HomeMy WebLinkAbout09-28-15 �
IN RE:
. ORPHANS COURT DNISION
MARII.YN L. MEEKS, �
An Alleged Incapacitated Person . �
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. Docket No. 21-15-0751'', ; '1; .
CORRECTION � W �;
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O� September 21, 2015, at the Court's direction of Septembei 18, 2015, the RespondenE
filed proposed alternative Findings of Fact, Conclusions of Law arid Oiders. The 2tEached`'��'
submitted as a conection to the Findings of Fact altemative related to the issue of guera�ianshi�!
The only change from what was submitted on September 18 is the addition of a new pazagraph
10 and a typo io paragrnph 5. For the coua's convenience, the entire document with the inserted
pazagraph and consequent renumbering follows. All other Findings of Fact, Conclusions of Law,
and Orders remain �espectfully s�bmitted foi the Court's consideration.
L Ma�ilyn Meeks is 88 yeazs old and currently lives at hec home at 4811 Bcai� Road,
Mechanicsburg, PA.
2. The case began on July 2, 2015, with the filing of an Emerge�cy Petition for the
Adjudication of Incapacity by the Petitionei, Gregory Meeks,by and tluough his counsel,
David D. Nesbit.
3. On luly 2, this Cou�t sigoed an Order that appointed Gregory T. Meeks, hereinahe�
`Petitiooei", as guazdian of the estate/pe�son of Mazilyn Meeks until a heacing coald be
held. That heacing was scheduled and held on July 22, 2015.
4. Grace E. D'Alo was appointed as counsel for Mazilyn Meeks by Ocdei of CouR dated
July 6, 2015.
5. Between Ap�il 17 and 7�1y 22, 2015, Mazilyn Meeks was residing in the Secuce Dementia
Unit of Country Meadows a[the behest of her son, Gcegory Meeks.
6. On Apcil ]0, 2015, prio� to being admitced to Country Meadows, Ms. Meeks suffered an
accidental fall. EMTs were called and �endered assistance. The EMT report from that
incident shows that shortly afre�the fall Marilyn Meeks was:
a. Oriented to person, place, time and event;
b. Had no head injury, was not intoxicated oi showing signs of chest pain,
shortness of breath, loss of consciousness, and that
c. No further caze was needed.
(RespondenYs Exhibit#2)
2. Prior to being admittcd to Country Meadows on April 17, 2015, Mazilyn
Meekswas the patient of Kathleen Sempeles,M.D, a family practice physician.
3. Dr. Semples never referred Mazilyn Meeks for a neurological exam or performed
� a mini-mental status exam on hec (Testimony of Dc Sempeles on Septembe� 18)
4. Mazilyn Meeks' last visits to Dv Sempeles were on Mazch ]0 and Mazch 24 of
2015.
5. On the stand, Dr. Sempeles idenUfied hec Outpatie�[ Notes from those office
visits in her testimony on September 18, 2015 (RespondenYs Exhibits #]0 and
#11)
6. RespondenYs F,xhibits tl10 and kl lshow thatin the month prioc to hec admission
at Country Meadows Dr. Sempeles did not assess, note or mention that Muilyn
Meeks has a neurological disorder, dementia, vasculac dementia, hallucinations or
delusions.
7. PeUtioner's only medical evidence was offeeed tluough Dc Sempeles and
eonsisted of the form shecompleted for Country Meadows on Apii] 14, 2015.
(Pctitioner's Exhibit#7, See Paragaph 10 below)
8. On the stand on Septembec 18, 2015, Dc. Sempeles confi�med tt�at aIIer Mazch
24, 2015, she had no office visits with Mazily� Meeks and had no communication
with her.
9. 0� Apcil 17, 20I5, Marilyn Meeks was admitted to [he Secured Dementia Unit of
Co�ntry Meadows based, in part,on D�. Sempeles averments in Petitione�'s
Elchibit #7.
IO. On Peti[ioner's Exhibit #7 Dc Sempeles's unambiguously indicates that her
evaluationof dementia, hallucinations and delusions was based on her office visit
with Mazilyn Meeks af Mazch 24. (See handurziting of Dr. Sempeles an
Petitioner's Exhibit#7 a�d paragraphs 6-9 above.)
