HomeMy WebLinkAbout03-0399IN THE MATTER OF THE PERSON
AND ESTATE OF:
LORRAINE A. LEWANDOWSKI,
AN ALLEGED INCAPACITATED
PERSON
· IN THE COURT OF COMMON PLEAS OF
· CUMBERLAND COUNTY, PENNSYLVANIA
· ORPHANS' COURT DIVISION
· NO.
PETITION FOR APPOINTMENT OF PERMANENT PLENARY GUARDIANS
OF THE PERSON AND ESTATE
AND NOW COMES THE PETITIONER, the Area Agency on Aging in and for
Cumberland County, Pennsylvania, who represents and avers as follows:
1.
The Petitioner is the Area Agency on Aging, in and for Cumberland County, with
its office located at 16 West High Street, Carlisle, Cumberland County, Pennsylvania.
2.
The alleged incapacitated person is Lorraine A. Lewandowski, age 77, who
resides at 119 November Drive, Camp Hill, Cumberland County, Pennsylvania and has
resided there for a period exceeding one (1) year prior to the filing of this Petition.
3.
The only known relative of the alleged incapacitated person is:
a. David Burleigh - nephew
6527 Rte 22
Plattsburgh, New York
4.
On or about February 12, 2003, Lorraine A. Lewandowski contacted the Camp
Hill police department and advised the police that someone entered her apartment and
stole $10,000.00 that was hidden in a suitcase in a closet.
o
On or about February 21, 2003, while in a grocery store, Lorraine A.
Lewandowski went around to different registers, said she had been shopping there all of
her life and that someone had told her that she could get her groceries for free.
6.
While in the grocery store on February 21,2003, she approached a complete
stranger and claimed she had no money for food. The stranger purchased groceries for
her and took her home where she insisted that the stranger come into her apartment
despite a warning from the stranger that she should not let strangers into her apartment.
7.
Investigation by Petitioner has determined that Lorraine A. Lewandowski began
to decline in her ability to care for herself during the latter part of the summer of 2002
and has deteriorated more since the beginning of 2003.
8.
During the month of February, 2003, Lorraine A. Lewandowski requested the
apartment complex manager to take her to the bank which she did and, while there,
Lorraine A. Lewandowski began to withdraw a large amount of money but was talked
out of it by the apartment complex manager.
9.
Further investigation by Petitioner reflects that:
A. AllFirst Bank, now M&T Bank, has eight (8) pages of comments by
bank personnel which indicate her to be confused and having difficulty
understanding her account balances;
Bo
Do
Bo
Fo
Go
Addus, a home health care agency, reports that Lorraine A.
Lewandowski has refused services several times and also reports that
she claimed that some unidentified woman she met in the elevator
purchased groceries for her;
She went to the bank on March 10, 2003 and accused people from the
bank of entering her safe deposit box. While there, she could not find
her key to the safe deposit box nor to her apartment and was so
irrational that the bank was required to call the police to have her
removed from the premises;
Camp Hill Police report having an increased number of contacts with
her and that her behavior is becoming more irrational;
She stated to the Protective Services worker for the Petitioner that on
March 12, 2003 two (2) men came into her apartment the night before,
went into a second bedroom and engaged in sex for about one-half
(1/2) hour. While this alleged activity was taking place, Lorraine A.
Lewandowski hid in a bathroom attached to her bedroom and was sure
that they did not know she was in the apartment;
Petitioner was informed on March 21, 2003 by Verizon that her long
distance service, not paid since September, 2002, had been terminated
due to nonpayment of her bill and, since March 21, 2003, her regular
telephone service has been terminated for nonpayment of her bill; and
She is no longer able to operate the thermostat in her apartment nor is
she is able to prepare food for herself.
10.
On or about April 11, 2003, after being reminded by the apartment complex
manager that she had not paid her rent, she showed up AllFirst Bank accompanied by two
or three men between the ages of 18 and 20 who were previously unknown to her where
she requested a check to pay her rent. She indicated that she had no checks but bank
personnel confirmed that a box of checks had been sent to her in March, 2003. Upon
presenting the check for her rent to the apartment complex manager, she had to be
escorted back to her apartment because she was unable to find her way back on her own.
11.
On March 13, 2003, a psychological evaluation was conducted of Lorraine A.
Lewandowski by G. David Smith, Ph.D. of Riverside Associates, PC and the following
observations were noted from the report:
A. Early stages of Dementia of the Alzheimer's type;
B. Adaptive functioning and ability to live independently are significantly
impaired;
C. Reports of changes in her behavior over the last six (6) months suggest that
the appearance of symptoms and reduction in functioning is progressive and
escalating;
D. Her disruptive and inappropriate social behavior represents a threat to her
ability to live on her own;
E. She has lost interest in her diet, food, and nutrition and her own reports
suggest that she neglects to eat appropriately. Unsupervised and unsupported,
Fo
she could become malnourished which would accelerate her decline and
threaten her health; and
She evidences significant deficits in all areas of adaptive functioning
including social interaction, language comprehension and expression, eating,
self-care, household skills, time awareness, money handling, and safety
awareness.
12.
Petitioner has determined that Lorraine A. Lewandowski has approximately
$3,385.00 in her checking account and may have bonds in a safe deposit box which have
not been verified.
13.
The monthly income of Lorraine A. Lewandowski consists of the following
sources:
A.
B.
C.
$590.00 - Social Security;
$138.00- General Electric pension; and
$921.00 - U.S. Civil Service pension
$1,649.00
14.
Petitioner believes and, therefore, avers that Lorraine A. Lewandowski will be at
risk of death or irreparable harm without the appointment of a Permanent Plenary
Guardian of her Person and Estate.
15.
Petitioner believes and, therefore, avers that Lorraine A. Lewandowski is best
suited to be placed in an assisted living facility.
16.
Less restrictive alternatives are not available because there is no one able to care
for her.
17.
David Burleigh, the nephew of Lorraine A. Lewandowski, is willing to accept the
appointment of Permanent Plenary Guardian of the Person and Estate of Lorraine A.
Lewandowski.
18.
The nature of Petitioner's interest is that of a welfare agency.
19.
David Burleigh has no interest that is adverse to the alleged incapacitated person.
20.
To Petitioner's knowledge, no previous application has been made for the Order
herein requested or for a similar Order.
21.
No other Court has ever assumed jurisdiction in any proceeding to determine the
incapacity of Lorraine A. Lewandowski.
22.
The failure to appoint David Burleigh as Permanent Plenary Guardian of the
Person and Estate of Lorraine A. Lewandowski will result in irreparable harm to the
person and estate of Lorraine A. Lewandowski.
WHEREFORE, Petitioner prays that this Honorable Court direct that a Citation be
issued upon Lorraine A. Lewandowski to show cause why she should not be adjudged an
incapacitated person and that her nephew, David Burleigh, be appointed as Permanent
Plenary Guardian of the Person and Estate of Lorraine A. Lewandowski.
Respectfully Submitted,
[ony L. DeLuca, Esquire
113 Front Street
P.O. Box 358
Boiling Springs, PA 17007
(717) 258-6844
VERIFICATION
I hereby verify that the facts and information set forth in the foregoing Petition for
Appointment of Permanent Plenary Guardians of the Person and Estate of Lorraine A.
Lewandowski are tree and correct to the best of my knowledge, information, and belief. I
understand that any false statements contained herein are subject to the penalties of 18
Pa. C.S. Section 4904, relating to unswom falsification to authorities.
Dated: M~ O, 2003
Janet Paull
IN THE MATTER OF THE PERSON
AND ESTATE OF:
LORRAINE A. LEWANDOWSKI,
AN ALLEGED INCAPACITATED
PERSON
· IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
.
PRELIMINARY DECREE
AND NOW, this ~ I~. [~.,, day of [/~ ,~ ,2003, upon consideration
of the annexed Petition, it is hereby ORDERED AND DECREED that a Hearing on this
matter is set for the ~ day of ~ , 2003, at ? :3~ /4'. M.
O'clock in Courtroom No. _/_ at the Cumberland County Courthouse, 1 Courthouse
Square, Carlisle, Pennsylvania.
o<~6g2z_~.~ ~-dz~~ ~/3~. is appointed to represent the allegedly
incapacitated person. 'o
BY THE COURT,
OF CUMBERLAND COUNTY
PENNSYLVANIA
ORPHANS' COURT DIVISION
IN THE MATTER OF THE PERSON
AND ESTATE OF LORRAINE A.
LEWANDOWSKI, AN ALLEGED
INCAPACITATED PERSON
PETITION FOR APPOINTMENT OF
PERMANENT PLENARY GUARDIANS O
THE PERSON AND ESTATE;CITATIO1
AND PRELIMINARY DECREE
ANTHONY L. DELUCA
ATTORNEY AT LAW
113 FRONT STREET
P.O. BOX 358
BOILING SPRINGS. PA 17OO7
IN THE MATTER OF THE PERSON
AND ESTATE OF:
LORRAINE A. LEWANDOWSKI,
AN ALLEGED INCAPACITATED
PERSON
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: ORPHANS' COURT DIVISION
: NO. 21-2003-399
DECREE
AND NOW, this
annexed Petition, it is hereby ORDERED AND DECREED:
1 .That the Permanent Plenary Guardianship of the Person and Estate of Lorraine
A. Lewandowski be terminated.
2.That the Court authorize Petitioner to release the assets and any other items of
personal property to her new Guardian, David Burleigh, appointed by the Court in the
State of New York.
3.That Petitioner is authorized to be reimbursed the sum of $765.37 from the
assets of Lorraine A. Lewandowski, which sum represents the cost of the psychological
evaluation of Lorraine A. Lewandowski by Riverside Associates, PC.
Anthony L. DeLuca, Esquire
For the Area Agency on Aging
day of November, 2003, upon consideration of the
Area Agency on Aging
Jo
Daniel Worley, Esquire
Attorney Lorraine A. Lewandowski
IN THE MATTER OF THE PERSON
AND ESTATE OF:
LORRAINE A. LEWANDOWSKI,
AN ALLEGED INCAPACITATED
PERSON
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
:
: ORPHANS' COURT DIVISION
: NO. 21- 2003-399
PETITION TO TERMINATE GUARDIANSHIP OF THE PERSON AND ESTATE OF
LORRAINE A. LEWANDOWSKI
AND NOW COMES THE PETITIONER, the Area Agency on Aging in and for
Cumberland County, Pennsylvania, who represents and avers as follows:
1.
The Petitioner is the Area Agency on Aging, in and for Cumberland County, with
its office located at 16 West High Street, Carlisle, Cumberland County, Pennsylvania.
2.
The alleged incapacitated person is Lorraine A. Lewandowski, age 77, who
formerly resided at 1 ! 9 November Drive, Camp Hill, Cumberland County, Pennsylvania.
3.
The only known relatives of the alleged incapacitated person are:
bo
Co
David Burleigh - nephew
6527 Rte 22
Plattsburgh, New York
Margaret Brown - sister
595 Columbus Avenue
New York, New York 10024
Esther Burleigh - sister
18 Terrace West Way
Plattsburgh, New York 12901
Theresa Gribbin - sister
906 Fassett Road
Elmira, New York 14905
e. Jean O'Neill - sister
9023 Del Rio
Grand Blanc, Michigan 48439
f. Frances Palombo - sister
9 Sacandaga Road
Scotia, New York 12302
g. George Parrotte - brother
187 Emmons Street
Dannemora, New York 12929
4.
On or about May 14, 2003, the Petitioner filed a Petition for the appointment of
Permanent Plenary Guardians of the Person and Estate of Lorraine A. Lewandowski.
5.
A hearing on the aforementioned Petition was held on June 6, 2003 at
which time the court found that Lorraine A. Lewandowski was an incapacitated person.
A copy of the Order of Court is attached hereto, marked as Exhibit "A", and incorporated
herein by reference.
o
On the morning of the hearing on June 6, 2003, Lorraine A. Lewandowski was
removed from the jurisdiction of the Court by her nephew, David Burleigh, and
transported to the State of New York where he resides.
7.
