Pełna transkrypcja odcinka The Thin Line Between Care And Control

help make the decision on who really had the right to consent to terminate this pregnancy. 00:06:50.039 --> 00:07:12.759 And it was a really interesting situation because you could kind of see both sides, but you know, you're trying to act in the best interest of a client as a conservator, but you have your own moral views and how they were struggling with it, but also how the team was struggling to be able to help the client and provide her the support she needed to, you know, do what she thought was right with her own body. 00:07:12.839 --> 00:07:19.560 So it was definitely a very interesting scenario that the court did have to get involved with to make the decision. 00:07:19.879 --> 00:07:48.279 What a, I mean, what a what a what a knock it out of the park first scenario, seriously, because it brings up so many touchy subjects that I I don't want to get into the politics or the you know the splitting the the the the listenership in half by taking a stance one way or the other, but boy, this is one that really you couldn't ask for a more stark, perfect example of what we're talking about than this, right? 00:07:48.920 --> 00:07:58.039 Uh my goodness, Sarah, did you weigh in on this with Angela when you guys were in your supervisions and and and the languages that you had to use and stuff? 00:07:58.439 --> 00:08:04.120 Yeah, I think you know, I it to me it really wasn't a whole big ethical dilemma, though. 00:08:04.279 --> 00:08:11.959 I mean, and we had the same scenario happen with a couple of our uh folks that are conserved regarding the COVID vaccine. 00:08:12.759 --> 00:08:16.759 I feel like you know the folks, guardians, conservators, they're human, right? 00:08:16.839 --> 00:08:18.360 They have their own beliefs. 00:08:18.599 --> 00:08:27.240 But when there's a conflict, I feel like this one was, you know, ripe to go back to probate court to go in front of the judge. 00:08:28.279 --> 00:08:36.920 The thing though that bothered me about this particular case is here's a client who's already going through a traumatic experience, right? 00:08:37.320 --> 00:08:41.240 And there's a whole lot of feelings around, I'm sure, the termination, right? 00:08:41.399 --> 00:08:43.639 And now she's got to go before a judge. 00:08:43.879 --> 00:08:48.680 And it's it and so that part felt a little icky to me. 00:08:49.000 --> 00:08:50.360 It feels icky, it does icky. 00:08:51.080 --> 00:08:55.000 Right, right, embarrassing, personal, right? 00:08:55.480 --> 00:08:56.600 Yeah, yeah. 00:08:57.399 --> 00:09:17.320 And and here's the thing that I'm thinking well, naturally we have our we have a conservator who who's in place, and you know, very often we have to have a conservator in place, or a guardian, depending on where you're living, you're living geographically, of course. 00:09:17.879 --> 00:09:31.399 And these decisions are that are being made by a fiduciary are most often brought into play in to give authority in non-elective procedures. 00:09:31.879 --> 00:09:33.879 This is an elective procedure. 00:09:34.440 --> 00:09:37.159 I so I'm gonna talk about it from the legal perspective right now. 00:09:37.240 --> 00:09:43.080 Okay, you know, you guys could talk about it from the humanistic side, and then I'm right there with you, I think. 00:09:43.240 --> 00:09:45.000 And maybe I am, maybe I'm not. 00:09:45.240 --> 00:09:56.840 But from the legal side, most of the most of the decisions that we ask a conservator or a guardian to get involved in is to give authority for more or less things that are emergent or non-elective type type of of issues. 00:09:57.160 --> 00:09:58.440 This is not that. 00:09:58.840 --> 00:09:59.160 Okay. 00:10:00.840 --> 00:10:04.360 Again, we are in a progressive state as far as this is concerned. 00:10:04.520 --> 00:10:08.040 I so we have to acknowledge that first right off the bat. 00:10:08.360 --> 00:10:28.200 And therefore, what I would say first and foremost on this from a legal perspective is that in in this case, Susan, our our client who wants to terminate this pregnancy, has absolute right to make a decision for what happens to herself as long as it's legal. 