HomeMy WebLinkAbout07-21-06
F IFILES\DA T AFILEIGeneral\Currentl 12096.1 amendedorder
Created 9.20/04 006PM
Revised 7/21106 326PM
12096 I
IN RE: VIRGINIA M. TAYLOR
ALLEGED INCAPACITATED PERSON
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-06-0435
IN RE: HOWARD 1. TAYLOR
ALLEGED INCAP ACIT A TED PERSON
NO. 21-06-0436
PETITION FOR AN AMENDED ORDER
f'\)
- .
AND NOW, come Virginia M. Taylor and Howard J. Taylor, by and through:their attol11eys,
-""'""1 .......~....,
MAR TSON DEARDORFF WILLIAMS & OTTO, and hereby Petition this Honorable Court to ~end-.
the Order of Court it issued on July 6, 2006, to permit completely unrestricted visitation, or in the
alternative, to permit unsupervised visitation by any individual each day during the period of 1 O:OOam-
11 :OOam and 5:30pm-7:30p.m., and in support thereof aver as follows:
1. Virginia M. Taylor and Howard 1. Taylor (hereinafter "Taylors"), were adjudicated by this
Court as totally incapacitated persons on July 7, 2006.
2. On that same date, this Court also appointed Cheryl E. Watson (hereinafter "Cheryl") as
plenary guardian of the person and estate of the Taylors, and appointed SandraNye as alternate plenary
guardian.
3. Since early June, 2006, the Taylors have been housed in the Ecumenical Community, a
nursing home operating in Dauphin County, Pennsylvania and licensed by the Commonwealth of
Pennsylvania.
4. Specifically, the Taylors have been participating in the Meadows Program, which is a sub-
program of the nursing home, specializing in the treatment and care of Alzheimer's Patients.
5. Despite their adjudication as "totally incapacitated," both Howard and Virginia Taylor are
able to communicate preferences. Howard, in particular, is high-functioning, and has only been diagnosed
with mild/moderate cognitive impairment.
6. When the Taylors were living at home, they frequently interacted with three sets offarnilies
in their neighborhood, the Burches, the Morrets, and the Shueys (hereinafter collectively referred to as "the
Neighbors"). They have known and have been friends with the Neighbors for forty years.
*-(;
7. On average, the neighbors have attempted to visit the Taylors in Ecumenical Community
about every other day to every three days, although they are unable to do so under the current order.
8. Around mid-June, Cheryl's relationship with the Neighbors began to grow tense.
9. Cheryl sought to restrict the Neighbors from visiting with the T aylors because she felt that
whenever the Neighbors visited the Taylors, Howard became "agitated."
10. In order to protect the Taylors' right to visit with their mends offoW'decades, the Taylors
petitioned this Court on June 16,2006 for an Order granting the Taylors unsupervised visitation with the
Neighbors.
11. A hearing was held on July 6,2006 to dispose of this motion. Evidence was received in
the form of testimony that Cheryl believed that the Neighbors' occasional visitation agitated the T aylors,
particularly Howard.
12. Cheryl testified to her belief that it took generally three days from a visit for Howard to
"calm down."
13. No evidence was presented that restricting visitation to a particular range of hoW's had any
effect on Howard's agitation.
14. In preparation for the July 6,2006, hearing, the Taylors were examined by Dr. Daniels,
who agreed generally with Cheryl that the Taylors were in no position to be living by themselves at home.
He also found, however, that there is no reason for restricting visitation (although instructing visitors to avoid
certain subjects was appropriate). A true and accurate copy of Dr. Daniels' report is attached hereto as
Exhibit "A" and incorporated herein.
15. The Taylors direct the Court's attention to page three of the doctor's report. Under the
heading "Recommendation," Dr. Daniel states: "No limitation in visitation is recommended, though
inappropriate encouragement of the Taylors to return to their home by well-meaning friends should be
discouraged. "
16. Following the hearing, this Court issued an order permitting unsupervised visitation every
day between the hours of I O:OOam-1 :OOpm.
17. The Taylors wish the Court to reconsider this Order, because some ofthe neighbors hold
fhll-time employment and restricting visitation to those hours has the effect offorcing those neighbors to wait
until the weekend to visit.
18. The Taylors wish to visit with their neighbors and are upset by this time schedule because
it means they are not able to see the neighbors as much as they would like.
19. Counsel for the Taylors contacted Cheryl's attorney to see if Cheryl would agree to a
change in the visitation schedule. A true and accurate copy of the letter the Taylor's counsel sent is
attached hereto as Exhibit "B."
20. Cheryl declined to concur with the instant Petition.
21. The Court is required to consider the least restrictive means of preventing agitation to the
Taylors. See 20 Pa. C.S.A. S55 12. I (a)(6)(requiringthat "the Court shall prefer limited guardianship.").