Petitioner, prior to the scheduled hearing on June 6, 2003, arranged for a
psychological evaluation to be conducted of Mrs. Lewandowski by Riverside Associates,
PC, which psychological evaluation cost Petitioner the sum of $765.37. A copy of the
invoice from Riverside Associates, PC is attached hereto, marked as Exhibit "B", and
incorporated herein by reference.
8.
Petitioner, subsequent to being appointed Guardian, took possession of certain
financial assets including U.S. Savings Bonds having a face value of $90,000.00 and
$15,682.76 in cash, together with other items of personal property. A copy of the safe
deposit box inventory is attached hereto, marked as Exhibit "C", and incorporated herein
by reference.
9.
On or about August 20, 2003, David Burleigh, nephew of Lorraine A.
Lewandowski, who removed her from this jurisdiction and who resides at 6527 Route 22,
Plattsburgh, New York 12901, filed a Petition for the Appointment of a Guardian of the
10.
Person and Property of Lorraine A. Lewandowski in the County Court of the State of
New York, County of Clinton. In said Petition, David Burleigh requested that he be
appointed as Guardian of Person and Property of Lorraine A. Lewandowski. A copy of
said Petition with Order to Show Cause is attached hereto, marked as Exhibit "D", and
incorporated herein by reference.
11.
On or about October 1, 2003 a heating took place before the Honorable Kevin K.
Ryan, Acting Justice, in and for Clinton County, New York wherein telephone testimony
was presented by Janet Paull on behalf of the Petitioner herein and Daniel Worley,
Esquire who was appointed local counsel for Lorraine A. Lewandowski.
12.
Upon further testimony presented before Judge Ryan on or about October 9, 2003
in Clinton County, New York, the court found Lorraine A. Lewandowski is an
incapacitated person and appointed David Burleigh of Plattsburg, New York as Guardian
of the Person and Property of Lorraine A. Lewandowski conditioned upon the
termination of the guardianship appointment of the Cumberland County, Pennsylvania
Office of the Aging by further Order of the Court of Common Pleas of Cumberland
County, Pennsylvania.
13.
Petitioner respectfully requests that, prior to the termination of the said
guardianship, it be reimbursed the sum of $765.37 which represents the cost of the
psychological evaluation of Lorraine A. Lewandowski by Riverside Associates, PC.
14.
Petitioner further requests that the existing permanent plenary guardianship of the
person and estate of Lorraine A. Lewandowski granted to Petitioner on June 6, 2003 be
terminated so that the guardianship may be transferred to the jurisdiction of Clinton
County, New York where Mrs. Lewandowski currently resides and that the Petitioner be
authorized to release the assets referred to in paragraph 8 hereinabove to her new
Guardian, David Burleigh, appointed by the Court in the State of New York..
WHEREFORE, Petitioner respectfully requests this Honorable Court to terminate its
permanent plenary guardianship of the person and estate of Lorraine A. Lewandowski in
Cumberland County, Pennsylvania; that the Court authorize Petitioner to release the
assets and any other items of personal property to her new Guardian, David Burleigh,
appointed by the Court in the State of New York and authorize the reimbursement of the
sum of $765.37 to Petitioner which represents the cost of the psychological evaluation of
Lorraine A. Lewandowski by Riverside Associates, PC.
Respectfully Submitted,
113 Front Street
P.O. Box 358
Boiling Springs, PA 17007
(717) 258-6844
VERIFICATION
I hereby verify that the facts and information set forth in the foregoing Petition to
Terminate Guardianship of the Person and Estate of Lorraine A. Lewandowski are tree
and correct to the best of my knowledge, information, and belief. I understand that any
false statements contained herein are subject to the penalties of 18 Pa. C.S. Section 4904,
relating to unswom falsification to authorities.
Janet Paull
IN RE: :
LORRAINE A. LEWANDOWSKI, :
AN ALLEGED INCAPACITATED :
PERSON :
:
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-2003-399
ORDER OF COURT
AND NOW, this .6th day of June, 2003, after
hearing, we find by clear and convincing evidence that Lorraine
A. Lewandowski is an incapacitated person. The Cumberland
County Office of Aging is hereby appointed permanent and plenary
guardian of her person and estate.
Edward E. Guido, J.
Anthony L. DeLuca, Esquire
For the Area Agency on Aging
Daniel Worley, Esquire
For Lorraine A. Lewandowski
Area Agency on Aging
srs
EXHIBIT "A"
FTCE, OF AGI'NG
~~ .... ,,_."~-..~ ~
i ers de
; 7172406118; , , 0ct-17-03 1:03PM; Page 3/3
2818 Green Street - Harrisburg, PA 171'10 · (717) P38-6880 Phon~ · (717) 2~-68P~5 Fax
ISERVICE FOR:
L. Lowandowsid - psychological evaluation
IBILL TO:
~Cumberland County Office of Aging and COmmunity Services
~ 16 West High Street
{.Carlisle, PA 17013
DATE
18-Mar-03
19-Mar-O3
20-Mar-03
23-Mar-O3
24-Mar-03
25-Mar-03 Write and Edit Report
13-Mar-O3 12 miles
DESCRIPTION UNITS
Clinical and informant interviews - Mm, ~ki's apartment 2.00
Score SIB-R 0.25
Phone conference with J. Wolbach 0.25
Outline and Di~ Report 0.50
Dictate Report 1.00
Edit Report 1.00
Phone conference with J. Wolbach 0.25
39.70
UNIT COST
$140.00
$140.00
$140,00
$140.00
$140.00
· $140.00
$140.[X)
$0.34
AMOUNT
$280.00
$35,00
$35.00
$70.00
$140.00
$140.00
$35.0O
· $70.00
$J~.31
21-Jul-03 Medicare payment
BALANCE
BALANCE DUE
INVOICES OUTSTANDING THIRTY (30) DAYS OR MORE WILL BE ASSESSED A. SERvICE
, CHARGE OF 1,6% PER MONTH,
+
$817.31
-$35,39
$78"1.92
""'EXHIBIT "B"
He'lpit~g peop~ meet the challenges of everyday life.
CO OFF[CE OF AGTNG ; 7172406118; Nov-13-03 1:1OPM; Page 2/2
sAFE,DEPOSIT BOX INVE'NTORY ,~,(~ ~
~NS~auc~.!ONS ........ . ......... . ....... .. - ... ~
(7)
(2)
(:~)
(4)
(5)
(7)
Cash.. RepOrt fetal only.
Stacks: List in detail every common or preferred cerfific0te, warrant or olher rights found in box. Stocks are
Io be designated by nome of company, certificate number, date of certifi~:ate, name in which stock is registered,
and number ef shores and class of stock.
Obllgat!ans ef U. S. Ga~rernme~lt: Number of items, c~ote of issue, face value, names in which registered
and type of ownership, i.e., jointly held, paya'b!e on death, elc.
Boads~ Designate by name, amount, serial number, or other designation. (Bearer Bonds)
~ank and Say!rigs and Loan Passbooks: State name of depositor, number of book, last date appearing in
book, ne'me of bank end branch, and balance.
Jewelry, Cains, .~tamps, NJanuserlpts, otc: List and describe as fully as possible.
Deeds, Mortgages, Current Insurance Policies er other evidences of indebtedness: List'and describe as
fully as possible.
All ether contents.
" .... ITEM DESCRIPTION
Certify under Dena'lty ofoeriurv that the abave record is corre.~l and complete to~th~ best' of m~y know'ledge
~ ~ ~ ~ _ ..... . .... .~ / ..... ..
NOTEs A~agh additional 8'&. x I 1" sheet(s) If necessary or u~e dupligotes of thlj page of form.
EXHIBIT "C"
09/24/03 15:28 FAX
~02
At a Special Part of the Cotulty Court of
the State of New York, held 'in and for
the County of Clinton at the Government
Center, located at 137 Margaret Street,
P.l_a_t,t_sb~r, gh, New York, on the '~day of
, 2003.
PRESENT :
Judge, County Court.
X
In the Matter of the Applicatzon of
DAVID BURLEIGH,
for the Appointment of a Guardian of
the Person and Property of
ORDER TO SHOW CAUSE
LORRAINE LEWANDOWSKI,
an Alleged Incapacitated Person.
IMPORTANT
AN APPLICATION HAS BEEN FILED IN COURT BY DAVID BURLEIGH
(HEREINAFTER REFERRED TO AS "PETITIONER"), WHO BELIEVES You MAY BE
UNABLE TO TAKE CARE OF YOUR PERSONAL NEEDS AND FINANCIAL AFFAIRS.
PETITIONER IS ASKING THAT SOMEONE BE APPOINTED TO MAKE DECISIONS FOR
YOU. WITH THIS P~PER IS .A COPY OF THE APPLICATION TO THE COURT SHOWING
WHY PETITIONER BELIEVES YOU MA¥ BE UNABLE TO TAKE CARE OF YOIIRPERSONAL
NEEDS ARD FINANCIAL AFFAIRS. BEFORE THE COURT M~K~$ THE A~POINTMENT OP
SOMEONE TO MAKE DECISIONS FOR YOU, THE COURT HOLDS A ~F_%RING AT WHICH
YOU ARE ENTITLED TO BE PRESENT AND TELL THE JUDGE IF YOU DO NOT WANT
ANYONE APPOINTED. THIS PAPER TELLS YOUW~ENTHE COURT HEA~RT_NG WILL TAKE
PLACE. IF YOU DO NOT APPEAR IN COURT, YOUR RIGHTS MAY BE SERIOUSLY
AFFECTED.
LAW OFFICES OF JOHN T, SNELL, PC - :201 WEST BAY PLAZA - PL.A'I-rSBURGH, NEW YORK 12901 - (518) 561-7190
EXHIBIT "D"
09/24/03 15:28 FAX
YOU HAVE THE RIGHT TO DEHAND A TRIAL BY JURY. YOU MUST T~LL THE
COURT IF YOU WISH TO HAVE A TRIAL BY JURY. IF YOU DO NOT TELL THE COURT,
THE HEARING WILL BE CONDUCTED WITHOUT A JURY.
THE NAMEANDADDRESSANDTELEPHONENUM~ER OF THE CLERKOF T~r~.COURT
ARE: JAN LAVIGNE, COUNTY/SUPREME COURT CLEI~K, CLINTON COUNTY GOVE~
CENTER, 137 MARGARET STREET, PLATTSBURGH, NEW YORK 12901, (~15) 565-
4715.
TE PARAGRAPH IF A~PROPRIATE] THE COURT HAS
EVALUATOR~PLAIN THIS PROCEEDING TO YOU AND TO INVESTIGATE T~E
CLAIMS MADE IN T~LICATION. THE COU~T MAY GIVE THE COURT EVA~UATOR
PERMISSION TO INSPEC~UR MEDICAL, PSYCHOLOGICAL, OR PSYCHIATRIC
RECORDS. YOU HAVE THeE RIG~ELL THE J~IDGE IF YOU DO NOT WANT THE
COURT EVALUATOR TO BE GIVEN THAT"P,E, RMISSION.
i THE COURT EVALUATOR S NAMe, ~ .
YOU ARE ENTITLED TO HAVE A LAWYER OF YOUR CHOICE REPP, ESENT YOU. IF
YOU WANT THE COURT TO APPOINT A LAWI~ER TO HELP YOU AND REPR~SF/~T YOU,
THE COURT WILL APPOINT A LAWYER FOR YOU. YOU WILL BE REQUIRED TO PAY
THAT LAWYER UNLESS YOU DO NOT HAVE THE MONEY TO DO SO.
LAW OFFICES OF JOHN T. SNELL, PC - 201 WEST BAY PLAZA - PI_A'I-I'SBURGH, NEW YORK 12901 - (518) 561-7190
~05
~ 04
09/24/03 15:28 FAX ,
[DELETE
ATTORNEY FOR YOU TO PROTECT YOUR INTEREST IN THIS PROCEEDING.
PARAGRAPH IF APPROPRIATE] THE COURT HAS A~POINTW. D AN
T~E
RIGHTS:
AT THAT H~RING AND IN THIS PROCEEDING YOU HAVE THE FOLLOWING
YOU HAVE THE RIGHT TO PRESENT EVIDENCE.