00:10:28.280 --> 00:10:31.640 And in this case, it it was something that was legal at the time. 00:10:32.840 --> 00:10:47.480 And as long as a doctor does his due diligence and interviews her and finds her to be of capacity, making an informed decision, etc., the doctor should say, okay, she wants to do this. 00:10:48.040 --> 00:10:55.000 But let's flip that coin too, because now you're the doctor, and the doctor knows that that Susan is conserved. 00:10:55.560 --> 00:11:00.360 How, and you know, he's also he also knows how much he's paying for his malpractice insurance. 00:11:01.720 --> 00:11:08.040 I can see where the doctor is also freaked out about doing this and wanting to get the blessing. 00:11:08.840 --> 00:11:09.400 I mean, that was a change. 00:11:09.480 --> 00:11:14.600 That was a did want to get the courts or did want to get the conservative court's blessing, right, Angela? 00:11:15.000 --> 00:11:23.960 Yes, and and and just to throw another spin on it, I mean, this this this situation that we're discussing now happened about you know 15 years ago. 00:11:24.120 --> 00:11:39.879 We just had a more recent situation this this year with the same scenario, not that the the conservator had any issues with consenting, but the doctor was getting involved in saying she's conserved and you know, you conservator need to give authority. 00:11:40.040 --> 00:11:49.800 And that particular conservator actually went into the statutes and said and took a whole nother spin about the fact that she wasn't making a decision right regarding to the fetus. 00:11:49.879 --> 00:11:54.200 Like she was only a conservator for the person, not the actual fetus. 00:11:54.280 --> 00:12:04.840 And so the judge, you know, in that case said, you know, the client had the authority to make that decision and gave her the consent to

decide what to do. 00:12:05.000 --> 00:12:15.400 So that was also another, you know, additional scenario of this whole complex, you know, thing around your right, your body as a woman, a child. 00:12:15.800 --> 00:12:16.120 Oh, sure. 00:12:16.920 --> 00:12:17.560 That's what I'm thinking about. 00:12:17.640 --> 00:12:19.480 I mean, you're opening up the entire Roe v. 00:12:19.640 --> 00:12:27.640 Wade argument right there about are we making a decision for the fetus or for the person or for the life or for the and that's not where we want to go in this podcast. 00:12:27.879 --> 00:12:29.160 No, by any chance. 00:12:29.560 --> 00:12:36.600 It's interesting where the court, though, has to get involved with regards to the who has the right to make the decision, right? 00:12:36.759 --> 00:12:52.120 Whether they're having their own religious things and they don't agree with it, or whether or not the client has the capacity to do it, and who at the end of the day really gets to make that decision when you have a person that's a conserved individual and makes it very, very challenging. 00:12:52.520 --> 00:13:07.640 And the it the nice answer that we do have to fall back on as far as supposedly as far as our laws in Connecticut are concerned, and again, guys, it's a progressive state, these laws are do not apply in most of the most of the states. 00:13:07.720 --> 00:13:09.960 So take this with a grain of salt. 00:13:10.280 --> 00:13:22.600 In in our state, if a judge has not given you express authority to make a decision or to act in a certain way, you do not have, as a conservative or fiduciary, you don't have that ability. 00:13:22.920 --> 00:13:33.480 So I would argue right off the bat that this is something that was not expressly granted, therefore it stays with with Susan's decision-making capacity. 00:13:33.800 --> 00:13:43.480 However, that having been said, I know that most courts, not only in Connecticut but across the country, are also still giving more or less blanket authority until questioned otherwise. 00:13:43.720 --> 00:13:46.520 So the answer is really not there. 00:13:46.759 --> 00:13:50.680 And it's again, there is no real good answer for this one. 00:13:50.759 --> 00:14:11.960 And depending on where you are, the culture of where you are, it could be a real, I mean, you know, not to get political, but look at the way that what Texas is doing right now to more or less outlaw and criminalize early termination of pregnancies in different ways, it really, and you know, these judges, their hands can be tied with it too. 00:14:12.280 --> 00:14:15.000 So again, we really got to think about it for more. 00:14:15.640 --> 00:14:16.600 I just want to add one more thing. 