular guardian had filed only five out of 58 appointed guardianships.
What has happened, one wonders, to Ms. Cromwell’s apartment, her possessions, her bank accounts? Who gets those things? The Boston Globe story does not address these questions.
In petitioning for guardianship, a certification of the elder’s condition is required including a detailed description of diagnosis and what decisions the elder has insufficient mental capacity to make. In 72 cases over the past five years,
“… mostly filed by hospitals and nursing homes, the medical certifications were so brief – some just a sentence or two – or so vague that they fell well short of what the court requires. Many were handwritten, some illegibly.”
In a separate study comparing certifications in Massachusetts, Pennsylvania and Colorado,
“…Massachusetts fared worst. The study found that in 154 cases in Massachusetts, the median length of the medical certification was 83 words. In one case it was just seven words.”
So in seven words, an elder can be confined to an institution until death without recourse - without access to personal property, records, bank accounts, one’s personal physician, an attorney, etc., and as in Ms. Cromwell’s case, there is no way to confront accusers or be heard in court. She has essentially disappeared.
As I said above, it is a nightmare - worthy of Kafka.
This story chilled me as I have no children and my only relative, a brother, lives on the west coast, 3,000 miles away. If a broken ankle can land me, shackled and permanently confined to an institution with my assets confiscated, I need to do something about that. Now.
I’ve had notes lying around for a long while regarding a power of attorney and a living will, but haven’t followed through. That power of attorney – someone I trust who is authorized to speak and decide on my behalf - has suddenly become imperative. I’ll take care of it soon.
[At The Elder Storytelling Place today, Nancy Leitz explains how a Wednesday Night at the Dante led to a family tradition still in force more than half a century later.]