YOU HAVE THE RIGHT TO CALL WITNESSES, INCLUDING EXPERT
WITNESSES.
YOU HAVE THE RIGHT TO CROSS-EXAMINE WITNESSES, INCLUDING
ANY WITNESS CALLED BY THE COURT.
YOU HAVE THE RIGHT TO BE REPRESENTED BY A LAWYER OF YOUR
CHOICE. IF YOU WANT THE COURT TO APPOINT A LAWYER TO HELP
YOU AND REPRESENT YOU, THE COURT WILL A~POINT A LAW~ER
FOR YOU. YOU WILL BE REQUIP,ED TO PAY THAT LAWYER UNLESS
YOU DO NOT HAVE THE MONEY TO DO SO.
2. Said Guardian, if appointed for you, shall have the authority
to exercise the following Dowers on your behalf.
PROPERTY MANAGEMENT POWERS
Collect all income, including but not limited to Social
Security, dividends, interest and pension;
2.2~
Endorse, collect, negotiate, deposit and withdraw Social
Security, Veterans Administration and/or other pension,
annuity or benefit checks and/or negotiable instruments;
2.3 .
Apply for government and private benefits on behalf of
the Alleged Incapacitated Person;
2 .4,
Deal with Medicare and Medicaid claims, litigation and
LAW OFFICES OF JOHN T. SNELL, PC - 201 WEST BAY PLAZA - PLATTSSURGH. NEW YORK 12901 - (518) S~1-7190
09/24/03. i5:2~ FAX
[~05
2.5.
2.6.
2.7.
2.8.
2.10.
2.1!.
2.12.
2.13.
2.14.
2.15.
2.16.
2.17.
settlement;
Claim, negotiate, obtain and settle claims and actions
for government entitlements and benefits of all kinds
with all government administrations and agencies;
Deal with all pension, retirement incentive,
IRA~Keogh~StP and similar type plans, programs and
annuities;
Sign tax returns and deal with all federal, state and
local tax authorities on all claims litigation,
settlements and other matters;
Marshal the Alleged Incapacitated Person's assets, and
invest and reinvest such assets as a prudent person of
discretion and intelligence in such matters seekin9
reasonable income, and apply so much of the income and
principal as necessary for the Alleged Incapacitated
Person's comfort, support, maintenance and well-being;
Pay the funeral expenses of the Alleged Incapacitated
Person;
Pay bills after the death of the Alleged Incapacitated
Person if incurred prior to said death, if authority to
pay any such bill would otherwise have existed;
BUy and sell stocks, bonds and Treasury bills;
Make statutory claims and elections;
Implement and make tax savings decisions;
Retain attorneys concerning the Alleged Incapacitated
Person's property and affairs an~ pay the same, subject
to prior approval of the Court;
Retain accountants, investment counsel and similar
professionals concerning the Alleged Incapacitated
Person's property and affairs and pay the same subject zo
prior Court approval;
Handle all banking transactions;
Apply for, pay and handle all claims and settlements
including insurance transactions;
LAW OFFICES OF JOHN T. SNELL, PC - 201 WEST BAY PLAZA - PLA'UI'-~BURGH, NEW YORK 129oI . (518) 551.7190
09/24/03. 15:2~ FAX
~]06
2.18. Handle estate transactions;
2.19. Defend or maintain any civil judicial proceeding;
2.20. Access confidential financial records, reports and
statements;
2.21. Access safe-deposit boxes/vaults/safes, if any;
2.22. Provide for the Alleged Incapacitated Person's
maintenance and support; and
2.23. Any other power which the Court in its discretion shall
deem appropriate to meet the Alleged Incapacitated
Person's property management needs.
PERSONAL NEEDS POWERS
2.24. Make decisions ~egarding general environment and other
social aspects of life of the Alleged Incapacitated
Person;
2.25. Determine whether the Alleged Incapacitated Person should
travel;
2.26. Consent or refuse generally accepted routine or major
medical or dental treatment;
2.27. Choose the Alleged Incapacitated Person's place of abode;
2.28. Access and disclose medical and confidential records; and
2.29. Any other power which the Court in its discretion shall
deem appropriate to meet the Alleged Incapacitated
Person's personal needs.
On reading and filing the annexed Petition of DAVID BURLEIGH, duly
verified the ~ day of August, 2003, from which it appears that
LORRAINE LEWANDOWSKI, the Alleged Incapacitated Person above named,
resides at 6527 Route 22, Plattsburgh, NY 12901, and is presently unable
to manage her person and property by reason of illness, infirmity and
mental weakness; and it appearing that the Alleged Incapacitated Person
ow~s and possesses certain real and personal property within and withou~
the State of New York,
LET LORRAIATE LEWANDOWSKI, the Alleged InCapacitated Person a~d the
~ CO%L~sel for the AIP [Delete as applicable] appointed
~WOFFICESOFJOHNT,$NELLPC-201WESTBAYPLAZA-P~'CI'$~URGH. NEWYORK12901-(~tS) 56"J~90
09/24/03. 15:2~ FAX
[~07
distributees o~ LORRAINE LEWANDOWSKI, being MARGA/~ET ~BROWN, ESTHER
BURLEIGH, T~LERESA GRIBBIN, JEAN 0'NEILL, FRANCIS PALOMBO, GEORGE
PARROTTE, the Clinton County Department of social Services, and the
Cumberland County Office of Aging & Community Services,
SHOW CAUSE before the Justice of this Court, at a hearing to be
held in the County of Clinton, at the Government Center, 137 Margaret
Street, Plattsburgh, New York '12901 on the ~L~ day of ~o~ ,
2003, at ~:~0 /l~./p.m. of that day or as soon thereafter as counsel
can be heard,
WHY an Order should not be made and entered herein, appointing a
Guardian of the personal needs and property management of LORRAINE
LEWANDOWSKI within the State of New York, based upon qualifying in
accordance with the laws of the State of New York;
WMY Petitioner shall not have such other and further and different
reliaf as may be just and proper.
SUFFICIENT reason appearing therefor, it is
O~ , having offices ~
_ , is hereby appointed
COURT EVALUATOR herein to exp~oceeding to LORRAINE
LEWANDOWSKI, the Alleged IncapacitatedPerson,~estigate'the
claims mad~ ~n th~ ~ .......... L .... ~ ~=~~h zf_ .p~on and ~t
is further
COUNSEL FoR AIP herein to ~xplain this proceeding to LORRAINE
LEWANDOWSKI, the Alleged Incapacitated Person, to protect her interest
in this proceeding; [Delete paragraph if appropriate] and it is further
ORDERED, that this Order to Show Cause and. a copy of the Petition
upon which it is based shall be served upon LORRAINE LEWANDOWSKI, the
person alleged to be incapacitated, by personally delivering them to
LORRAINE LEWANDOWSKI not less than fourteen (14) days prior to the
return date of this Order to Show Cause, and if the person alleged to be
incapacitated is not served at her residence, a copy of this Order to
Show Cause and the Petition shall be left at her residence; and it is
further
ORDERED, that the Order to Show Cause and a copy of the Petition
shall be served by reqular mail postage pre-paid or by personal delivery
to the office
LAW OFFICES OF JOHN T. SNELL, PC - 201 WEST BAY PLAZA - PLATTSBURGH, NEW YORK 12g01 - (518) 561-7190
09/24/03 15:28 FAX ~08
~L<QI~~o Ik. ~7~L~the Court-appointed COUNSEL FOR AIP, within
seven (7) days-followin~Jthe appointment of said
~ A ~'~ [Delete as appropria%e] and ztuis further
ORDERED, that this Order to Show Cause and a copy of the Petition
shall be served by regular mail postage prepaid upon the Clinton County
Department of Social Services and the Cumberland County Office of Aging
& Community Services within seven (7) days following the date' this Order
to Show Cause is signed; and it is further
ORDERED, that this Order to Show Cause and a copy of the Petition
shall be served by regular mail postage prepaid upon MARGARET BROWN,
ESTHER BURLEIGH, THERESA GRIBBIN, JEAN O'NEILL, FRANCIS PALOMBOj GEORGE
PARROTTE not less than seven (7) days prior to the return date of this
Order to Show Cause; and it is further
ORDERED, that the Counsel for AIP ~r [Delete
as appropriate] appointed herein shall comply with Part 36 of the Rules
of the Chief Judge and file the 'certificate required by Section 36.1(d)
and the notice of appointment required by Section 36.3 of the Rules of
the Chief Judge.
ENTER :
Judge; County C~u~
LAW OFFICES OF JOHN T, SNELL, PC - 201 WEST BAY PLAZA - PLATTSBURGH, NEW YORK 12901 - (S18) .~81-7190
09
09/24/03 15:28. FAX
COUNTY COURT OF TME STATE 0F NEW YORK
COUNTY .OF CLINTON
In the Matter of the Application of
-X
DAVID RURLEIGH,
I~dex No.: 03-0898
for the Appointment of a Guardian of
Ehe Person and Property of
V~RIFIED PETITION
LORRAINE LEWANDOWSKI,
an Alleged Incapacitated Person.
X
TO TR~ COUNTY COURT, STATE OF NEW YORK, COUNTY OF CLINTON:
The petition of DAVID BURLEIGH, respectfully states and alleges:
PETITIONER
That your petitioner is DAVID BURLEIGH and resides at 6527 Route
22, Plattsburgh, New York 12901, telephone number (518) $61-5896.
Your petitioner is the nephew of the Alleged Incapacitated Person.
As such, your petitioner is familiar with the facts 'an~
circumstances regarding the background and living conditions of
LORRAINE LEWANDOWSKI, which necessitates this Court proceeding to
bring help to the Alleged Incapacitated Person.
JURISDICTION
That your petition invokes the jurisdiction of this court pursua/%t
~o Mental Hygiene Law section 81.04(2).
That LORRAINE LEWANDOWSKI has been adjudged'an ~-ncapacitated person
by the Court of Common Pleas of Cumberland County, Pennsylvania,
Orphans' Court Division, Honorable Edward E. Guido, J, dated June
6, 2003, a copy of which i~ attached hereto and made a part hereof
as exhibi~ "A.'
That a copy of the Petition in the aforesaid proceeding is attached
hereto and made a part hereof as exhibit
That petitioner repeats and re-alleges all of the allegations
contained in the aforesaid petition as if they were fully set forth
herein.
LAW OFF;CE$ OF JOHN T. SNELL. PC -201 WEST BAY PLAZA - PLA'I-FSBURGH. NEW YORK 12901 -(St8) 561-7190
09/24/03 15:28 FAX ~10
10.
ALLEGED INCAPACITATED PERSON
That LOR/~AINE LEWANDOWSKI is 77 years of age. she currently
resides with petitioner, having resided there since June 6, 2003.
That I was notified of the proceeding in Cumberland County, PA on
or about January 2003. Tha~ my wife and I traveled to Pennsylvania
in order to appear at the hearing scheduled on June 6, 2003. That
upon arrival and after seeing the condition of my aunt and the
conditions she was living in, I removed her from her apartment and
returned her to Plattsburgh. Neither my aunt nor I appeared at the
hearing.
Upon information and belief, none of LORRAINE LEWANDOWSKI's
immediate siblings offered to assist her. Each of them is elderly
themselves. None were listed in the aforesaid petition. None live
near Cumberland County, PA.
That I have considered LORRAIN~ LEWANDOWSKI's abiiiuy to manage the
commonly recognized activities of daily living: bathing, dressing,
toileting, tr~sferring (getting in and oUt of a chair or bed) and
continence (voluntary bowel and bladder f%t~lctions). LORPJ~iNE
LEWANDOWSKI baths herself; she ca~ dress herself with assistance;
she can walk without assistance; she can feed herself but cannot
prepare her own meals; she can toilet hereself; she does not need.
assistance to stand up from a chair or to get out of bed.
N~D FOR PROPERTY MANA~EMENT
AND PERSONAL NEEDS POWERS
Because of the aforementioned infirmities, advanced age and
illness, LORRAINE LEWANDOWSKI has been unable to manage her
property and personal needs. The appointment of a Guardian of her
Property Management and Personal Needs will ensure her
preset-ration, maintenance and care of her'personal and financial
affairs.
