HomeMy WebLinkAbout11-09-11IN RE: Vivian Peters IN THE COURT OF COMMON PLEAS ~ .
An Alleged Incapacitated Person :CUMBERLAND COUNTY, PEYLVAAFIA -: , ~=';
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PETITION TO ADJUDICATE AN INCAPACITATED PERSON AND TO APPOINT A
PLENARY GUARDIAN OF HER PERSON AND ESTATE
AND NOW, comes the Petitioner, Patricia Haywood, by and through her counsel,
Jane Adams, Esquire, and respectfully pe#itions this Honorable Court pursuant to 20
Pa. C.S.A. §5511 for an Order adjudicating Vivian Peters to be an incapacitated person
and appointing a guardian over her person and estate and in support thereof states as
follows:
1. Petitioner, Patricia Haywood, (hereinafter "Petitioner"), is the daughter of
Vivian Peters. Petitioner is a competent adult individual who resides at 126 Milky Way,
Shippensburg, Cumberland County, Pennsylvania, 17257.
2. The Alleged Incapacitated Person is Vivian Peters, who currently resides at
Green Ridge Village, 210 Big Spring Ave., Newville, Pa. 17241.
3. Residential services are currently being provided to the alleged incapacitated
person by Petitioner at Green Ridge Village.
4. Vivian Peters is eighty-four (84) and has a birth date of December 16, 1926.
5. Vivian Peters has the following diagnoses: Parkinson's disease and related
dementia. These conditions impair her ability to make any decisions regarding her
physical condition, health, well-being, and-any other matters.
6. Dr. Mukherjee, a Geriatric Psychiatrist, who practices at Summit Health in
Chambersburg, Pennsylvania, has been involved in regular treatment of Vivian Peters
and believes that Vivian Peters is incapable of making any decisions regarding her
medical treatment at this time due to her diagnosis. A certification signed by the doctor
will be filed under the above-docket number and the doctor's testimony will be provided
at hearing.
7. Vivian Peters is unable to manage or take care of matters pertaining to her
own health and well-being without the existence of another individual who will act as
guardian of her person. She is unable to resist fraud or undue influence without the
assistance of a guardian.
8. Upon information available to the Petitioner, Vivian Peters has no valid living
will, advance directive for health care, power of attorney, or other document regarding
her wishes pertaining to her personal affairs and/or medical care in the event of her
incapacity while in residence at Green Ridge Village.
9. The spouse of Vivian Peters died in 1991. Other than Petitioner, she has
two other children, namely:
Suzanne Hoch, daughter
665 Walnut Bottom Road
Shippensburg, Pa. 17257
Jeffrey Peters, son
549 E. Liberty Street
Chambersburg, Pa. 17201
These individuals will be notified of this proceeding.
10. Upon information and belief, Vivian Peters was never a member of the
United States Armed Forces.
11. Upon information and belief, no other guardians of the person or estate of
Vivian Peters have been appointed, and no other court has assumed jurisdiction in any
proceedings to determine the capacity of Vivian Peters, the alleged incapacitated
person.
12. Petitioner seeks the appointment of a guardian of the person and estate
because, in the opinion of the doctor, Vivian Peters is mentally incapacitated and
unable to make decisions regarding her personal affairs. Her condition is such that she
would be unable to resist fraud or undue influence without the assistance of another
non-interested individual to act as her guardian.
13. Presently, the alleged incapacitated person is a resident of Green Ridge
Village, Newville, Pennsylvania. The essential requirements for her health and safety
are provided at the facility. A guardian over her person and estate is required to
provide consent for medical and surgical treatments, if necessary, and to ensure that
Vivian Peters' continued personal needs and financial obligations are met.
14. Petitioner believes that there are no less restrictive appropriate alternatives
to seeking a guardianship, over the person and estate of Vivian Peters.
15. Patricia Haywood, the proposed guardian, has no interest adverse to the
alleged incapacitated person.
16. Petitioner respectfully requests that the proposed guardian be given powers
over the person and estate of Vivian Peters.
17. Insofar as Petitioner can ascertain, Vivian Peters' assets consist of the
following:
a. A mobile home located at 5 Robin Drive, Shippensburg, Pennsylvania.
b. an M&T checking account.
18. Insofar as Petitioner can ascertain, Vivian Peters' income consists of the
following:
a. Social security in the amount of $395 per month.
b. a CSRS survivorship benefit in the amount of approximately $733 per
month.
c. A Heinz pension in the amount of $57 per month.
d. An Ameriprise annuity in the amount of $100 per month.
19. Vivian Peters' mental and physical condition mandates that a guardian be
appointed to make decisions concerning her person and estate, including, but not
limited to, her living arrangements, her medical and psychiatric care, the administration
of medications, surgical interventions, the employment and discharge of physicians,
dentists, nurses, etc., for her physical care and to make decisions regarding
management of her personal finances.
WHEREFORE, Petitioner respectfully request that this Honorable court issue a
citation directed to Vivian Peters, the alleged incapacitated person, with notice to such
persons at this court may direct, to show cause why she should not be adjudged a
totally incapacitated person, and why Patricia Haywood should not be appointed
guardian over her person and estate.
Respectfully submitted:
Date: ~~ - ~ --
J Adams, Esquire
. D No. 79465
1 West South Street
arlisle, Pa. 17013
(717) 245-8508
ATTORNEY FOR PETITIONER
PATRICIA HAYWOOD
CONSENT AND VERIFICATION OF
PROPOSED GUARDIAN PATRICIA HAYWOOD
I hereby consent to act as Plenary Permanent Guardian of the Person and
Estate of Vivian Peters, an alleged incapacitated person.
I have no interests (financial or otherwise) adverse to those of the alleged
incapacitated person.
I have reviewed the attached petition and have verified that the information
contained therein is true and correct to the best of my knowledge. I declare that the
statements in the petition are true subject to penalties of 18 Pa.C.S.§4904 relating to
unsworn falsification to authorities.
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Date:.';'` 1 ~ ~ ~ Patricia Haywood, P itioner