22. The Taylors continue to believe that the least restrictive means in this case would be to
instruct the neighbors about appropriate conduct, but permit completely unrestricted visitation.
23. If the Court still feels that some restriction is appropriate, the Taylors submit that granting
a change in permissible visitation times would be consistent with the least restrictive means analysis.
24. Counsel for the Taylors has interviewed each of the neighbors and it seems that the
following schedule would work better for everyone (including the Taylors who have hUlch during the current
visitation schedule): lO:OOam-ll:00am and 5:30pm-7:30p.m.
WHEREFORE, Petitioners request the Court amend its July 6,2006 Order of Court to permit
completely unrestricted visitation, or, in the alternative, Petitioners request the Court amend the order to
permit unsupervised visitation by any individual each day during the period of 1 0:00am-II :OOam and
5:30pm-7:30p.m.
Respectfully Submitted,
MARTSON DEARDORFF WILLIAMS & OTTO
71LAttct}
DATE:
07 ILl
I
,2006
George B. Faller, Jr., E uire
P A Attorney J.D. No. 49813
Michael 1. Collins, Esquire
PA Attorney J.D. No. 200427
10 East High Street
Carlisle, PAl 7013
(717) 243-3341
Attorneys for Petitioner
EXHIBIT A
0'/05/2005 07:35
71 74853022
THREE SPRINGS FAM PR
PAGE 02/04
30 June, 2006
Summary
Virginia M. Taylor and Howard 1. Taylor we.re evaluated to determine their
current cognitive function. This was initiated by their attorney for the purposes of
establishing their mental capac.ity and recommending the least restrictive appropriate
degree of guardianship.
Mrs. Taylor has excellent p.hysical health but has severe dementia of the
Alzheimer type. She is completely cognitiveJy incapacitated, and requires full-time
supportive care.
Mr. Taylor has advanced cardiac disease and mild/moderate dementia, most
consistent clinically with multi-infarct dementia. While he is currently capable of
Activities ofDaHy Living and some Executive Functions, he has deficits in short-term
memory and judgment; his most significant deficiency is a limited awareness and/or
acceptance of his wife's and his failing cognition. He should no longer drive, live alone
or manage his financial affairs without supervision.
The Taylors function best as a couple; they shOuld remain together as long as
pennitted by Mrs. Taylor's progressive dementia and Mr. Taylor's failing cardiovascular
health. In view oftbis interdependency, the best Hving arrangement is the cwrent one,
which provides the safety and support more needed by Mrs. Taylor. Activities and
visitation typical of an Assisted Living Care Facility are appropriate without special
restriction other than prevention of elopement. Supervised day furloughs outside the
facility and liberal access to visits from friends and family are within the Taylors'
physical, mental and emotional capacity, and wiI1 enhance the quality of their remainimg
years. Financial decisions made on. the Taylors' behalf should include Mr. Taylor as
much as possible, but ultimately must be directed by his guardian(s).
Report of Consultation
Virginia M. Taylor,OOB 0711 0/1930, and Howard J. Taylor, DOB 08/03/1926,
were evaluated at Three Springs Family Practice clin.ic on 29 June, 2006, from 1300 to
1415 hours. They were interviewed and examined together, and in tlte presence of Mr.
Michael Conins, who represents their legal interests. The Taylors have no children, and
no other family members were present. The Taylors were recently adjudicated totally
incapacitated by a law judge, and their nieces were appointed as plenary and permanent
guardians. Consultation was requested by their attorney for the purposes of evaluating the
Taylors' mental capacity and establishing tbe least restrictive degree of guardianship.
Outpatient medical records were provided in advance of the consultation and were
reviewed in their entirety. There were no records of Mrs. Taylor's May 2006 geriatric
psychiatric hospitalization, Mr. Taylor's May 2006 medical hospitalization, or their
current nursing home care. Patient history was obtained by records review and interview.
Focused physical. and mental status exams were completed, including administration of
the MioiMentaJ Status Exam (MMSE) and Clock Drawing.
Mrs. Taylor
Mrs. Taylor has a history of hypothyroidism following thyroid J131 ablation,
hysterectomy for fibroid infarction, hyperlipidemia, and progressive dementia. She
07/05/2005 07:35
71 74853022
THREE SPRINGS FAM PR
PAGE 03/04
presented in February 2001 with self-reported decreased memory; a family history of
dementia in her 91 year old mother was obtained. A MMSE was 26/30, indicating mild
dementia~ an MR1 showed age related changes. and metabolic studies were normal. A
diagnosis of Alzheimer's dementia was made. She was followed intennittently for her
routi.ne medical problems until May 2006. when she decompenstated during her
husband's hospitalization_ Her niece, Sandy Nye. came from her residence in Colorado to
provide supportive care, and initiated outpatient evaluation accomplished 10 May, 2006.