00:14:16.759 --> 00:14:28.840 And in the cases that we're gonna discuss today, whether it's something like this, like termination of pre terminating a pregnancy, or life and death stuff that we're gonna talk about in a little bit, time is of the essence. 00:14:29.000 --> 00:14:32.280 And so some states there is time restrictions. 00:14:32.440 --> 00:14:41.560 And so by the time you get a hearing and by the time the procedure gets scheduled, I mean, there are certain time constraints that people are up against. 00:14:41.720 --> 00:14:44.440 And so it's just that's an excellent point, too. 00:14:44.600 --> 00:14:44.759 Yeah. 00:14:44.920 --> 00:14:46.040 Well, and that's what I mean. 00:14:46.200 --> 00:14:46.920 Think about okay. 00:14:47.000 --> 00:14:54.920 So actually, Sarah, since you since you led us right into it, let's talk about a case that's been on your brain a lot, especially in the last year. 00:14:55.160 --> 00:15:00.600 We're calling her Elena for purposes of this this podcast. 00:15:01.240 --> 00:15:06.440 And I'm basically a subject that's near and dear to my heart because of family. 00:15:06.680 --> 00:15:09.560 Tell us about Elena and and what's going on with her. 00:15:09.800 --> 00:15:13.240 Yeah, so Elena's case got dropped into our lab. 00:15:13.400 --> 00:15:24.600 So I got a call, I think, on a Thursday, from the local mental health authority, the clinical director, about a family that had been desperate in calling the local mental health authority for service. 00:15:24.680 --> 00:15:26.759 She wasn't even connected to anybody. 00:15:27.160 --> 00:15:42.840 So the family member was calling because their niece had pretty significant, they thought, breast cancer, to the point that there was an open wound and it was looking infected. 00:15:43.160 --> 00:15:53.720 And this particular person, Elena, was going into the woods every day, you know, just leaving very early in the morning, coming back very late in the evening. 00:15:53.879 --> 00:15:57.160 So whereabouts unknown, um, psychotic. 00:15:57.400 --> 00:16:08.440 So just really experiencing a lot of the symptoms of untreated schizophrenia, where she was paranoid and delusional and just not in a good place, you know, not really tending to her hygiene. 00:16:08.520 --> 00:16:12.280 It just there was just that she was just not in a good place. 00:16:12.680 --> 00:16:17.480 Well, I mean, take it a step further, I'll say, because I know you don't want to, but it was melodorous. 00:16:17.720 --> 00:16:18.440 Yeah, yeah. 00:16:18.520 --> 00:16:20.120 It was it was taking care of it. 00:16:20.200 --> 00:16:20.360 Yeah. 00:16:20.520 --> 00:16:21.400 Yeah, it was bad. 00:16:21.640 --> 00:16:22.440 It was bad. 00:16:22.759 --> 00:16:30.600 So we got involved, and it took us a good solid two to three weeks to engage this individual, Elena. 00:16:30.920 --> 00:16:43.080 And it that was extremely difficult to do, but we were able to coordinate the team and get her into the hospital, which that was actually a really tough thing to do, believe it or not. 00:16:43.240 --> 00:16:52.680 We had to really work with the mobile crisis teams and the local law enforcement and the local mental health authority to really make a case for grave disability. 00:16:52.920

--> 00:16:56.280 But once we got her into the hospital, this is where it got interesting. 00:16:56.520 --> 00:17:01.640 So they did confirm that she had breast cancer and it was progressed, it was significant. 00:17:02.680 --> 00:17:10.519 She was refusing treatment, refusing all treatment, refusing even to have them do a scan just to stage it. 00:17:10.920 --> 00:17:17.559 And so the discussion became can she make that decision? 00:17:17.799 --> 00:17:26.039 Because the conservator, of course, wanted at least the diagnostic testing done and and figuring, you know, figuring out what the course of treatment options were. 00:17:26.519 --> 00:17:35.240 Could she refuse that and then just be discharged back out to the street to just die, you know, with her with her rights on? 00:17:37.799 --> 00:17:52.039 Or did the community, the hospital, the conservator, the probate court, did the community have an obligation to try to treat her psychiatric illness to see if she could actually make better decisions. 