11.
POWERS BEING SOUGHT
I am seeking particular property management a~d/or personal needs
powers. I am req%lesting that the Court authorize and empower the
Guardian to handle the following matters=
Property Management
collect all income, including but not limited to Social
LAW OFFICES OF JOHN T. SNELL, PC - )-01 WEST 5AY PLAZA - PLA'~'Sr~URGH, NEW YORK 12901 - (Sla) 561-71a0
09/24/03 15:28 FAX 11
C ~
ho
j o
Security, dividends, interest and pension;
endorse, collect, negotiate, deposit and withdraw Social
Security, Veterans Administration and/or othis pension,
annuity or benefit checks and/or negotiable instruments;
apply for government and private benefits on behalf of
the Alleged Incapacitated Person;
deal with Medicare and Medicaid claims, litigation and
settlement;
claim, negotiate, obtain and settle claims and actions
for government entitlements and benefits of all kinds
with all government administrations ~nd agencies;
deal with all pension, retirement incentive,
IRA/Keogh/SEP and similar type plsuas, programs and
annuities;
sign tax returns and deal with all federal, state and
local tax authorities on all claims litigation,
settlements and othis matters;
marshal the Alleged Incapacitated Person's assets, and
invest and reinvest such assets as a prudent person of
discretion a/id intelligence in such matters seeking
reasonable income, and apply so much of the income and
principal as necessary for the Alleged Incapacitated
Person's comfort, support, maintenance and well-being;
pay the funeral expenses of the Alleged Incapacitated
Person;
pay bills after the death of the Alleged Incapacitated
Person if incurred prior to said death,.if authority to
pay any such bill would othiswise have existed;
buy and sell stocks, bonds and Treasury bills;
make statutory claims and elections;
implement and make tax savings decisions;
retain attorneys concerning the Alleged Incapacitated
Person's property and affairs and pay the same, subject
to prior approval of the Court;
LAW OFFICES OF JOHN T. SNELL, PC - 201 WEST BAY PLAZA - PLATI"~BURGH, NEW YORK 12901 - (518) 561-71 DO
09/24/03 15:28 FAX ~ 12
Vo
aa,
bb.
retain accountants, investment counsel and similar
professionals concerning the Alleged Incapacitated
Person's property and affairs and pay same subject to
prior Court approval;
handle all banking transactions;
apply for, pay and handle all claims and settlements
including insurance transactions:
handle estate transactions;
defend or maintain any civil judicial proceeding;
access confidential financial
statements;
records, reports and
access safe-deposit boxes/vaults/safes, if any;
provide for the Alleged
maintenance and support; and
Incapacitated
Person's
any othis power which the Court in its discretion shall
deem appropriate to meet the Alleged Incapacitated
Person's property management needs.
Pe=sonal Needs
make decisions regarding general environment and other
social aspects of life of the Alleged Incapacitated
Person;
determine whether the Alleged Incapacitated Person should
travel;
consent or refuse generally accepted. ~outine or major
medical or dental treatment;
choose the Alleged Incapacitated Person's place of abode,
including the ability to place her in a nursing home as
defined by the Public Health Law;
access and disclose medical and confidential records; and
any other power which the Court in its discretion shall
deem appropriate to meet the Alleged Incapacitated
Person's personal needs.
LAW OFFICES OF JOHN T, SNELL, PC - 201 WEST BAY PLAZA - PLA'/=t'SBURGH, NEW YORK 12901 - (818) S61-7190
09/24/05 15:26 FAX ~13
12.
13.
14.
15.
FINANCIAL RE~0URCES
As it is necessary to marshal assets of LORRAINE LEWANDOWSKI, the
Alleged Incapacitated Person, to meet current obligations for her
medical care, treatment and other purposes, and as there is no
possible question as to h~r inability to do so, it is important
that a Guardian be appointed, as soon as possible, to access the
bank account(s), spend down to the permissible Medicaid resource
level, create the permissible luxury and burial accounts, and
assis~ LORRAINE LEWANDOWSKI in filing a Medicaid application on
LORRAINE LEWANDOWSKI's behalf.
That petitioner's alleged plan of protective management is as
follows: to maintain LOR/~AINE LEWANDOWSKI in my home for as long as
possible and then to move LORRAINE LEWANDOWSKI to a skilled Dursing
facility with appropriate care as needed.
That all of the assets and income of LORi~AINE LEWANDOWSKI are
alleged to be placed under said Guardianship.
That the anticipated duration of the Guardianship should be
indefinite.
16.
I.NTERESTED PARTIES
That the family, or distr~butees, of LORRAINE LEWANDOWSKI to the
best of petitioner's knowledge are:
Name
Margaret Brown
Esther Burleigh
Theresa Gribbin
Jean O'Neill
Frances Palombo
George Parrotte
Address
595 Columbus Ave.
New York, NY 10024
18 Terrace West Way
Plattsbur~h, NY 12901
906 Fassett Road
Elmira, NY 14905
9023 Del Rio
Grand Blanc, MI 48439
9 Sacandaga Road
Scotia, NY 12302
187 Emmons Street
Dannemora, NY- 12929
Telephone No.
212.721.4797
518. S6!. 3152
607.733.~733
810.694.5366
518.346.4710
~!8.492.1030
Relationship
Sister
Sister
Sister
Sister
Sister
Brother
LAW OFFICES OF JOHN T. SNELL, PC - 201 WEST BAY PLAZA - PLA'I'I'SBURGH, NEW' YORK 1290'1 . (~lS) 561.7190
09/24/03 15:28 FAX ~ 14
17.
18.
19.
20.
22.
23.
PROPOSED GUARDIA~
That your petitioner requests that this Court appoint himself as
the Guardian of LORRAINE LEWANDOWSKI's person and property.
That Judy Ryan, ProtectiVe Services Caseworker, Clinton County
Department of Social Services Adult Protective unit has conducted
a home visit of our home after June 6, 2003. Upon information and
belief, she found our home to be an acceptable placement for
LOR2QAINE LEWANDOWSKI.
That my wife and I are certified Foster Care Parents, mlthough we
have not accepted a child into our home for the last two years.
OTHER INFORMATION
That for the personal well-being of the Alleged Incapacitated
Person, it is necessary that LORRAINE LEWANDOWSKI be declared
unable to address her personal needs or manage her property within
the State of New York and elsewhere and that some proper person be
appointed Guardian for her personal needs and property management.
All resources available to LORRAINE LEWANDOWSKI have been
considered by your petitioner and relief is still necessary under
Article 81 of the Mental ~ygiene Law.
That no previous application for the relief herein requestmd has
been made to this Court.
That the questions of fact arising upon the inability of LORRAINE
LEWANDOWSKI, the person with respect to whom petitioner prays for
the appointment of a Guardian, be set down for a hearing or be
tried by the Court at Special Part hereof, to be held in the County
of Cli~on, at the courtroom located at 137 Margaret Street,
Plattsburgh, New York, on such day as this Court may direct and
that the case be placed at the head of the calendar and be disposed
of at said term of Court and that the Justice presiding act as the
presiding Officer at said hearing.
WHEREFORE, Petitioner prays:
That the Court direct a hearing to determine the issue of
competency;
That a Guardian of .the person and property of LORRAINE
LEWANDOWSKI, the Alleged Incapacitated Person, be appointed;
LAW OFFICES OF JOHN T. SNELL. PC - 201 WEST BAY PLAZA - PLATTSBURGH, NEW YORK '/2901 - (518) 581-7'/90
09/24/03. 15:2~ FAX ~15
DATED:
That the annexed Order to Show Cause be signed by this Court;
That in the discretion of the Court, some proper person be
appointed Court Evaluator or Counsel.or both in the Court's
discretion for the said LORi~AINE LEWANDOWSKI, the Al!e~ed
Incapacitated Person, to investigate the claims made in this
application and give guidance to the Court and, further, to
protect his interests in this proceeding.
That the petitioner have such other, further or different
relief as may be just and proper.
Plattsburgh, New York
August(~-'~'~ , 2003
'LAW OFFICES OF JO~ T. SNELL, PC
A. ELL, Esq.
Attorney for Petitioner
201 West Bay Plaza
Plattsburgh, New York 12901
(518) 561-~190
LAW OFFICES OF JOHN T. SNELL, PC' - 201 WEST BAY PLAZA - PLA'~'SBURGH, NEW YORK 12901 - (518) 561-71~0
09/24/03. 15:25 FAX ~16
VERIFICATION
STATE OF NEW YORK )
)ss.:
COUNTY OP CLINTON )
DAVID BURLEIGH, being duly sworn, ~eposes and says: that he is the
petitioner in the within entitled action; that he has read the foregoing
petition and knows the contents thereof, and that the same is true to
his own knowledge except as to matters therein alleged upon information
and belief and that as to those matter, he believes it to be true.
DAVID BLIRLE I G~I
Sz~_~ to before me this
~ of Aunt, 2003
Notary Public
Comm. Exp. ~{2'~/~.~O~--
OFFICES OF JOHN T. SNELL. PC - 201 WEST BAY PLAZA - PLA3=rSBURGH, NEW YORK 12901 - (518)
09/24/03 15:2~ FAX ~l?
EXHIBIT A
09/24/03, 15:2~ FAX ~18
IN 'RE:
LORRAINE A. LEWANDOWSKi,
AN ALLEGED INCAPACITATED
PERSON
IN THE COURT OF CO,OM PLEAg OF
CUI~IBERLAND COUNTY, PEAYNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-2003-399
QRDER .OF.. COURT
AND NOW, this 6th day of June, 2003, after
hearing, we find by clear and convincing evidence that Lorraine.
A. Lewandowski is an incapacitated person. The Curaberland
County Office of Aging is hereby appointed permanent and plenary
guardian of her person and estate.
the
Edward E. Guido, J.
Anthony L. DeLuCa, Esquire
For the Area Agency on Aging
Daniel Worley, Esquire
For Lorraine A. Lewandowski
Area Agency on'Agin~
A TRUE COPY FROM RECORD
In TesTJ, mony wl~, I hereunto
of said Coull at C.,artl~ PA ,
09/2~/03, 15:2& FAX
EXHIBIT B
09/24/0~. ~5:2~ FA~
~20
IN R_E: Lorraine A. Lew~udowski
au alleged incapacitated person
' IN THE COIfRT OF COM]viON PLEAS OF
· CUlv[BB~ CO~, PENNSYLVANIA
· ORPHANS' COURT DMSION
- NO. 21-2003-399
IM_PORT~ NOTICE
· CITATION WITH NOTICE
A petition has been filed with the Court to trove you d¢clared an Incapacitated Person. If the
Court finds you to. be an Incapacitated Person, your rights will be affected, ihcluding our fight lo manage
money and properW and to make decisions. A copy of the petition which has been filed by A_rea Ar, ency
Of Aging is attached.
You are hereby ordered to appear at a hearing to be held in Court RoomNo} L Cumberland
County Courthouse, Carlisle, Permsylvmia, on Iune 6 ., 200__~3 at 9:30 A..._M. to tell the
Court why is should not fittd you to be an incapacitated Person and appoint a Guardian to act on your
behalf.
To be aniucap acitated Person meam that you are not able to receive and
effectively evaluate information md. communicate decisions and that you are unable to
m~nage .your money md/or other property, or to make necessary decidou~ about where
you will live, what medical care you ~ get, or how your money will be spent
,at the heating, you have the right to appear, to be represented.by an attorney, and
to request a jury trial. I/you clo not have an attorney, you have the right to request the
Court to appoint an attorney to represent you and to have the attorney's fees pa/d for you
if you cannot'afford to pay them yourself. You Mso have the right to request that the
Court order that an independent evaluation as to your alleged incapacity.
'.r/the Court decides that you are an Incapacitated person, the Court may appoint
Guardian for you, based on the nature of any condition or disability and your capacity t~
09/24/03, 15:2~ FAX ~21
m~<c and communicate decid~nm Tho C-~.ardian will 5¢ o£your person amd/or yo~
money and' other property mud will ha'vt either limited o'f f-ull powers to act for you.