Geriatric psychiatric hospitalization occurred two days Jater, and Mrs. Taylor was
eventually transferred to Country Meadows (a nursing home).
On physical exam, Mrs. Taylor was neatly and casually dressed, unguarded,
reserved but socially interactive. She appeared younger than her chronologie age of 75
years. Her general physical exam was unremarkable. Her mental status exam
demonstrated severe dementia, with profound impairments of recent and remote memory.
situational awareness, and judgment. The quality of her speech was unimpaired, but the
content was severely limited. She routinely deferred to her husband for assistance in
answering questions, and he gently directed her answers. No delusional thinking was
identified.
Mr. Taylor
Mr. Taylor bas history of longstanding and significant coronary artery disease
dating from 1.976, complicated by myocardial infarction, coronary bypass surgery,
ischemic cardiomyopathy (ejection fraction of 15% since 1997), congestive heart failure
and cardiac dysrhythmia necessitating placement of an internal cardiac defibrillator and
c.hronIc anticoagulation. He has hyperlipIdemia, osteoarthritis. benign prostatic
hypertrophy, pulmonary fibrosis, gout and reflux esophagitis. He was hospitalized in May
2006 for congestive heart failure, complicated by hyponatremia, acute renal insuffiCiency
and delirium. Psychiatric, neurologic and Social Services consultations were obtained; a
diagnosis of Alzheimer's dementia is recorded in the outpatient summary. as well as an
assessment that the patient was <~ot able to take care of himself and needs either rehab or
an assisted living facility." He was discharged to Country Meadows.
Mr. Taylor was neatly and casually dressed for the evaluation, and appeared
younger than his chronological age of79 years. He is a physically impoSing person, and
retains a demeanor consistent with his occupational history of being a supervisor. He was
cooperative and open. His general physical exam was surprisingly good in view of his
severely depressed cardiac function, and no evidence of congestive heart failure or
cardiac decompensation was noted. He was patient, gentle and protective of Mrs. Taylor
during her examination. His thought form was well organiled, and flow was lUlfestricted.
Content included frustration and anger over loss of control, and was directed towards his
nieces. He voiced suspicion about their management of his finances. and anger that he
and his wife were prevented from hving in their own home. He asserted that he could
take care ofhi.s wife and himself, that she could drive. and that she would take care oftl1e
interior house responsibilities while he would manage the exterior/yard. He denied
problems with paying the bills, and was able to appropriately describe balancing a check
book (there was no additional infonnation available to corroborate Mr. Taylor's
efficiency at these Executive Functions prior to his hospitalization.) He reported that he
liked the room 8.nd food at COWltry Meadows, but was bored; he apparently enjoys
07/05/2005 07:35
71 74853022
THREE SPRINGS FAM PR
PAGE 04/04
crafting "ditty bags" (a plastic frame with yam bindings and designs), and has asked that
his nieces bring him those supplies. He demonstrated some repetition ofthemes,
recounting twice and in quite similar detail the number and fashion of ditty bags he's
completed. MMSE was 27/30, with misidentification of season, late recall of the
President, and failed recollection of one of three words on short-term memory testing.
Proverb interpretation was concrete, and judgment was fair. VisuospaciaJ testing was
good, and Clock Drawing was excellent.
Impression
Mrs. Taylor has advanced dementia of the Alzheimer's type. She requires a
protected environment, and white she does not require full-time supervision she is
incapable of self-administration of medications, financial decision making, or driving.
She is dependent on her husband for orientation and emotional. security, which he appears
to provide effectively and without reservation.
Mr. Taylor has mild/m.oderate cognitive itnpairment, most consistent with multi-
infarct dementia. This distinction is based on weJI preserved visuospacial function. (whiCh
is usually an early and progressive .Ioss in Alzheimer's dementia) and a significant history
of vasculopathy~no confirmatory radiographic stud.ies were available for review. This
fonn of dementia typicaJJy progresses in a stairstep pattern, with episodic deterioration
interspersed with periods of stability. He demonstrates little awareness and no acceptance
of his cognitive impairment, nor does he think his wife's is particularly problematic.
While he retains reasonable math and organizational skills, his limitation in awareness
makes his unsupervised management of finances and independent choice ofHving
accommodations inappropriate. RoutineinvoJvement of Mr. Taylor in the discussion of
choices made for his wife and him may be helpful in. allaying his suspicions, but
ultimately conflicts relating to safety and financial security must be resolved in favor of a
guardian. There is nothing on history or exam that suggests routine visitation. of friends
and family would harm Mr. Taylor, though they must be sensitive to Mr. Taylor's
inappropriate assessment that Mrs. Taylor and he could live independently, and avoid
encouraging that ex.pectation.