00:17:54.200 --> 00:17:56.359 You know what bothers me about that right off the bat? 00:17:56.839 --> 00:18:00.279 That they're automatically assuming that she wasn't making a good decision. 00:18:01.640 --> 00:18:09.240 Think about it, because they're saying, well, you're obviously making a wrong decision, so we need to treat you psychiatrically in order for you to make the quote unquote right decision. 00:18:09.720 --> 00:18:14.759 Well, I think the and this is where it just becomes an ethical dilemma, because I had feelings around it too, right? 00:18:14.839 --> 00:18:17.640 So did the conservator, so do the doctors. 00:18:19.400 --> 00:18:26.360 The initial issue was that she was refusing the diagnostic testing, which were completely in in non-invasive. 00:18:27.160 --> 00:18:32.200 So she wasn't even and it was due to the symptoms of her psychosis. 00:18:32.279 --> 00:18:33.960 She was paranoid delusional. 00:18:34.360 --> 00:18:49.880 And so that was the first step of trying to figure out do we treat the psychiatric illness and see if she is developed some more insight, and then we can assess whether or not she wants the diagnostic testing. 00:18:50.039 --> 00:19:01.720 It was tough because we're we were dealing with somebody who was clearly floridly psychotic, and we were trying to reason with that person in terms of you know, medical treatment for themselves. 00:19:01.880 --> 00:19:03.480 That was life or death. 00:19:03.880 --> 00:19:04.279 Right. 00:19:04.680 --> 00:19:10.920 And yeah, and quality of life, meaning the advanced nature of the illness. 00:19:11.480 --> 00:19:12.840 Yeah, the infection was gonna be over. 00:19:13.319 --> 00:19:15.160 It was weeping, it was yeah. 00:19:15.240 --> 00:19:23.400 I mean, it was, folks, it was it's a pretty gross, disgusting presentation, to be honest, from you know, talking about it. 00:19:23.559 --> 00:19:32.680 Sorry to put it that way, but and and this goes back to that question of capacity. 00:19:33.080 --> 00:19:39.720 What what capacity does she have to make an informed decision about her well-being, etc.? 00:19:40.200 --> 00:19:51.080 And you had several people in this particular case saying she's she's not even making an informed decision about you know what day it is, never mind. 00:19:51.799 --> 00:20:09.960 And I remember, do you remember we got in a in a discussion one time with with with our friends over at the Legal Rights Project, where I was saying that I respect this guy's right to make a decision, but not when he's making it because based on the manifestation of an illness, right? 00:20:10.200 --> 00:20:14.039 The guy's floridly psychotic, like like like Elena here. 00:20:14.519 --> 00:20:24.440 And the manifestation of that illness is such that she's not capable of making an informed decision. 00:20:24.519 --> 00:20:27.160 She's just, and it's not her fault, it's the illness's fault. 00:20:27.400 --> 00:20:27.960 Right, right. 00:20:28.200 --> 00:20:41.080 So, yes, when a person is floridly psychotic or in the grips of this kind of decompensation, arguably, they cannot make informed decisions, and therefore we can't listen, and we should not listen to those decisions. 00:20:41.319 --> 00:20:47.080 Now, she could say she wants X, she wants, she wants to say, I don't want the diagnosis. 00:20:47.240 --> 00:20:54.279 And we could go through all the checks and balances and go through all the different different layers of inquiry. 00:20:54.440 --> 00:20:58.279 And it could come back that she's okay, she we agree with her then. 00:20:58.440 --> 00:20:59.319 You know, that's fine. 00:20:59.559 --> 00:21:05.559 Well, that's that is what I think the conservator and our goal was. 00:21:05.799 --> 00:21:10.600 Let's see if she can actively participate in this decision. 00:21:10.840 --> 00:21:15.000 Let's see if we can get the symptoms under control so that she can have some insight. 00:21:15.160 --> 00:21:24.600 And initially the hospital was pushing back and really poo-pooing that, but we made a really good case and we were like a bee in a bonnet, and it got kicked all the way up. 00:21:24.680 --> 00:21:25.400 Is that the right term? 00:21:27.559 --> 00:21:28.519 That's another Sarah's. 00:21:28.920 --> 00:21:32.039 I think it is the right term, a bee in a bonnet, because I we were very nudgy. 00:21:32.120 --> 00:21:34.039 We were very, we were very nudgy. 00:21:34.440 --> 00:21:36.680 Be in a bonnet is something good. 00:21:37.400 --> 00:21:52.920 Okay, well, we were definitely nidgy to the point that we got the president of the hospital involved and and coordinated all sorts of meetings, and it was determined that they were going to treat her involuntarily for her psych condition. 00:21:54.920 --> 00:21:59.960 And that did lead to, I mean, I can talk about the outcome if you want, but yeah, sure. 00:22:00.039 --> 00:22:07.240 I mean so what happened on this case is she was involuntarily treated for her psychosis. 00:22:08.120