If~e court finds you are totally incapacitated, your fcgal fighfs will be affected
and you will no~ bc able to make a contract or gif~ of your money to other propcr~y. If the
court finds'that you are partially incapacitated, your legal rights will also be l~rnited as
directed by the Court.
If ymi do not appear at the.heaziug (either in person or by a.u attorney representing you)
the court will still hold the heating in yollr absence and may appoint the Guardian requested.
Cl~rk, Orphans' Court Division u .
Cumberland County, Carlisle, PA.
My Commission Expires 1*t Monday,
January, 200___~6
09/24/03,
15:2& FAX
~]22
IN TI{E I~LATTER OF TKE PERS ON
AND ESTATE OF:
~LORR&[NE. A- LEWANDOWSKI,
AN ?~T_LF-GED [NC_&PACITATED
PERSON
' IN ~ COURT OF CO~ON PLEAS OF
: CLrM~ERL_~u'qD COLrNTY, PENNSYLVANIA
COURT DMSION
PRELI~INA_RY DECItEE
~N'DNOW, this }~3-/4 dayo'f ~.~ ,2003, nponconsideration
of the -annexed Peritio. n, it is hereby ORDER_ED AND DECREED that a Hearing on th.is
manerisserforthe' ¢'r3q dayof~'L,LL~__-- ,2003, atO:~6 .A-__.M.
O'clock La Courtroom No, j_ at r. he Cumberlmnd Cotmry Courthouse, I Courthouse
Square, Carlisle, Pennsylvarfia.
i_nc ap acitared p ers on.
BY THE COURT,
TRUE COPY FROM RECORD
In Testimony ~flerof, ! hereunto
set my hand and ~e seal
of said ~ at Carlisle, PA, _
09/24/03, 15:2~ FAX
IN ~ I~GTYElt 0~ TtIE PEltEON
-AND ES/A?]E 0F~
LORRAm~ ~ LEWANDOWSKI,
AN ALLEGED L'qCAPACITATED
· ~q ~ COURT OF COM/ViON ~PLEAS OF
· CUMB[EkLAiN-D COUNTY, ]:ENNSYLVAN'IA
0KPEA_'~'S' COURT DMSION
NO.
PETITION FOR APPOLNTM~NT OF PERMANENT PLENARY GUARDL~.NS
OF TI-i~_ PERSON .~ND ESTATE
A_ND NOW COMES TF1Z PETITION-El{, the A_rea Agency on. Aging in and for
Cumberland County, Permsylv~nia, who represents and avers as follows:
The Petitioner is the Area Agency on A~ng, in and foz Cumberland County, with
its office located at 16 West High Street, Carlisle, Cumberland County, Pennsylvania.
2.
The alleged inca. pacitaed person is Lorra'me A. Lewandowski, ag~ 77, w15o
resides at 119 November Drive, Camp Hill, Cumberland County, Pennsylvania and h~
resided there for a period exceeding on~ '(1) year prior to the filing of this Petition.
3.
The only known relative of the alleged incapacitated perion i.~:
a. David Burleigh - nephew
652'7 Rte 22
Plattsburgh, New York
4.
On or about February 12, 2003, Lorraine A. Lewandowski contacted the Camp
Hill pohce department and advised the police that someone entered, her apazument and
stol~ $10,000.00 that was h/alden in a ~uitcase in a closet.
~23
09/24/03 15:25 FAX ~24
On or about F. ebrum-'y 21,.3_003, while fna ~ocery store. Lorraine A.
Lewmudowski went m'ound to different re,stets, s~d she had been shoppin=~ there ~11 of
her life m~d that someone had.told her that sh~ could get her groceries for fr~e.
6.
While in. the ~ocery smrc on Febn~ary 21,2003, she approached a complete
st~-an~¢r and claimed she hsd r~o money for food. The stranger purchased ~ocerfes for
her a_nd took her home where she insisted that the ~tran6er come into her cpartment
dcspff¢ a wamJn~ from the S{Tan=c~r that she should not let strand, ers inzo her apa~ent.
7.
~yesti~afion by Peti~oner has determined ¢hat Lorraine k. Lewandowski
to decline in .her ability to car~ for herself dufin=~ the latter part ofth~ summer of 2002
and has deteriorated more since zhe be~innin§ of 2003.
8.
'Durin=~ the month ofFeSru~'y, 2003, Lon-aine A, Lewandowski req~es.t~d the
apariment'compIex m~.. a=~,er to take her to the bcnk which she did end, while there,
Lorraine A. Lcwandowskj began to w/thdr~w a large amount of money bu~ was talked
ou~ off[ by the apartment complex
9.
Further investigation bY Petitioner reflects that:
A. AiLFh-st Bank, now M&T Bank, has ei=~ht (8) pa=~es of comments by
bank personn¢i wMch indicate her to be confused arid havinE difficulty
understandin~ htr recount balances;
09/24/03, ~$:25 FAX , ~25
Co
Addus, a horne.h~alt}: care agency, reports' ~at Lorraine A.
Lewandowski has refused ~ervices ~everal times and also report~ that
she cla/rned ~hat some unidentified woman she met in the elevator
purchased groceries for her;
She went to the bank on March 10, 2003 and accused people fi.om the
bank of entering her safe deposlr box. While there., she' could not find
her key to the s_afe deposit box nor to her aparument and wa~ so
irrational that the bank was required to call the police to have her
removed from ti~e premises;
Camp Hill Police repor~ ha~Sng an increased number of contacts with
her and that her behavior is becoming more irrational;
She stated to the Pro~ective Services worker for ~he Petitioner that on
March 12, 2003 two (2) men came into her apartmem the ai~t before,
went into a second bedroom .aD..d engaged in sex for abou'c one-half
(1/2) hour. While this alleged activity, was raldng place, Lorraine A.
Lewandowsld hid in a bathroom attached to her bedroom and wa~ sure
that they did not know she wa~ in the apartment;
Petitioner was Luforrned on March 21, 2003 by Ver/zon that h:r long
disiance serv/ce, not paid since September, 2002, had been term/hated
due to nonpayment 6fher bill and, since March 21, 2003, her regular
telephone service has been terminate~l for nonpayment of her 5il/; and
She is no longer able to operate the thermostat in her apartment nor is
she is able to prepare food for herself.
09/24/03. 15:3,8 FAX ~26
On or ab'out Apr{1 11, 2003, after being reminded by the apartment complex
manager that she had not ptid her rent: she showed up AllFirst Bank a~companied by
or three men between the ages of 18-and 20 who were previously u.nkno'kn to her where
she requested a check to pay her rent. She ir/dicated that she had no checks but bank
personnel confirmed'That a box of checks had been sent to her in March, 2003. U?on
p. resenfing the check for her rant to the apartmen.r complex manager, she had to be
escorted back to her apartment b'ecause .qbe wa~ maabte to find her way back on her own.
ll.
On March 13, 2003, a psy.~holog/cal evaluation was conducted ofLorra/ne A.
L~w~ndowski by G. David Smith, Ph.D. cfR/versicle Assocjales, PC and the following
obse~atlon~ were noted from the report:
A. Early stages o£Dementia of the Alzheimer's
B. Adaptive functioning and ability to [ive. lndependently ~r.e si~ificantly
impaired;
C. Reports of changes i_n her behavior over the last six (6) months suggest that
the appearance of symptoms a~d reduction m function/rig
escalating;
D. Her disruptive and inappropr/ate social behavior represents a threat to her
ability to live on her own;
]~. She has lost interest in her d/et, food. and nutr/fion and her own reports
suggest that she neglect~ to eat appropri,.tely. Unsupervised and u_~upported,
09/24/03~ i$:2~ FAX ~ ~27
she could become mM. nourished wtdct would accelerate her decl~e
~catcn her health; ~d
F. 'She evid~ces si~ific~t deficits ~ all are~ of adaptive ~cfio~ng
including soci~ interaction, l~age comprehen~on ~d expression, eating,
sel-f-c~e, houschold's~ll¢, time aw'~¢n¢~, money h~dHng, and
12.
Pmkion¢r has deie~incd ~at Lo,sine A. Lew~ndo~s~ ha~ epproximzt¢ly
~5,38~.00 ~ hei chcc~ng acco~¢ end.may h~ve bonds in ¢ sef¢ d~osit box w~ch haw
not b~cn vc~fied.
15.
~e mon~ly ~ncom~ ofLo~e A. L~weudow~ki consists of~c following
SOUrCeS',
B.
C.
$590.00 - ~ocial S. ecu.rity;, ..
S138.00 - General Electric pension; and
$921.00 - U.S. Civi/Service pension
$~1649.00
Petitioner believes and,. therefore, avers that Lo.rrain¢ A. Lewandowstd will b e at
risk of death or irreparable harm without r. he appointmen~ of ~ Permaneut Plenary.
C-uardi~a of her Person and Estate:
15.
Petitioner believes a~d, thcref'ore, avers that Lorraine A. L~wandowski is best
suited to be placzd in au assisted living facility.
09/24/03 15:Z8 FAX ' ' ,. 929
issued upon Lorraine A. Lewandowski to show cause wlxy she should not be adjudged an
incapacitated person and that her nephew, David Burleigh, be appointed ~s Permanent
Plenary Guardian of the Person and EstaTe ofLorra/ne A. Lewandowski.
Respect~lly Submitted,
113 Front Street
P.O. Box 358
Boiling Springs, PA 17007
(717) 258-6844
09/24/0~ ~$:28 FAX ....
~30
VERJI~ICATION
I hereby verify that the facts and information s¢~ forth in the forego~ug Petkion for
-&ppo~ntm~t ofPe~cnt P~n~ O~s of the Person ~d Estate ofLo~ine A.
lcw~dows~ ~e t~e ~d co~ect to the be~ ofmy~owledge, ~fo~on, ~d belief. I
~derst~d that ~y false s~tm~ts cpntzined herein ~e zubject ~o the penalties of I g
Pa. C.S. Section 4904, relating to m~om 51sificafion to au~ofities.
Dated:
09/24/03, ~5:2~ FAX '' · ~27
she could become malnourished wkich woulc[ accelerate Her d~cl~e and
threaten her health; and
F, 'She evidcnce.~ ¢ignific~nt ~¢ficits in ali areas of adaptive functiordng
including social interaction, lan~,age comprehension and expression,
Petitioner h~ deia~ined ~t Lo.Circe A. L~wandow~ ha~ ¢pproximet¢ly
$3,38~.00 ~ hei chec~ng acco~¢ and.may hev~ bonds in ¢ safe d~osit box w~ch haw
not be~n v~fi¢d.
The monthly [ncom~ ofLo~¢ A. L~wm~dow~ consists of~¢ following
Petitioner believes ~. ~refora, aver~ that Lqma~¢ A. Lcw~dows~ will b c
G~d~ o~her Person ~d
~eddon~ beHev~ ~d, ~e~orc, Avers ~At Lo~z~e A. L~dowsk~ ~s best
s~tcd ~o be plzccd ~ ~ assisted 1i~g
09/24/03'
for her,
1'5':28 FAX
16.
Les~ res~ctNe altern~tive~ ~re not available because there {s no one able to care
17.
David Burlei~?21, the nephew of Lorraine A. Lew~dowski, is willing to accept the
appointment of?ermanent ?Ienary Gdardian of [he Person and Estate of Lorraine A.
Lewandowski.
· The nature of Petitioner's interest is that ora welfare agency.
i9.
David Burleigh has no inter~t that is adverse to the a/leged incapacitated person.
20.
To ?etifioner's knowledge, no previous application bm~ .been made for the Order
herein requestad or for a similar Oi'der.
No other Court has ever ~$u.mec[ juristict/on.in any proceeding to determi2e the
incapa~it-y of Lorraine A. Lewandow~ld,
22.
The failure to appoirit David Burleigh as Permanent Plenary Guardian of the
Person and]Estate of Lorraine A. Lewandow~ki wilI result'in irreparable harm to the
person and estate of Lorraine A. Lewandowsld.