Recommendation
Mr. and Mrs. Taylor should remain in an Assisted Living or comparable facility
with protection from eJopement~ their present facility seems quite appropriate. Every
effort should be made to keep them together, even if it would require placing Mr. Taylor
in a more restrictive setting than his dementia currently requires. No limitation in
visitation is recommended, though inappropriate encouragement of the Taylors to retu.rn
to their ~orne by welJ meaning friends shou.ld be discouraged. Financial guardianship is
appropnate, but need not exclude Mr. Taylor's participation, and shoul.d allow deference
to his preferences where the result does not compromise safety or security.
Michael Daniels, MD
Three Springs Family Practice
Mt. HoJly Springs, PA
EXHIBIT B
-
.\ nOR'.I."':; &. ('IX '\,rU.ORS AT L,I\
Tl:LL?1 !')\I"
F\l ''''"!.I.
I'\TJ:R \LT
n ~12-n-33.+J
I "71 ::) 2'+3- I ,\.; i)
\\,\\I,:ndl\ O.c'UIl1
\VILL.\\I F \1 \,nSl),.
JOII.\ B. h~\\!I.R III
D\\!u K. DI:,\,wI'RfI-
TdO'.1 \,1. "V '1.1.1 \'1:';*
II" V 01:') III
(;1'';(1,. B.F\LLlRJR.*
';{( /:.)( ,<I. !,I}l.
C\RL C. RiSlll
D.\\ Ji) .\, FiI7S!\I0's
('HIUSTfY'HIR E. Rlu
h'.\:'I.R L. SPURS
HH.l.'.KY ..\.01 \\
\llt '11l:L 1. (',jLU\.;
10 E,\ST Hil.H SII'IIT
C\RLlSLL. PI..\\'>'tL\\\LI j-O IJ
11" \: Si'!, : \i"d
July 13,2006
VIA FACSIMILE (245-0829) AND US MAIL
Stephen 1. Hogg, Esquire
RE: Virginia M. Taylor and Howard 1. Taylor
Our File No. 12096.1
Dear Mr. Hogg:
I write on behalf of my clients, Virginia and Howard Taylor, with respect to the visitation order
Judge Ebert issued at our hearing on July 6, 2006. The order permits unsupervised visitation by the
neighbors between the hours of 1 0:00am and 1 :30pm. Because of work schedules, this range in times is
not convenient and has the effect offorcing some of the neighbors to wait until the weekend to visit the
Taylors or not visit at all. I am sure Judge Ebert did not intend this result when he issued his order.
I am requesting that you ask your client whether it would be possible to agree to a change in the
visitation schedule to permit the neighbors to visit with the Taylors during the following hours every day:
1 0:00am-II :OOam and 5:30pm-7:30pm. Granting this request will not afford the neighbors a greater
number of visitation hours then they already have, it would just shift the visitation time to hours that are
convenient for everyone.
I would like to resolve this amicably. Please indicate by the end of the day on Friday, July 12,2006
whether Cheryl will agree to this reasonable change in visitation. If the answer is to the negative, I will be
forced to file another motion with the court on behalf of my clients.
Very truly yours,
\1JCmmp
MARTS ON DEARDORFF,WILLIAMS & OTTO
7i:[,; [", E )A: H \, ~
Michael 1. Collins
i r.lu- S D.\ T \FIU:'(lL'nl.'r.il'ClilTI.'I1! ,: ~I~"l() I ..11 :)
I :\ FOR VI A T I 0:\ . A D V I (' E . A D V 0 C . \ C Y S\1
.
VERIFICA nON
Michael 1. Collins, Esquire, of the firm of MAR TSON DEARDORFF WILLIAMS & OTTO,
attorneys for Howard and Virginia Taylor, the Alleged Incapacitated Persons, in the within action, certifies
that the statements made in the foregoing Petition for an Amended Order are true and correct to the best
of his knowledge, information and belief. He understands that false statements herein are made subject
to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
l{L {,,~j
Michael J. Collins
CERTIFICATE OF SERVICE
I, Mary M. Price, an authorized agent for Martson Deardorff Williams & Otto, hereby certifY
that a copy of the foregoing Petition for an Amended Order was served this date by depositing same in
the Post Office at Carlisle, P A, first class mail, postage prepaid, addressed as follows:
Stephen J. Hogg, Esquire
19 South Hanover Street
Carlisle, Pennsylvania 17013
Attorney for Respondent
MARTSON DEARDORFF WILLIAMS & OTTO
..-.,
'\ i (
By 4~~ y.l, Juce,
Mary WI Pnce
Ten East High Street
Carlisle, P A 17013
(717) 243-3341
Dated: 7)21/ {J &