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HomeMy WebLinkAbout21-2006-0155 Orphans' IN RE: DAVID F. HECKENDORN An alleged incapacitated person IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHAN'S COURT DIVISION NO. 21-06-155 GUARDIANSHIP - INCAP ACIT ATED PERSON IN RE: OPINION PURSUANT TO PA. R.A.P. 1925 Ebert, 1., June 9, 2006. In this unfortunate incapacitation case, Appellant David F. Heckendorn has filed an appeal to the Superior Court of Pennsylvania following an order adjudging him a totally incapacitated person and granting his mother, Mary Anne Heckendorn, plenary guardianship of his person and estate. Appellant's stated grounds for appeal are: (1) a lack of clear and convincing evidence of incapacity and inability to meet his central needs without guardianship, and (2) in the alternative, if he is incapacitated, Appellant claims he is not in need of guardianship.l This opinion in support of the order granting guardianship is written pursuant to Pa. RAP. 1925(a). STATEMENT OF FACTS David F. Heckendorn ("Heckendorn") is a 35 year old adult individual who was involuntarily committed to the Mayview State Hospital on March 2,2006. He was a patient there until he was returned to the Cumberland County Prison on May 26,2006. Previously, he had been incarcerated in the Cumberland County Prison since January 24,2006. Since late 2001, Heckendorn has undergone various forms of treatment for paranoid delusions and other mental conditions. In addition to these serious mental health issues, Heckendorn has been diagnosed with ulcerative colitis, which affects his digestive tract, and 1 Appellant's Concise Statement of Matters Complained of On Appeal, filed May 17, 2006, ~ 1-2. primary sclerosing cholangitis ("PSC"), which affects his liver function and will likely require a liver transplant within the next five years. However, Heckendorn insists that he is in good mental health and refuses to stay on medication to treat his mental illness. These decisions render him ineligible to receive a liver transplant? Heckendorn's history of mental illness extends over five years. After working twelve years with the Pennsylvania Department of Health, during which time he rose to the position of network administrator and supervisor, he was terminated due to complications associated with his mental instability on December 14, 2004.3 Beginning around October 2001, Heckendorn began exhibiting unusual behavior at work, such as pushing employees, kicking doors, and accusing other employees of spying on him. In response to these behaviors, he was referred to the State Employee's Assistance Program ("SEAP"), through which he met with psychiatrists and counselors regarding his mental health issues.4 At that time he was diagnosed as paranoid delusional. 5 As a result of those incidents at his workplace, Heckendorn lost his supervisory authority and his pay grade was reduced. As a condition of his continued employment, he was directed to follow through with the SEAP therapy. The Order of Court which Heckendorn now appeals granted plenary guardianship to his mother, Mary Anne Heckendorn. She resides with her husband, Heckendorn's father, Fred M. Heckendorn. In September 2003, Heckendorn was committed by his parents to Polyclinic Hospital to undergo mental health treatment for ten days.6 Following treatment, in October 2003, he moved into his parents' home. Over the next year, complications associated with his mental instability eventually led to his previously described termination of employment 2 Notes of Transcript held April 20, 2006, p. 56 (hereinafter "NT _"). 3 NT 18, 23-34. 4 NT 19. 5 Petitioner's Exhibit 6 from Hearing held April 20, 2006 (hereinafter "Petitioner's Exhibit _ "), NT 19. 6 NT 20 2 on December 14, 2004? During the next few days, Heckendorn was verbally and physically abusive toward his parents, culminating in an incident where he shoved his mother. On December 19, 2004, his parents had him committed to Holy Spirit Hospital for mental health treatment. 8 After being evicted from an apartment in July 2005, Heckendorn moved back to his parents' residence, where he stayed in their boat house but came into the main house for meals. He explained to his parents that "the voices" told him to come back. 9 During this period following his termination, Heckendorn did not work but depleted his deferred compensation account to pay his bills.lO In mid-August 2005, as his parents were preparing to leave on a vacation, he became enraged. He broke dishes and furniture, beat his father, and chased his mother as she tried to reach police on her cell phone. 