~28
0
0
I r./}
o
~ 0
('~ I,-I
~0
0
CO
<:- 0
0~
mnherlani (gaunt (Office nf ging
16 West High Street, Carlisle, PA 17013
HUMAN SERVICES BUILDING
[717] 240-6110 or 697-0371, Ext. 6110
532-7286, Ext. 6110 Fax: 240-6118
website: www.ccl~a.net/a~in~
e-maih aeine~ccpa.net
Bruce Barclay
Chairman
Gary Eichelberger
Vice Chairman
Richard L. Rovegno
Secretary
Terry L. Barley
Director
FINAL GUARDIANSHIP REPORT
FOR LORRAINE LEWANDOWSKI
February 3, 2004
Report from Former Guardian of Person:
Cumberland County Office of Aging
Janet E. Paull, Aging Care Manager III
On June 6, 2003 Guardianship of Person and Estate for Lorraine A. Lewandowski was
granted by Judge Edward E. Guido to the Cumberland County Office of Aging. At the
time of the appointment, Ms. Lewandowski's nephew, David Burleigh, had removed
her from her home and transported her to his residence in Plattsburgh, New York. Ms.
Lewandowski was visited at least two times by the Protective Services worker for
Clinton County Social Services, New York. They reported that the client was being
well cared for by Mr. and Mrs. Burleigh.
On October 9, 2003 Judge Ryan of Clinton County Courts found Ms. Lewandowski to
be an incapacitated person and appointed David Burleigh as Guardian of her Person and
Property. On November 30, 2003 Judge Guido terminated the Permanent Plenary
Guardianship of the Person and Estate of Lorraine Lewandowski.
On January 23, 2003 Mr. Burleigh traveled to Carlisle and met with me. During his
visit, Mr. Burleigh reported that Ms. Lewandowski is now residing in a small personal
care home for women in Plattsburgh, New York and that she is doing fine.
HI_rMAN SERVICES BUILDING
(gumherlanil aunt (0ffire af 3t[tin6
& (gmnmunitl/ eruire
16 West High Street, Carlisle, PA 17013
[717] 240-6110 or 697-0371, Ext. 6110
532-7286, Ext. 6110 Fax: 240-6118
website: www.ccpa.net/agine
e-mail: aeine~ccpa.net
FINAL GUARDIANSHIP REPORT
FOR LORRAINE LEWANDOWSKI
Bruce Barclay
Chairman
Gary Eichelberger
Vice Chairman
Richard L. Rovegao
Secretary
Terry L. Barley
Director
February 3, 2004
Report from Former Guardian of Estate:
Cumberland County Office of Aging
Janet E. Paull, Aging Care Manager III
On June 6, 2003 Guardianship of Person and Estate for Lorraine A. Lewandowski was
granted by Judge Edward E. Guido to the Cumberland County Office of Aging. At the time
of the appointment, Ms. Lewandowski's nephew, David Burleigh, had removed her from her
home and transported her to his residence in Plattsburgh, New York.
Following the heating, the Office of Aging opened a new checking account for Ms.
Lewandowski at the branch of the bank where she banked. At that time it was an Allfirst
Bank We kept her remaining account open because her retirement and social security checks
were directly deposited into that account. Because the client's checkbook was never found
and because of the removal of the client from her home prior to the hearing, once her
monthly checks were deposited in that account, we would transfer the money into the new
account. A minimal balance was kept in that account. There was never any attempt by
anyone to access that account. We also closed out her Safety Deposit Box at PNC because
she had no other accounts at that bank. The bank's customer service person inventoried the
box. We then transferred the items to a new safety deposit box at Allfirst Bank. Because
Allfirst was later absorbed by M&T and the branch we had been dealing with was closed, we
again had to move the contents of her box. We opened a new box at the High Street, Carlisle
branch of M&T.
On October 9, 2003 Judge Ryan of Clinton County Courts found Lorraine to be an
incapacitated person and appointed David Burleigh as Guardian of her Person and Property.
On November 30, 2003 Judge Guido terminated the Permanent Plenary Guardianship of the
Lorraine Lewandowski
Guardianship Account 951214830
Check Date Description Payment/ Deposit/ Remaining
Number Debit Credit Balance
~6/6/03 Cash found in apt. 8057.82 $8,057.82
6/6/03 Transfer 5000.00 $13,057.82
6/13/03 Bank charge Safety Deposit Box Fee 16.00 $13,041.82
6/13/03 Money in safety deposit Box 540.00 $13,581.82
~101 6/17/03 Camp Hill Plaza Apts. Back Rent/Heat 2127.18 $11,454.64
102 6/17/03 Cumb. Co. Aging - home support (Feb-Apr) 89.40 $11,365.24
6/18/03 Cash found in apt 69.00 $11,434.24
103 6/26/03 'Budget Rental - moving expense 63.99 $11,370.25
104 6/26/03 U-Haul moving supplies 24.43 $11,345.82
105 6/26/03 Stor Mor storage expense 104.80 $11,241.02
6/30/03 Cash found in apt 25.56 $11,266.58
106 7/7/03 OSI Collection - phone 191.92 $11,074.66
107 7/7/03 PP&L electric 56.24 $11,018.42
108 7/7/03 NCO Financial - phone 67.66 $10,950.76
109 7/7/03 Cumb. Co. Aging - home support (May) 20.86 $10,929.90
110 7/7/03 Priscilla Whitman moving supplies 22.63 $10,907.27
7/18/03 Transfer from 1500.00 $12,407.27
111 7/28/03 Verizon phone 67.66 $12,339.61
112 7/28/03 PP&L electric 20.91 $12,318.70
113 7/30/03 Stor Mor storage expense 84.80 $12,233.90
114 8/18/03 PNC Bank - drill safety deposit box 95.00 $12,138.90
115 8/21/03 Cumb. Co. Aging - home support (Jun) 6.50 $12,132.40
8/21/03 Safety deposit box refund 13.33 $12,145.73
116 8/28/03 Stor Mor storage expense 84.80 $12,060.93
9/16/03 Verizon refund 67.66 $12,128.59
9/22/03 Transfer 3500.00 $15,628.59
117 10/1/03 Stor Mor - storage expense 84.80 $15,543.79
118 10/28/03 Stor Mor - storage expense 84.80 $15,458.99
10/28/03 Transfer 1500.00 $16,958.99
119 11/17/03 Cumb. Co. Aging - Riverside 765.37 $16,193.62
120 11/17/03 Voided $16,193.62
121 11/17/03 Stor Mor - storage expense ,84.80 $16,108.82
122 11/17/03 L. Lewandowski to close account 16108.82 $0.00
Lorraine Lewandowski
Guardianship Account 951214830
Income Housing Miscellaneous expense
Income Check Apartment Check
__Date Source Amount # Date Expenses Explanation Amount # Date Expenses Explanation Amount
'101 6/17/03 Camp Hill Plaza Back Rent/Heat $2,127.18 Safety Deposit
6/~6/03 Cash found in apt. $8,057.82 Apts. . (Feb-Apr) 6/13103 Bank withdrawal Box Fee $16.00
6/6/03 Transfer $5,000.00, 102 6/17/03 Cumb. Co. Aging Home support $89.40 103 6~26~03 Budget Rental Moving expenses $63.99
Money in safety 106 7/7/03 OSI Collection Phone $191.92
6/13/03 deposit Box $540.00 104 6~26~03 U-Haul Moving supplies $24.43
'6/18/03 Cash found in apt $69.00 107 7/7~03 PP&L Electric $56.24 105 6~26~03 Stor Mor Storage expense $104.80
6~30~03 Cash found in apt $25.56 108 7/7/03 NCO Financial Phone (May) $67.66 110 7/7/03 Priscilla Whitman Moving supplies $22.63
7/18/03 Transfer $1,500.00 109 7~7~03 Cumb. Co. Aging Home support $20.86 113 7~30~03 Stor Mor Storage expense $84.8~
Safety deposit box 111 7~28~03 Verizon Phone $67.66 Drill safety
8/~21/03 refund $13.33 114 8/18/03 PNC Bank deposit box $95.0R
9/16/03 Verizon refund $67.66 1~2 7~28~03 PP&L Electric $20.91 116 8~28~03 Stor Mor torage expense $84.8~
,115 8121103 Cumb. Co. Aging Home support $6.50
9~22~03 Transfer $3,500.00 (Jun) 117 10/1/03 Stor Mor Storage expense $84.80
10/28/03 Transfer $1,500.00 118 10/28/03 Stor Mor Storage expense $84.80
119 11/17/03 Cumb. Co. Aging Riverside $765.3?
121 11/17/03 Stor Mor Storage expense $84.80
122 11/17/03 _. Lewandowski Close account $16,108.8~
20,273.37 $2,648.33 $17,625.04
Income received 20,273.37
Housing exp -2,648.33
Misc exp -17,625.04
0.00
Lorraine Lewandowski
Checking Account #55389503
Date Explanation Deposit Transfers Remaining
Beginning Balance
Balance $5,181.17
06/09/03 5000.00 $181.17
07/01/03 U.S. Civil Service 921.07 $1,102.24
07/01/03 G.E 100.38 $1,202.62
07/03/03 Social Security 590.00 $1,792.62
· 07/18/03 1500.00 $292.62
08/01/03 U.S. Civil Service 925.07 $1,217.69
08/01/03 G.E 100.38 $1,318.07
08/03/03 Social Security 590.00 $1,908.07
09/01/03 U.S. Civil Service 925.07 $2,833.14
09/01/03 G.E 100.38 $2,933.52
09/03/03 Social Security 590.00 $3,523.52
09/22/03 3500.00 $23.52
10/01/03 U.S. Civil Service 925.07 $948.59
10/01/03 G. E 100.38 $1,048.97
10/03/03 590.00 $1,638.97
10/25/03 1500.00 $138.97
11/01/03 925.07 $1,064.04
11/01/03 100.38 $1,164.42
11/03/03 590.00 $1,754.42
Bank check to close account 1754.42 $0.00
Riverside Associates, P.C.
2818 Green Street, Harrisburg, PA
(717) 238-6880
17110
PSYCHOLOGICAL EVALUATION
DATE OF EVALUATION: MarCh 13, 2003
DATE OF REPORT: March 26, 2003
CLIENT PROFILE
Name:
Date of Birth:
Etilnicity:
Gender:
Referral Diagnoses:
Current Medications:
Referral Source:
Case Manager:
Residence:
Lorraine Lewandowski
February 19, 1926
Caucasian
Female
Rule out Dementia and Psychotic Disorder
None
Cumberland County Office of Aging and Community Services
Jennifer Wolbach, Care Manager
Own apartment, Camp Hill, Pennsylvania
REASON FOR REFERRAL
Purpose/Method
Cumberland County Office of Aging and Community Services Care Manager, Jennifer
Wolbach referred Lorraine Lewandowski for a psychological evaluation on February 21st, 2003.
Ms. Wolbach asked that Mrs. Lewandowski be assessed for symptoms of paranoia and Age-
Related Cognitive Decline.
Information for this report was obtained through clinical and informant interviews and
direct observation of Mrs. Lewandowski's behavior conducted on March 13, 2003 between 11:15
am and 1:15 pm in Mrs. Lewandowski's apartment at 119 November Drive, Camp Hill,
Pennsylvania. Information was also obtained through follow up telephone interviews with Ms.
Wolbach on March 18 and 24, 2003. Ms. Wolbach reported that she has known Mrs.
Lewandowski for approximately four and one-half years. During this time, she visited Mrs.
approximately once or twice each year until November 2002 when she began to make monthly
visits.
Interviews conducted on March 13~ were structured and involved administration of the
Mini Mental Status Examination, Scales of Independent Behavior-Revised (SIB-R), and completion
of a checklist of symptoms associated with Dementia and Age-Related Cognitive Decline. Mrs.
Lewandowski and Ms. Wolbach served as informants for completion of the SIB-R and the
Dementia checklist
BACKGROUND/PERSONAL HISTORY
Mrs. Lewandowski lives alone in a two-bedroom apartment located on the second floor of a
multiple-unit apartment building at 119 November Drive, Camp Hill, and Pennsylvania. By her
account, she has lived at this address since she and her late husband moved to Camp Hill
approximately 25 years ago. Mrs. Lewandowski reported that her late husband died
approximately 20 years before the date of the interview. Subsequent information provided by Ms.