11. Petitioner's Exhibit #7 is the form that Dr. Sempeles completed on Apeil 14,
2015,to secure placement of Mazilyn Meeks in the Secured Dementia Unit. As
stated above,prior to April 14, Dr. Sempeles's records and Petitioner's evidence
aze more notable for what is not included:
i. Prioc to Apol 14, 2015, there nothing in any Outpatient Notes
authored by Dc Sempeles or any other doctor of Marityn Meeks
having dementia, vascular dementia, hallucinations o�delasions.
ii. Dc. Sempeles testified that she did not perform a mini-meutal
status exam;
iii. Dr. Sempeles testified t6at she did not refer Mazilyn Meeks to a
❑eurologist;
� iv. Dc Sempeles filled out the Country Meadow's form after
"reaching ouY' to Michelle Meeks.
v. Dr. Sempeles did not"reach ouY' to Marilyn Meeks, talk to he�,oc
communicate with her in anyway after Mazch 24.
vi. Dc Sempeles did not follow up on the EMT �eport regazding
Marilyn Meeks fal] on April ]Q (See Pazagiaph 6 above) and
testiHed that she would have been surprised by its conclusions.
]2. Country Meadows did a pie-screening assessment of Mcs. Meeks on April 16,
2015. (Respondent's 8xhibit#1)
13. The Personal Care Home Assessment Form, signed by Amanda 6obb, [he
Executive Director of the Demen[ia Unit assessed Mrs. Meeks in:
a. Activities of Daily Living;
b. InsWmentul Activiries of Daily Living;
c. Ability to Hear;
d. Ability to See;
e. Understanding Instruction a�d what is said;
£ Ability to communicatc needs and articulate thoughts, and
g. Memory.
(RespondenYs Exhibit#1)
14. In all the categories lis[ed above, Mazilyn Meeks was assessed as having either
"No impairmenY' or `9mpairme�t evident but does not inte�fere with everyday
fitnctioning".
(Respo�denYs Exhibit #l, Transciipt of hearing o� July 22, 2015 (hcreinafrec
`Tcansc�ipt], testimony of Amanda Bobb, Executive Di�ector of the Secured
Dementia Unit at Country Meadows, pp. 3537)
15. Amauda Bobb furthe� testified lhe "[Mazilyn Meeks'] family had a location for
her independent living. Something happened. I apologize. I am not su�e exactly
what it was."(Transciipt, p. 28)
16. Petitioner did not offe� any factual, medical or anecdotal evidence regardin�*
Mazilyn Meeks' mental oc physical status o� condition while she was in the
Secuced Dementia Ouil at Cou�hy Meadows between Apcil 17 and July 22 of
2015.
17. Seven exhibits were entered into the record on betialf of Petitioner and o�ly the
last relates to Marilyn Meeks' alleged incapacity. This is Petitioner s Exhibic #7
and it is fully discussed.
18. On July 22, this Court dissolved the F.mecgency Guacdianship tha[ gave Petitioner
plenary power over his mother's person and estate. .
19. On July 2 and after July 22, 2015, Marilyn Meekshad several conversations and
mee[ings with an attorney, Adam DeLuca, Esq, to prepa�e a new POA, Will, and
Advanced Health Care Directive.
(RespondenPs Exhibit#5)
20. Pursuant to AAA standazds, Mr. DeLuca assessed Marilyn Meeks' mental
capacity.Mr. Deluca determined that Marilyn Meekswas and is, in brief, more
intclligent, reasoned and awaze than most of his clients of any age.
a. Mazilyu Meeks was able to discuss options available [o her and make
reasoned c6oices;
b. Marilyn Meeks was able to communicate hei fi�aneial concems and life
style preferences;
c. Marilyn Meeks undeestood the implications oCher decisions.
21. After July 22, pursuant to tt�is CourPs Order, Marilyn Meeks saw Dr. Irwin, a
ueurologist at the Universiry of Pennsylvania and an expert in his field.