11 Heckendorn was not receiving mental health treatment at this time, and had not been since he was terminated from his employment. Additionally, although he previously received treatment in the form of counseling as a condition of his employment, his father indicated that he had not been taking the medications he was prescribed and had been off them for two and a half years or more at the time of the August 2005 incident. 12 This is supported by Heckendorn's own statements as to the side effects of the medications and the fact that he doesn't need those medications since nothing is wrong with ho 13 1m. Appellant's mental condition continued to deteriorate over the course of the next few months such that his parents grew more concerned for their well-being and discussed their legal 7 NT 23-25. When Heckendorn was presented with an employment evaluation giving him "average grades" as opposed to extraordinary grades, he at first refused to sign it, and then drew a stick figure with X's over the eyes and a knife in the head. 8 NT 24, 27. 9 NT 26. 10 NT 30. 11 NT 29. 12 NT 29. 13 NT 73. 3 options with an attorney. 14 On December 15, 2005, Heckendorn became violent again in his parents home, and they had him served with an eviction letter. He was arrested the next day for refusing to vacate the home. IS On January 24, 2006, he was arrested again for criminal trespass after refusing to leave a hotel room in which he was staying because he thought the cleaning people were spying on him.16 He remained in jail until March 2, 2006, when he was involuntarily committed to Mayview State Hospital 17 under 97102 of the Mental Health Procedures Act. 18 Heckendorn has little money in his savings and after depleting his deferred compensation account his parents have been paying many of his bills. Meanwhile his serious medical condition is proving expensive - one required medication for his liver condition costs between $50.00 to $150.00 per week. Instead of requesting the benefits that are available to him through his former state employment which would cover his many medical needs, Heckendorn filed for Regular Retirement from the Commonwealth of Pennsylvania. This retirement option would provide him little more than $300 a month and no medical benefits. 19 He refuses to apply for the disability benefits for which he is eligible because of his adamant belief that he is in fine mental health. Given his length of state employment, the vested disability retirement for which he is eligible would provide full medical benefits in the amount of$728.00 per month and $1,486.65 per month in disability payments for the rest of his life.20 Heckendorn admits this option is available to him, but refuses to apply for it because of his continued insistence that he is not mentally ill, even though this conclusion endangers his life. 14 NT 32-33. 15 NT 34. 16 NT 35. 17 NT 36. 18 See 50 P.S. ~ 7102. 19 NT 10-11; Petitioner's Exhibit 2. 20 NT 12; Petitioner's Exhibit 3. 4 In February 2006, Heckendorn was found by this Court to be incapacitated and his mother was given temporary guardianship.21 The Court ordered an independent psychiatric evaluation of Heckendorn by a mental health professional.22 Although Heckendorn had petitioned for the expert evaluation, he refused to meet with the appointed psychiatrist, John M. Hume, M.D., due to his distrust of medical doctors?3 Based on an examination of Heckendorn's health records, Dr. Hume stated that the mental illness from which Heckendorn appeared to suffer since 2001 was correctly diagnosed as Bipolar Affective Disorder I with psychosis. This illness is characterized by periods of normalcy - perhaps months or years - interspersed with episodes of bizarre or psychotic behavior. Heckendorn "feels like he's okay, and for brief periods of time between episodes, he is okay," which contributes to his problems with taking medication.24 His refusal to take medication to treat this illness has serious consequences on his mental state. With each new psychotic episode, it becomes more difficult to get the illness under control, making ongoing medication the treatment of choice. Heckendorn's eligibility for the liver transplant that will soon be necessary to prolong his life rests on receiving ongoing treatment of his mental illness with medication. Dr. Hume also reviewed Heckendorn's laboratory studies of his liver function, and stated that although they have remained fairly stable, Heckendorn has shown a tendency to fail to keep up with necessary testing in a timely fashion. Dr. Hume stated within a reasonable degree of medical certainty that Heckendorn's mental illness impairs his ability to make and communicate decisions and renders him incapable of handling his financial affairs as well as making decisions concerning his own medical care.2S 21 See Order of Court dated Feb. 28, 2006; Ebert, 1. 