Wolbach placed Mr. Lewandowski's death at about six years prior to the present date. Mrs.
Lewandowski has not remarried and has been living alone at her current address since her
husband'S death. Mrs. Lewandowski reported having had no children or other living relatives in
the immediate area. She alluded to correspondence with a biological sister in upstate New York.
It was subsequently determined that this sister is suffering age-related decline and is no longer in
communication with Mrs. Lewandowski. The only relative presently involved with Mrs.
Lewandowski's care is a nephew living in upstate New York.
Mrs. Lewandowski reported that she is in good health, takes no medications, and has
perfect vision. This report was confkmed by Ms. Wolbach who indicated Mrs. Lewandowski's
most recent physical examination was approximately two or three years prior to the date of this
interview.
Mrs. Lewandowski reported that she was born in upstate New York and was one of at least
three children born to parents of French-Canadian decent. According to her recollection, she
completed high school with good academic performance and, after graduation, took an
administrative position with the General Electric Corporation in her home area. She reported that
she continued working for General Electric until she and her husband moved to Camp Hill,
Pennsylvania. Mrs. Lewandowski could not recall her age at the time of her marriage. She
reported that she was sure she took a new job after moving to Camp Hill, but could not recall the
name of her employer or the nature of her work. She reported to be certain however, that she had
retired at the same time as her husband.
Ms. Wolbach reported that Mrs. Lewandowski's late husband had suffered a prolonged
illness, and, during the terminal period of his illness, he and Mrs. Lewandowski began receiving
support through the Cumberland County Office of Aging and Community Services. Ms. Wolbach
reported that the Cumberland County Office of Aging and Community Services has been providing
case management services and arranging for errand services since then. Recently, she reported,
that the personnel providing errand services have had to make repeat visits due to Mrs.
Lewandowski's uncooperative behavior. Similarly, Ms. Wolbach reported that, during the past
year, Mrs. Lewandowski has not been cooperative with attempts to arrange needed health care
appointments. Often, this lack of cooperation is reported to have been related to Mrs.
Lewandowski's recurrent suspicion that those attempting to help her are some how ~taking
advantage of her.
Mrs. Lewandowski reported that she has never had many friends and seldom participated in
social events with groups of people. She related that she presently has no friends and does not
participate in any regular social activities in the community. According to Ms. Wolbach's report,
the manager of the apartment building provides some assistance to Mrs. Lewandowski (e.g. paying
bills), though Ms. Wolbach also reported that, despite this assistance Mrs. Lewandowski has not
paid her phone bill since September 2002 and is now facing termination of service.
CLINICAL INTERVIEW/BEHAVIORAL OBSERVATIONS
Mental Status Examination.
Mrs. Lewandowski is a woman with a medium build, medium length, and dark brown hair,
whose appearance was consistent with her chronological age. On the day of the interview, Mrs.
Lewandowski wore slacks, a matching blouse and, tennis .shoes. Her clothing was neat and clean
though somewhat baggy, suggesting recent (undocumented) weight l°ss. Informant reports
suggest that Mrs. Lewandowski has been subsisting on a daily diet of small amounts of fresh fruit,
milk, and little else for the past several months. Mrs. Lewandowski reported that she has perfect
vision and has never worn glasses. Observation of her behavior during the interview suggests that
her hearing is adequate. Mrs. Lewandowski was observed to walk well and exhibit good fine and
gross..,~,,~ ...... o,~,~o.V:"o She~ ..... '-t'"~ *~'q~,.,~ ..v"'~ phy~i~a!_ ~v . enrnplaint~w ........... Mrs. Lewandowski's .personal hygiene
appeared good. Her hair, fingernails and hands were clean, and there was no noticeable body
odor.
Prior to my arrival, Mrs. Lewandowski had been told that she was to be visited by a
doctor. When I arrived, she greeted me at the door to her apartment. The apartment was
noticeably dark, however, Mrs. LewandoWski turned on additional lights when asked. Visual
inspection of the apartment revealed the absence of a television (which Mrs. Lewandowski
reported she had had removed after her husband's death) and otherwise spartan furnishings. The
apartment appeared however, to have been well kept, clean, and relatively orderly.
Mrs. Lewandowski was polite and seemed to appreciate having a visitor. Rapport was
established and maintained relatively easily. She was cordial and socially appropriate (with some
exceptions noted below). Eye contact was established and maintained throughout the interview.
Mrs. Lewandowski was oriented to place, person, and present situation. Her orientation to
time was poor. When asked her age, she replied that she was about 200 years old. Later in the
interview, she referred to herself as 80 years old. She could not accurately name the season, date,
day, or month. She explained that she does not watch television or read newspapers and that when
she needs to know the day or date, she calls a telephone number (which she could not recall) for
this information.
Mrs. Lewandowski maintained attention to the interview relatively well. She responded to
most questions directly and offered spontaneous information freely. She did, however at times
express thoughts that were tangential to the conversation and perseverated on recollections of her
late husband frequently throughout the interview. Mrs. Lewandowski also expressed concerns that
she has not been receiving current bills, (e.g. telephone or electrical service), has lost her
checkbook, does not know where her bank is located, and needs to be wary of others who are
trying to steal her money. Also, at times during the interview Mrs. Lewandowski tended to
respond in an inappropriate and silly manner to questions as if they were trivial and not worthy of
answering. She interrupted her answers at times to comment about the examiner's appearance and
personality.
When asked to repeat three spoken object names, Mrs. Lewandowski did so immediately.
However she was not able to remember any of these object names three minutes later. Mrs.
Lewandowski recognized and named common objects (e.g. pencil and wristwatch), repeated
familiar phrases, followed a three-stage oral command, followed a written instruction, and wrote a
complete grammatical sentence, but refused to copy a design with intersecting pentagons. Mental
status examination revealed poor orientation to time, difficulty learning new material, and some
socially inappropriate responding.
Mrs. Lewandowski's mood was relatively normal and appropriate to the situation though
she was occasionally n;,h~,, and even silly i,, her interacticm~ with the examiner. Mrs.
Lewandowski's affect was congruent with mood. During the interview, she showed some signs of
suspicious thinking to the extent that she repeated her fears that someone (unnamed) may be trying
to steal her money. Mrs. Lewandowski evidenced no signs of depression and denied disturbances
of appetite or sleep. She denied suicidal and homicidal ideation. When asked, Mrs. Lewandowski
noted that she cries occasionally (no more than once weekly) when thinking about her late
husband.
BEHAVIOR ASSESSMENT
The SIB-R was completed during the Clinical interview based upon observation of Mrs.
Lewandowski, her own reports, and Ms. Wolbach's reports of Mrs. Lewandowski's current and
recent behavior. The SIB-R is a comprehensive measure of adaptive and problem behaviors. It is
designed to measure functional independence and adaptive functioning at home and in other
situations and to identify individual support needs. Scores allowed comparison of Mrs.
Lewandowski's current functioning to others of the same age. A table of scores summarizing the
outcome of this administration is attached.
Overall, Mrs. Lewandowski's functional independence is very limited (less than 99.5 % of
the reference group.) SIB-R results suggest that Mrs. Lewandowski is able to do tasks that others
her age can perform about 27 % of the time. Her greatest strength is in the area of motor skills
where she scored at the 34m percentile. Mrs. Lewandowski's social and communication skills are
limited (at the 1st percentile). Though Mrs. Lewandowski's language expression is very good, her
score was affected by her inability to retain, recall, and explain oral and written material such as
that contained in newspapers, magazines, or verbal lectures. Her score was also influenced by her
rare use of the telephone. Similarly, administration of the SIB-R revealed that Mrs. Lewandowski
is socially isolated and does not engage in activities with others. Her personal living skills
including eating, toileting, dressing, self-care, and domestic skills are very limited (at the 1~
percentile). Mrs. Lewandowski is apparently continent and this represents strength, however,
evidence suggests that she has become increasingly less interested in eating and presently does not
prepare cooked meals for herself. It is also notable that she no longer shops for herself and is
reported to rely on others to take the initiative for making appointments and looking after her
healthcare needs. Mrs. Lewandowski no longer operates a washing machine and reported having
little or no idea how to address simple household problems such as replacement of light bulbs and
fuses, setting the thermostat at a comfortable temperature, etc. Finally, Mrs. Lewandowski's
community living skills including her ability to manage money, tell time, and use community
resources is very limited (at the .5~' percentile). Reports revealed that Mrs. Lewandowski's skills
for managing money are negligible. This apparently represents a reduction in skills, which has
been noted during the past six months. Similarly, Mrs. Lewandowski's awareness of time is
significantly diminished. Reports indicate that, while she understands the function of community
resources, such as the post office, public transportation, banks, libraries, etc., she no longer avails
uet'~cn ut u,cac resources .,a ovnroeeocl c-nnfiminn ,hnnt how tO do so.
It was reported that Mrs. Lewandowski calls local police relatively frequently to report her
suspicions that (unnamed) others are planning to take advantage of her. It was also reported that
she has engaged in unusual social behavior in the local mall, once asking a grocery store clerk to
provide her free groceries in light of her advanced age. On another occasion she is reported to
have asked a salesperson in a local department store to help her find her late husband's picture
among those framed in a section of the store. Reports indicate that these behaviors have become
increasingly more frequent during the past six months.
Overall, the results of the SIB-R administration show that Mrs. Lewandowski presently
requires intermittent supports (much more than others her age) primarily because of very limited
adaptive behavior. Intermittent supports are required by individuals who may be able to manage
most daily activities marginally well but nevertheless need daily advice, support, assistance, or
supervision to do so effectively.
A checklist of symptoms associated with Dementia was completed based upon information
provided by Mrs. Lewandowski and Ms. Wolbach. Mrs. Lewandowski evidences memory
impairments illustrated by difficultly recalling her date of birth or age, inability to recall the nature
of prior employment, and problems learning new information such as the recollection of three
object names within three minutes. Mrs. Lewandowski however does not presently exhibit
symptoms of Aphasia, Apraxia, or Agnosia, though she evidences some minor disturbance of
executive functioning, especially in planning and abstract reasoning. Mrs. Lewandowski
misplaces objects of value (e.g. her checkbook) and shows lapses in associating activities with
times of day or day of week. She seems to be generally more fearful than in the past as evidenced
by her frequent reports to police of the suspicious behavior of others to perpetrate against her and
she is now less likely to engage in spontaneous activities that were previously typical for her such
as preparing hot meals.
DIAGNOSTIC FORMULATION
Mrs. Lewandowski presents as a socially isolated 77-year-old woman with diminished
cognitive and adaptive skills. Her cognitive -,and adaptive skill decline appears to have had a
gradual onset with a more rapid deterioration noted in recent months. Mrs. Lewandowski also
exhibits some disturbances of behavior suggesting diminished planning and abstract reasoning
ability. She expresses "suspicious" ideation including frequent and unfounded reports to local
police. Informant reports suggest that she has become increasingly negligent of her financial
obligations and personal care. Mrs. Lewandowski exhibits memory impairments greater than
would be expected for others her age though these are not presently extensive. Though she is
fairly persistent in reporting her suspicions and engages in some socially inappropriate behaviors,
she does not presently exhibit any clear signs of disturbed thinking (e.g. hallucinations or
delusions) usually associated with Psychotic Disorder.
Mrs. Lewandowski's presentation is consistent with the early stages of Dementia of the
Alzheimer's type. Evidence indicates that the deterioration of her cognitive functioning is
progressive and is becoming increasingly more rapid. Despite this however, the present frequency
and relatively mild severity of her symptoms suggests that her current condition is best described
as Cognitive Disorder, Not Otherwise Specified.
In summary, Mrs. Lewandowski diagnostic profile includes the following:
AXIS I:
AXIS II:
AXIS III:
AXIS VI:
AXIS V:
294.9 Cognitive Disorder, Not Otherwise Specified
V71.09 No Diagnosis
Rule out vascular disease
Moderate, social isolation with regard to primary support group
Mrs. Lewandowski current global assessment of functioning score is estimated to
be approximately 49, indicating a need for intermittent supervision and support.
