All Americans Deserve CheneyCare
When I Was Young Meme

A Kafka-esque Nightmare in Elder Abuse

category_bug_ageism.gif 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.]


Comments

Ronnie, your sharing surely sent chills through me this early morning in Tennessee. Thank you for bringing up this important subject. I kept having thoughts of should I do this and then realized even though I am healthy and always handled my affairs and also very private an emergency could arise. Recently I appointed my youngest daughter and son jointly as power of attorneys regarding financial and health. Jointly because my son is out of the country half of the year. At the moment in Thailand. Also thought it would not be such a burden on one if they shared decisions jointly. I sense in my heart I did the right thing. Blessings sent your way this cold morning.

Thanks for bringing this story to our attention. It reminded me of the horrible noise that started buzzing loudly whenever my elderly mother tried to get out of bed or wheel-chair at the rehabilitation center where she was sent for three weeks after a short hospital stay. The center had the reputation for being one of the best in the area but, boy, was I happy to get her out of there!

Thanks, again, Ronni

Your story chilled me also. Like you I have no children. Luckily I do have siblings and nieces and nephews in the area. But I think I am going to have to do something about this as well. I am not sure which I would trust with this. Maybe two or more jointly.

Because all of my children are out of state I took care of the durable power of attorney, living will, and disposition of my assets a long time ago.

I think you have to know the people involved before assigning joint power to them. If they disagree on how your medical situation should be handled it could cause a rift between them. I put my daughter on my bank account so she could pay immediate bills when I die and my children are on my deed as joint heirs. They cannot touch my assets until I am dead.

It is wise to spend the money for an attorney before doing this so your documents will comply with the laws in your state. Arizona supplies living will forms free that comply with the State laws. I started my research at my Senior Advocate Center and they put me in touch with an attorney who handled such matters.This can be a complicated problem and should be thoroughly thought through before signing legal documents.

Ronni, your brother could still be given your Power of Attorney even though he is 3,000 miles away. There are fax machines to send documents instantly. Physical presence should not be necessary.
A nightmare like you relayed should never happen in this country, but it surely does more often than we know. Horrible!!

What a horror story! Mr. kenju and I signed all the necessary stuff on that about 10 years ago, but now I feel the need to check on it and make sure everything is up to date.

We're in the process of getting those legal documents set up as we're two women with no children (and a mess of ill-defined legal statuses despite being a 28-year couple.)

I have to say, kudos to the Globe for headlining that story. Elder abuse by "guardians" seems to be something that crops up periodically in many states. The society has always offloaded care of elders to families and families just ain't what they used to be. Literally.

This is something I've been thinking about for a long time. The hard part is deciding who I can trust.

I am so appalled I am sicked, as I read these words, Ronni. That this could happen at all - let alone in a country where I thought our citizens were protected against such things - is horrible.

that is terrifying. Does this poor woman have any recourse now that her situation has been publicized? It sounds like those guardians then get the assets? I had no idea something like that could happen.

Definitely people without family need to have friends or a lawyer they trust appointed as their guardian in such a situation. Who would even dream it could happen until reading this!

Rain...

I wondered that too along with a lot of questions the Boston Globe didn't get into.

Undoubtedly, Ms. Cromwell had some assets. Certainly she has some kind of pension and/or Social Security. Was there jewelry in her home? Many people, not wealthy, have sentimental, family pieces that have value.

What about her personal records? How about family photos? And just stuff that means nothing to others, but we each care about?

The Globe also doesn't tell us if there is any reason to believe Ms. Cromwell has cognitive difficulties, mentioning only her broken ankle. I mean, even as mystifying and inadequate as the diagnoses seem to be, you'd think there must be some reason a physician believes she can't live on her own.

Or maybe it is more sinister. There is no way to know from the Boston Globe story, which implies but doesn't state that aside from the broken ankle, Ms. Cromwell is fine.

What a nightmarish story! Thank you so much for sharing it. Fortunately my parents had drawn up living wills, health proxies, power of attorney documents, so that coping with my dad's Alzheimer's Disease and my Mom's Parkinson's Disease was not as dreadful as it could have been.

For many years my mom was an Alzheimer's support leader and legislative advocate. She alerted countless elders to the necessity of drawing up these documents long before you need them.

I remarried in 2001 at age 56.. My husband and I had the nec ssary documents drawn up in the first 6 months of our marriage.

