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Monday, August 12, 2002 Seniors reluctant to seek help even when neededBy MARK I. JOHNSON | News-Journal Staff Writer NEW SMYRNA BEACH — Sitting in her recliner in the cluttered but clean living room of her Pioneer Trail mobile home, Imogene McComas has some definite opinions about what she wants. "I want to stay in my home and be left alone," said the 84-year-old West Virginia native. "My daughter takes good care of me and I don't want people worrying about me." According to Florida law, she has that right, even though trained crisis intervention personnel believe McComas is incapable of taking care of herself. The octogenarian uses a walker to get around the residence she shares with her 53-year-old daughter, Cheryla Lynn Shaw, and a blind poodle. She is hard of hearing, and Volusia County sheriff's reports indicate she sometimes forgets to take her medicines or eat. Council on Aging spokesperson Betty Davis said such conflicts are not unusual. Almost all seniors her agency deals with fight to stay in their homes, along with trying to avoid assistance because they believe the next step may be a nursing home, she said. Sheriff's deputies say McComas depends on her daughter for care. However, Shaw takes medications to treat mental illness and has been hospitalized in the past, leaving her mother home by herself. When that occurs the elderly woman is lost. "Imogene is like a child," said Deputy Saundra Peck. "She is unable to take care of herself." Peck, along with other deputies, has responded to McComas' home as many as 13 times since December on complaints ranging from neighbors smelling foul odors, to McComas calling a stranger's answering machine "begging for help." But when help has been offered to the older woman, in most cases McComas has turned it down. A member of the sheriff's new crisis intervention team (CIT), Peck has taken it upon herself to seek assistance for McComas through a variety of means, but those efforts have been less than successful, according to Peck and District 5 commander Capt. John Szaroleta. "CIT is there to head off problems before they happen," Szaroleta said. "Because of the numerous reports written by Deputy Peck, we believe we need to continue to monitor this and make sure no harm comes to this woman." But, the law does not allow for such monitoring without the subject's consent unless a court determines she cannot take care of herself and orders a guardian to take over her affairs. As a result, such cases are problematic not only for law enforcement, but for everyone who deals with the elderly. "People have their civil rights and they have the right to refuse services," said Davis. "This is not a police state." She said it is not unusual for elderly adults to reject offers of help because they believe service providers are meddling in their affairs. But that does not stop her agency from trying. "Our dedication is to keep people in their homes and age in place with dignity," said Davis. To make that work, she said the council provides services that include help in taking a bath, transportation, delivery of meals, adult day care and even guardianship if required. But unless the client wants the services, or the court orders they be implemented, the council caseworkers cannot intervene just because they night not like the way a person is living, she said. "I think it is dangerous if we draw those kinds of conclusions for people," said Davis. Michael Pyle, an Ormond Beach attorney who practices elderly law, said he sees such situations regularly and guardianship is about the only alternative to involuntary commitment available to those who care for the elderly. Under guardianship, the court assigns a person to take control of another's affairs if an independent panel and the judge declare that individual is incapable of caring for himself. Unfortunately, there are very few alternatives to guardianship, which can be an expensive legal process. Currently, plans are underway to develop a publicly-funded guardianship program through the Council on Aging, but funding has not been forthcoming. Davis said her agency is working with Volusia County to secure $75,000 to kick start the program, but no decision has been made. In such public situations, the person in need of assistance, usually an indigent individual without a family member to assist them or be named guardian, would go through the same process and the council would be appointed as caregiver. The problem seems to arise when the elderly person can remain somewhat independent, but still needs help and refuses to accept it. Davis, Pyle and other elderly affairs experts said there are not many options except letting these people remain alone, or forcing them into a guardianship. In the McComas case, Peck and Szaroleta contacted the state Department of Children and Families, which is mandated by the Legislature to deal with adult protective services. Pat Thigpen, spokesperson for the DCF's District 12 office, which covers Volusia and Flagler counties, said her agency has had at least six investigators visit the McComas' residence in the past several months. For the most part, they were rebuffed. But in one instance DCF did step in. On May 29 McComas was hospitalized for a mental evaluation at the request of a DCF investigator, according to sheriff's reports. The report says the investigator indicated McComas had "depleted" her medications and had no way to get refills and needed other medical assistance. When McComas refused to go to the hospital, she was taken involuntarily under the state's Baker Act. The act allows police to force a person into custody for a mental health evaluation for a maximum of 72 hours, if they believe the person is a threat to himself or others. If officials believe more treatment is needed, they must go to court for an order to hold the person longer. During a June 6 competency hearing, McComas' personal physician, officials with the Halifax Medical Center psychiatric unit and a circuit court judge ruled she could go home when her condition stabilized. Thigpen said once it is determined someone like McComas has the "capacity to consent" to services and understands the consequences of rejecting them, DCF's hands are tied to go much further than to continue making offers of help. "We can't force services on anyone," she said. A June 12 sheriff's report indicates DCF adult protective services officials were reluctant to take court action against McComas because that "upsets the person too much" as well as "involving a lot of court and legal work." And while McComas has recently accepted some services, including food deliveries and nursing care, the Sheriff's Office believes more should be done. But until the law is changed or McComas is declared mentally unable to make decisions for herself, those who could provide that assistance say they are powerless to step in. "The law is clear what we may do," said Thigpen, "whatever we may feel personally." |
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