22 See Order dated March 8,2006; Ebert, 1. 23 NT 52; 71. 24 NT 53. 25 NT 55, 59. 5 DISCUSSION In making a determination of incapacity and the appointment of a guardian, the court must consider and make specific findings of fact. 20 Pa. C. S.A 95512.1. These requirements, which have been met with clear and convincing evidence of the Appellant's incapacity and need of guardianship, are listed and discussed below. (1) The nature of any condition or disability which impairs the individual's capacity to make and communicate decisions. 20 Pa. C.S.A. ~5512.1(1). David Heckendorn suffers from a serious mental illness diagnosed as Bipolar Affective Disorder I with Psychosis. The nature of Heckendorn's condition is such that he may experiences periods of time of perhaps months or years during which he feels - and acts - mentally healthy. However, the intermittent psychotic episodes will likely be lifelong and become more and more difficult to treat. This greatly impairs Heckendorn's ability to make decisions, especially concerning his health and financial situation which in this case have serious consequences to his overall physical condition and survival. (2) The extent of the individual's capacity to make and communicate decisions. 20 Pa. C.S.A. ~5512.1(2). Mental capacity is best determined by one's spoken words, his acts, and conduct. In re Urquhart's Estate, 245 A2d 141, 146 (Pa. 1968). Dr. Hume's testimony that Heckendorn's capacity in this regard is impaired is supported by Heckendorn's own statements and actions. While a tendency toward poor decisions cannot be considered an impaired faculty for purposes of incapacity and guardianship, in this case Heckendorn's decisions are particularly destructive, culminating not just in termination from a job at which he was successful, but in grave consequences to his physical and financial well-being. It is not the fact that Heckendorn's parents, medical experts, and general common sense are at odds with his refusal to stay on 6 medication or to forego financial opportunities; it is his insistence that he is healthy that precludes him from making informed decisions on his own behalf. (3) The need for guardianship services, if any, in light of such factors as the availability of family, friends and other supports to assist the individual in making decisions. Heckendorn's parents and other family members are obviously available to him but cannot be effective as a support system without the appointment of guardianship. Heckendorn's tendency toward violent outbursts and his history of attacking his parents, during psychotic episodes, along with his continued insistence that he is in fine health, render it nearly impossible for his parents to have a real positive impact on his decision-making. Furthermore, his medical needs are financially and likely emotionally exhausting for family members. Without the appointment of guardianship, Heckendorn is simply incapable of both financially supporting himself and receiving the medical treatment he needs to prolong his life. (4) The duration of the guardianship; and (5) The court shall prefer limited guardianship. Heckendorn's condition is long-standing, and according to Dr. Hume's testimony, will continue throughout Heckendorn's lifetime. Because of the nature of Heckendorn's psychosis, his insistence that he is of fine mental health interferes with his decision-making abilities and will only continue during the periods of normalcy that can last months or even years. His faulty perception caused by his mental illness encourages him to stop taking medication or seeking treatment. This course of conduct is jeopardizing his chances for a liver transplant. Meanwhile, his mental illness is a lifelong condition and can be expected to produce psychotic episodes throughout his lifetime. Plenary guardianship in this instance is therefore appropriate in view of Heckendorn's inability to manage his health and financial resources and the permanent nature of his condition. 7 CONCLUSION After careful examination of the record presented in this case, there is clear and convincing evidence that David Heckendorn's ability to receive and evaluate information effectively and to communicate decisions is significantly impaired and that as a result of this impairment, he is totally unable to manage his financial resources or to meet the essential requirements for his own physical health and safety. 20 Pa.C.S.A 95501. Accordingly, plenary guardianship of his person and estate is therefore awarded to his mother, Mary Anne Heckendorn. BY THE COURT, M.L. Ebert, Jr., 1. Leslie A Tomeo, Esquire 155 South Hanover Street Carlisle, PA 17013 Attorney for the Appellant Nathan C. Wolf, Esquire lOWest High Street Carlisle, PA 17013 Attorney for the Appellee 8