(RespondenYs Exhibit# 8, Resume and CVof Dr. Itwin)
22. Dv Irwin pcepared a[eport reflecting his assessment of Muilyn Meeks.
(RespondenPs �xhibit#9)
23. The salient findings in Dr. Irwids report are:
i. Mazilyn Meeks appeared well medically.
ii. A neucologic evaluation revealed that Marilyn Meeks was atteutive
during the course of the evaluation.
iii. During the evaluation, Mazilyn Meeks was ociented to persoq
place and time.
iv. Marily� Meeks' score on the Mini Mental StaWs Exam was 27 out
of 30, only failing to cor�ectly spell the wo�d"wodd"backwazds—
she inverted two letters.
v. Marilyn Meeks' recognition was reliable.
vi. Mazilyn Meeks made no grammatical errors.
vii. There was no problem with repetition.
viii. Marity� Meeks was uot depcessed.
ix. Mazilyn Meeks appeazed to 6ave some lack of insight inm 6ec
diffiwlties �
(RespondenYs Hxhibit#9, p. 3)
b. Dc Irwin testified a�d concluded in his repoR "Due to the ielative
preservation of her episodic memory, I do not feel that an eady stage of
Alzhcimer's is likely."(Emphasis added)
(RespondeuPs Exhibit#9,p. 4)
c. Uc Irwin testified and concluded:"I believe [Marilyn Meeks] has mild
executive and visuospatial difficulties that are likely related to her small
vessel atherosclerotic cerebcovaseulaz discase."
(RespondeuPs Exhibit#9,p.4)
d. Dc Irwin exp�essed concems tt�at Marilyn Meeks may need assistanee
handling a eomplex cegimen of inedications but also stated in �elation to
that issue:
"We discussed visiting companions and health aides, day centers and
inpatient facilities.
(RespondenPs Exhibit#9, p. 4)
24. Dr. Irwin did not conclude in eithec his testimony oi his ieport:
a. That Mazilyn Meeks had dementia, vasculac dementia, or suffeeed from
hallucinations or delusions (note that dementia, vasculaz dementia and
cerebrovasculaz disease aze distinct diagnoses);
b. That Marilyn Meeks is rotally o�partially incapaci[ated;
a That Mazilyn Meeks nceds a guazdian.
25. Dr. lrwin's report and tes[imony support facmal conclusions that Marilyn Meeks:
� a. Can receive and evaluate information effectively;
b. Can communicate decisions in a way that is not impaired ro such a
significant exte�t that she is totally unable to manage her finaucial
resources; and
a Can the meet essential ieqoirements for her physical health and safery.
26. All of the medieal evidence and testimony supports the factual conclusiou that
Marilyn needs some assistance with some complex tasks of daily liviog and that
help can be provided through family members,neighbors, and support services.
27. Petitioner p�esented no factual evidence as to why less restrictive altematives aze
not appropriate.Petitioner offers only speculation that at some undetermined time
in the future Marilyn Meeks may experience health problems, could possibly
resist treatment, might change her Powei of Attomey. Following Petitione�'s
logiq all of us oould be placed in secured demenfia units.
28. Yonne August has demonshated excepfiona] caze and concern foc her mother in
Ihe past several yeazs and has willingly assumed the duties and �esponsibilities
under the Power of Attorney entered on the record as RespondenYs Exhibit#5.
29. Yvonne August statements to the Coutt in the lnformation submitted to this Court
on September 21 appeaz ieliable and this Court believes that Ms. August will
continue to piovide caze for her mother based on advice from neurological and
ge�iatric experts,to assist her mother with medications,to pmcure support services
as needed, to monitor her mother's health, and do whatever else is necessuy to
assureMarilyn Meeks'health, safety and genera] welfaze.
IN RE: . ORPHAN'S COURT DNISION
MARiLYN L. MEEKS .
An Alleged Incapacitated Person . Na 21-15-0751
CERTIFICATE OF SERVICE
i
�� i'"1 ��%�) `7
AND NOW, this �_ day of SeptemberG� I, orace E. D'Alo hereby certify
that I have served a true and correct copy of the attached"CORRECTION" by regulaz first mail,
Huough the United States Postal Service, to the following perw� at the following address and:
DAVID NESBIT, Esq.
Keystone Elder Law,P.C.
555 Gettysbu�g Pike
Suite C-100
Mechanicsbucg PA 17055
Attomey foc Petitione�
e�sputfuLLy Submitted,
�� � �
�:�`l �.a.,r.��� � ��
', G ACE E.D'ALO �
'C rt Appointed Attomey for the
Alleged Incapacitated
530 Greason Road
Caclisle PA 17015
ATTORNEY [D#26146