This is a very sad story, and being a nurse has made me afraid of things like this forever. Why didn't the reporter of this story help her find an ombudsman. They could help her find out where her "stuff" is? Usually, I thought the nursing home will require all your money and assets be available to pay for your care. Anyone know about this?

Yes, it is a nightmare story and all too true. I know more about this than I ever wanted to know.

We have ended up the caretakers of our friend Duck after a thrombosis and flu-centric dehydration ended him up in the hospital. He is gay, lived by himself in a senior highrise, gave parties, traveled the world, and slowly found himself with only a few friends still alive.

His best friend who had the power of attorneys moved. My husband took over....for without Duck in our lives, we would never have met. We care a great deal, but we couldn't keep all his belongings at our small condo. We followed the directions in his will, stored his art and personal keepsakes, and put the rest in a sale to help people with AIDS. We visit every day, and we stay on top of things as best we can. Only after he had been in the nursing home for 11 months did we learn that he had a first cousin, and he had a burial plot in far away Wisconsin.

I write about him every day in my blog. Today I posted some pictures....one of him in India. I wish his story didn't have this ending.

Terrifying! And this is happening in the same town that has Beacon Hill Village? Disparity reigns.
My understanding is that we all need to have three documents, at the very least, (1)a durable health power of attorney, (2) a financial power of attorney, and (3) a Do Not Resuscitate Order (if that is your choice). Word from the EMT's is that you should have these documents taped to the front of the refrigerator. Apparently, they are trained to look for things like that.
Thanks for the heads up, Ronni.

We set up a trust, living will and powers of attorney shortly after dealing with the nightmares involved in my mother's death. It has been four years since her death and we are STILL trying to get JP Morgan to settle the estate. She had left her will with a local bank as executor, and never changed her will as the big banks bought the smaller banks and finally JP Morgan bought Chase... and didn't provide custody for my disabled sister and nephew, so we had to go through all the hassles of getting fiduciaries and guardians set up for them. Thank goodness their share of the estate went into a trust for them.

I was just out doing pet therapy work today with my dog Darwin in a beautiful nursing facility. Many residents had their own furnishings in their rooms, there is independent living at the facility along with full nursing care when required.

It is sad that for so many people this will never be an option, and they will be at the mercy of the state or uncaring family.

Ronni,
That story is scary...please don't put off till tomorrow what you can do today.
Although my will is made..and I am only 57...I willbe calling my notary tomorrow to make a living will...and power of attorney. I truly believe that can happen anywhere. God forbid.

It is truly sickening that people can be treated in this way. If the poor woman is confined in these conditions she will surely become mentally ill anyway. Is that what the authorities are counting on?

While this story is scary, let's look at the other side of the coin.
Here's a woman with no POA, no family, no friends.
Having been an RN in Massachusetts and now hearing my daughter's stories of being an ER nurse in that state, there are many in this woman's situation. I find it difficult to believe that the broken ankle was the justification for the nursing home and feel she probably does have some form of mental illness or dementia, deeming her unsafe to care for herself.
I don't know about you, but I'd much rather see her warm, safe and cared for by professioanl staff rather than out on the street as a bag lady with nobody to look out for her.
And while I'm not certain about the laws in Mass. I do know that here in Florida a legal guardian has no recourse to the assets or property of her clients.

Thank you Ronnie for bringing this subject of elder abuse to attention.
For several days now I have been casting around for a place to share my experience.
I have been a caregiver to elderly men and women in their own homes for seven years.
I recently left a position in Connecticut due to ongoing neglect from the guardians of the elderly person. Over sixteen months that I was one of a group of caregivers, I tried numerous times to bring the harmful actions resulting in injuries to our client to the attention of the three self-appointed guardians, with the result that I was humiliated, ignored, and all-round told to quit informing them of inappropiate, risky and injurous behavior from another "caregiver."
This is so upsetting to me, I can't sleep at night and am very sad that the person I had cared for and grown to love and be so close to, is treated this way. She has suffered multiple injuries and flesh wounds, she was fed raw chicken, she has fallen and suffered multiple injuries and bruising when the caregiver was supposed to have been right beside her to support her and didn't. She is denied a walking frame when a professional physiotherapist advised one to be provided for her.
She has been kept standing and walking in the cold and pouring rain.
She is not washed or cleaned properly. She suffers from constipation and being dirty with feces all day after a bowel movement that she cannot totally expel. She was injured when an inexperienced unqualified caregiver could not help her out of the bath properly. The client is ninety years old, is wealthy, has dementia, with all family members living out of state.
There are many things that are just not good enough about this persons' care even though she is at home and is well off.