DISCUSSION
Mrs. Lewandowski appears to evidence symptoms associated with the early stages of
Dementia of the Alzheimer's type. Her Adaptive functioning and ability to live independently
are significantly impaired. Reports of changes in her behavior over the last six months suggest
that the appearance of symptoms and reduction in functioning is progressive and escalating.
Though Mrs. Lewandowski presently requires intermittent (daily) supports, it is likely that
more intense supports including around-the-clock supervision will be required in the relatively
near (within one year) future.
Mrs. Lewandowski's disruptive and inappropriate social behavior represents a threat to her
ability to live on her own. Her tendency to be suspicious of others and fearful of her welfare has
increased and false complaints to local law enforcement have also increased in frequency. If this
trend continues, intervention will likely be required to forestall repeated disruptive calls to the
police. Though Mrs. Lewandowski appears to be in good health, it is also concerning that she has
lost interest in her diet, food, and nutrition and that her own reports suggest that she neglects to eat
appropriately (e.g. no longer cooking meals for herself). Unsupervised and unsupported, Mrs.
Lewandowski could become malnourished which would accelerate her decline and threaten her
health.
Mrs. Lewandowski evidences significant deficits in all areas of adaptive functioning
including social interaction, language comprehension and expression, eating, self-care, household
skills, time awareness, money handling, and safety awareness. These deficits are greater than
99% ofu~.,.h ......... o~.~.~,...~,.b~,.~rlF~'-'-°-n°or~ ,,.o...oOc'e"lte ,,fy. t~his oxmhmtinn~, -.--~.v.. m~o~e~t that Mrs. Lewandowski is an
"incapacitated person" who without daily supervision for portions of the day is unable to perform
activities of daily living and is at significant risk of harm.
Given reports of progressive deterioration in her condition, it is likely that deficits noted in
this report will become increasingly more serious as time passes. Though daily supervision and
other remedial environmental supports may slow Mrs. Lewandowski's decline, there is no
likelihood that her adaptive behavior deficiencies will improve or that her cognitive decline will
reverse.
6. David Smith, Ph.D.
Psychologist
Date
CC:
Mrs. Lewandowski
Ms. Wolbach
Riverside Associates Clinical File
7
REPORT OF ADAPTIVE BEHAVIOR TESTING
Lewandoski, Lorraine
March 13, 2003
Page 2
TABLE OF SCORES: Scales of Independent Behavior--Revised
Developmental Zone
CLUSTER/Subscale AE Easy Diff PR
BROAD INDEPEND 9-9 7-5 12-9 0.5
MOTOR SKILLS 7-9 5-8 10-3 34
Gross-Motor 5-2
Fine-Motor 10-10
SOCIAL/COMM 8-11 6-5 11-10 1
Social Inter 7-5
Language Comp 8-6
Language Expr 11-0
PERSONAL LIVING 12-5 9-9 15-2
Eating 9-6
Toileting 56[80]
Dressing 12-4
Self-Care 11-4
Domestic Skills 14-7
COMM LIVING 10-4 8-1 13-3
Time and Punc 7-10
Money and Value 12-7
Work Skills 11-4
Home-Community 10-10
SS SS Band RMI
61 59-63
94 89-99
62 57-67 19/90
1 62 59-65 25/90
Skill with
age-level tasks
27/90 ltd to very ltd
84/90 age-appropriate
ltd to age-app
limited
ltd to very ltd
very limited
ltd to very ltd
ltd to very ltd
ltd to very ltd
very ltd to ngl
age-appropriate
very limited
very limited
ltd to very ltd
13/90 very limited
very limited
very ltd to ngl
limited
very limited
0.5 61 57-65
Maladaptive Indexes
GENERAL MALADAPTIVE INDEX (GMI)
Internalized {IMI)
Asocial (AMI)
Externalized (EMI)
Score
-8
-9
2
-6
Level of Seriousness
normal
normal
normal
normal
SUPPORT SCORE: 76 (Intermittent Support)
AUTHORITY TO PAY COURT APPOINTED COUNSEL ",J ~ JUL 1 1 2003
1. COURT 2. VOUCHER
[] District Justice [] Common Pleas [] Appellate E] Other NO , ? 9 3 ?
5. I~,UDGET CODE
3~'~;T~oCRPp~-~LATE) 4. AT (clw/STC~Hisle' Pennsylvania
6. N THE CASE OF 7. CHARGE/OFFENSE (PURDON CITATION) 8. [3 Pl:l I~' OFFENSE
N RE: Lorraine ~. Lewandowski [3 FELONY [] MISDEMEANOR
9. PROCEEDINGS (Describe briefly) ! 1. PERSON REPRESENTED 12. CIVIL DOCKET NO.
, ~ Defendant-Adult 21-2003-399
2 [] Delendant -Juvenile
Guardianship Proceedings 3 a
4 E] Ai3pellee 13. CRIMINAL DOCKET NO.
5 E] Habeas Petitioner
6 [] Material W~tnesa
? E] Parolee Charged With Violation
10. PERSON, REPRE.SENT~.D (,Full Name), ,. 8 E] Probationer Charged With Violation 14. APPEALS DOCKET NO.
Lorraine A. LewanaowsKi 9 [30t.e~
5ii4i03 ~6. NAME OF ATtORNEY/PAYEE AND
ApOt Oate MAILING ADDRESS
Daniel D. Worley, Esquire
Edward E. Guido TURO LAW OFFICES
NAME OF COMMON PLEAS JUDGE ASSIGNED TO CASE 28 South Pitt Street
Carlisle, PA 17013
CLAIM FOR SERVICES OR EXPENSES
19. ,, SERVICE HOURS DATES AMOUNTS CLAIMED
a. Arraignment and/or Plea Multiply rate per hour times total
b. Preliminary Hearing hours to obtain "In Court" com-
pensation. Enter total below.
c. Motions and Requests
I~: d. Sail Hearings
g e. Sentence Hearings
f.3 f. Trial
Z
g. Revocation Hearings I .g Ul UI
h. Juvenile Hearings
i. Appeals Court 9A. TOTAL IN COURT COMP.
j. Other (Specify on additional sheets)
TOTAL HOURS =' 1.8 X~0 p~E~HOUR = $
81
!20. a. Interviews and conferences /I O ~/"J ~//I ~/~ Multiply rate per hour times total
: b. Obtaining and reviewing records ,.~ v, v, ~, , ,~ ,., hours. Enter total "Out of Court"
. u,. ~_ ~ compensation below.
Orr I c. Legal research and brief writing
8 8 d. Invesligarive and olher work (Specify o~ additJonaJ sheets) 20A. TOTAL OUT OF COURT
TOTAL HOURS = 4.2 x~ PER HOUR =
1 Rq nn
21. ITEMIZATION OF REIMBURSABLE EXPENSES AMT. PER ITEM ......
Mileage $.~per mile x
~- 21A. TOTAL ITEMIZED EXP.
O
40 miles to clients home and back $ I1:~0'0 7~'. ~'C =s
22. CERTIFICATION OF ATTORNEY/PAYEE -'~ 23. GRAND TOTAL CLAIMED
Has compensation and/or reimbumement for work In thla ca~® prevlouely ~.n applied for'? ID YES .1~ NO
Ilyes. wereyoupaid? [3 YES [3 NO Ifyes,bywhomwereyoupald? Howmuch?.
Has the person represented paid any money to you, or to your knowledge anyone else, in connection with the matter for 24. DEDUCT. P,I~OR PYMTS.
which you were appointed to provide representation? /~ YES 13[ NO _ If yes, give details on additional sheets == $
swear or affirm the truth or con'ectness ~ ..~, ~t,/--~l~ '"7-- I O -0,-~ 25. NET AMOUNT CLAIMED
of the above statements
Signature of..~/P~ee Date
Copy I - Mail to Court Administrator at completion of service
Person and Estate of Lorraine Lewandowski. Immediately prior to this action, all bank
accounts held in Ms. Lewandowski's name were closed and the funds sent to Mr. Burleigh.
Summaries of these accounts are attached.
On January 23, 2003 Mr. Burleigh traveled to Carlisle and met with me. At that time we
closed out the safety deposit box with a bank customer service person assisting in
inventorying the items against the original inventory. At that time we also transferred locks
on Ms. Lewandowski's property being stored Stor-Mor Storage in Carlisle, Pennsylvania.
The Office of Aging removed there lock and Mr. Burleigh put his own. Mr. Burleigh signed
off on inventory lists for both the Safety Deposit Box and the storage facility.
IN THE MATTER OF THE PERSON
AND ESTATE OF:
LORRAINE A. LEWANDOWSKI,
AN ALLEGED INCAPACITATED
PERSON
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: ORPHANS' COURT DIVISION
: NO. 21-2003-399
DECREE
AND NOW, this
annexed Petition, it is hereby ORDERED AND DECREED:
1.That the Permanent Plenary Guardianship of the Person and Estate of Lorraine
A. Lewandowski be terminated.
2.That the Court authorize Petitioner to release the assets and any other items of
personal property to her new Guardian, David Burleigh, appointed by the Court in the
State of New York.
3.That Petitioner is authorized to be reimbursed the sum of $765.37 from the
assets of Lorraine A. Lewandowski, which sum represents the cost of the psychological
evaluation of Lorraine A. Lewandowski by Riverside Associates, PC.
Anthony L. DeLuca, Esquire
For the Area Agency on Aging
Daniel Worley, Esquire
Attorney Lorraine A. Lewandowski
day of November, 2003, upon consideration of the
Area Agency on Aging
IN RE: : IN THE COURT OF COMMON PLEAS OF
LORRAINE A. LEWANDOWSKI, : CUMBERLAND COUNTY, PENNSYLVANIA
AN ALLEGED INCAPACITATED : ORPHANS' COURT DIVISION
PERSON :
: NO. 21-2003-399
ORDER OF COURT
AND NOW, this .6th day of June, 2003, after
hearing, we find by clear and convincing evidence that Lorraine
A. Lewandowski is an incapacitated person. The Cumberland
County Office of Aging is hereby appointed permanent and plenary
guardian of her person and estate.
the
Edward E. Guido, J.
Anthony L. DeLuca, Esquire
For the Area Agency on Aging
Daniel Worley, Esquire
For Lorraine A. Lewandowski
Area Agency on Aging
srs
IN RE: Lorraine A. Lewandowski
an alleged incapacitated person
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-2003-399
IMPORTANT NOTICE
CITATION WITH NOTICE
A petition has been filed with the Court to have you declared an Incapacitated Person. If the
Court finds you to be an Incapacitated Person, your rights will be affected, including our tight to manage
money and property and to make decisions. A copy of the petition which has been filed by Area Agency
of Aging is attached.
You are hereby ordered to appear at a heating to be held in Court Room No. 1, Cumberland
County Courthouse, Carlisle, Pennsylvania, on June 6 ,2003, at 9:30 A.M. to tell the
Court why is should not find you to be an incapacitated Person and appoint a Guardian to act on your
behalf.
To be an incapacitated Person means that you are not able to receive and
effectively evaluate information and communicate decisions and that you are unable to
manage your money and/or other property, or to make necessary decisions about where
you will live, what medical care you will get, or how your money will be spent.
At the heating, you have the right to appear, to be represented by an attorney, and
to request a jury trial. If you do not have an attorney, you have the right to request the
Court to appoint an attorney to represent you and to have the attorney's fees paid for you
if you cannot afford to pay them yourself. You also have the right to request that the
Court order that an independent evaluation as to your alleged incapacity.
If the Court decides that you are an Incapacitated person, the Court may appoint a
Guardian for you, based on the nature of any condition or disability and your capacity to
make and communicate decisions. The Guardian will be of your person and/or your
money and other property and will have either limited of full powers to act for you.
If the court finds you are totally incapacitated, your legal rights will be affected
and you will not be able to make a contract or gift of your money to other property. If the
court finds that you are partially incapacitated, your legal rights will also be limited as
directed by the Court.
If you do not appear at the hearing (either in person or by an attorney representing you)
the court will still hold the hearing in your absence and may appoint the Guardian requested.
Clerk, Orphans' Court Division ~ ....
Cumberland County, Carlisle, PA [ ~)/
My Commission Expires 1st Monday,
Janua~, 2006