To help protect yourself, the very first thing to do is make an appointment with an Elder Law Attorney. Don't wait. When my husband was diagnosed with Alzheimer's in 2001, we immediately sought the advice of an Elder Law Attorney, who then redid our wills and powers of attorney, etc. to fit our situation. I am so glad we did. If my husband has to go into a nursing home, our attorney will be involved in order to protect assets and so forth. Any one of us might end up with an illness that necessitates being in a nursing home -- being a client of an Elder Law Attorney before that occurs is absolutely critical if you are not at poverty level (eligible for Medicaid).

This is for Sue: What about hospice for the woman you mentioned? Hospice (at least in our area) takes dementia patients. Oh, but then her guardians would have to okay it. Guardians have all the say. What about calling the police? I feel so sorry so her -- but for the grace of God .........

Oops, I mean "I feel so sorry FOR her."

Thanks Suzy for your reply. I shall certainly be making inquiries to elder care authorities in CT as to the possibility of an inspection of the situation.

Mystery fans might be interested in Sue Grafton's most recent "T is for Tresspass" which focuses on elder abuse and identity theft.

I am a 56 year old female who served in the U. S. Air Force during the Viet Nam conflict. I have been in the state of Delaware since 1975. There are no family members locally. I came from Chicago. In 1997 I was hospitalized (after a severe accident)and then sent to a nursing facility where I saw first-hand some of the terrible things spoken in your article.
My care, had it not been for someone in my chuch and a R.N. supervisor, I never would have gotten on or off the bedpan! I was not the only one!
A social worker at the V. A. Hospital helped me a few years ago with papaerwork several years ago. Now,it looks like that should be reviewed and redone.
Thank you for bringing this to everyones' attention, mine too!
I have never replied like this before, so I'm not sure what happens next.
A note, I am currently waiting on ssdi and have been turned down once. Also, I'm not in great shape, financially So I guess almost anything could happen to me if the State decided to do anything!
I would not turn down any advice!

My grandmother recently passed away. After 20 years of not visiting her in TN because of a rift in the family after my mother passed. I came back to TN to find horror stories about my uncle who moved back from chicagon and my aunt who moved away to california, and how they handled the care of my grandmother and had her sign over poa to them, even though she may havt been in her right mind. the estate was intestate heir property under the lasws of the state of Tennessee, since my grandfather who preceded my grandmother in death had no will drawn up. My mother and her sister had passed away after my grandfather, leaving their share of teh estate to their heirs, their children. My uncle and aunt conspired to sell off the property, and misapprpriate the funds for their own personal use. I was also told byt relatives that my grandmother had been removed from the home of my uncle who had deeded 5 acres of the property to himself, after finding that she had a stage 5 bladder infection, had been living in her own squalor, and was not being fed properly, neither her or my elderly aunt. I need to know what are my rights as to suing the builders, contractors, title company, my grandmother's attorney, and my aunt, and even my uncle and his wife, although my uncle is now dead, after passing out shortly after coming back from blowing a quarter of a million in vegas? I also need to know how do i go about acquiring the records that my grandmother was actually removed from the property, and/or if there was a will left by grandmother before the poa was signed by her, and doctor's records showing she was in an advnaced stage of alzheimers or dementia?

My grandmother was taken over by Nancy Doty http://www.njdoty.com/staff.html

In three months she has charged my grandmother less than half of her savings 87 thousand dollars. She was living fine and happy by herself in her own house. My grandmother always spent her money carefully When the company took over they made all kind accusations to advance their cause. they took a picture of a room that had looked a mess for 30 years and used that as evidence that she needed care. they made up all kinds of things. even try to accuse my mother of having a credit problem so they could advance. They have no right to watch someones money. They cannot keep a budget. They should be put in jail for elder finiancial abuse.

That's awful, thank you for shedding light on an all too often over-looked subject. Unfortunately elder abuse has been overshadowed by other issues in the media for many years, & as a result has been overlooked by policy makers & society as a whole.

Here's an article that provides some insight on how we can help recognize abuse and report it.

http://www.workingcaregiver.com/articles/protectingseniors/elderabuse

Thanks again for getting the word out.

My Best,
Tuesday

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