--> 00:22:11.319 After that, she did agree to the diagnostic testing. 00:22:12.519 --> 00:22:15.080 And we were able to stage the cancer. 00:22:15.240 --> 00:22:21.160 They were so in this case, they've got her to a baseline where she was was able to make informed decisions about it. 00:22:21.240 --> 00:22:25.319 And well, yeah, so she was able to agree to the diagnostic testing. 00:22:25.799 --> 00:22:35.799 They were able to stage the cancer, and then the treatment options were discussed, and I believe she was able to more actively participate in that. 00:22:36.039 --> 00:22:38.120 Ultimately, she didn't end up getting the treatment. 00:22:39.000 --> 00:22:48.600 Ultimately, she ended up a diff with on a different course, which was wound care, which would not have happened had she not been treated involuntarily for the psychiatric condition. 00:22:49.000 --> 00:23:07.480 And she ended up going to a skilled nursing facility where they could manage her medical condition and also give her the dignity to choose the course that she wanted in terms of her end of the life, end of life, you know, uh decision making. 00:23:07.799 --> 00:23:11.640 So it was not a like happy ending, right? 00:23:12.600 --> 00:23:19.080 But it was the best we could do with it's her dignity, it's her life, it's her choice. 00:23:19.240 --> 00:23:37.319 I mean, Angela, we see that a lot with like criminal cases, you know, over at when people go from the criminal courts, they get put into forensic psychiatry where they have to undergo these evaluations just to determine whether or not they can even participate in their own defense is one thing. 00:23:37.400 --> 00:23:40.680 But in this case, it's it's the decision-making process. 00:23:41.160 --> 00:23:45.799 But Angela, tell us in terms of sort of shifting gears here. 00:23:45.880 --> 00:23:53.400 And and this story reminded me of a story that we talked about on another podcast that we did together, where I mentioned the woman who had the gangrenous leg. 00:23:53.559 --> 00:23:58.759 If you guys remember that, where she refused to have it cut off and it was going to kill her, blah, blah, blah. 00:23:58.840 --> 00:24:00.680 But so check out that podcast. 00:24:00.759 --> 00:24:06.279 I believe that's our our right to make a choice or choices, something about choice is the title. 00:24:06.360 --> 00:24:08.200 I don't remember what it is exactly. 00:24:08.519 --> 00:24:15.000 But I want to talk also about again, medical decisions are always going to be tough ones. 00:24:15.240 --> 00:24:21.559 But there's another layer of tough ones that we've had, and I've had this, you know, in my in my professional experience as well. 00:24:21.720 --> 00:24:28.920 And Angela, I know you dealt with a case of Teresa recalling for purposes of this episode. 00:24:29.160 --> 00:24:32.440 Why don't you tell us about the situation that Teresa found herself in? 00:24:32.519 --> 00:24:41.400 Because we've had a couple of these cases along the way, thinking about a guy by the name of Kenny who was involved with one of our clients for a long time and we couldn't get rid of him. 00:24:41.480 --> 00:24:44.680 And uh I see you remember that case fondly. 00:24:44.920 --> 00:24:52.440 Uh, tell us tell us about Teresa and her case and what what why you wanted to talk about that particular situation here. 00:24:53.000 --> 00:24:59.319 Yeah, so Teresa's case was really something I'd never seen out of 20 something years that I've been doing this. 00:24:59.559 --> 00:25:02.840 So Teresa had a mental health waiver. 00:25:03.000 --> 00:25:11.880 So she had certain services coming into her home to assist her with ADLs, grocery shopping, case management type tasks, getting her to appointments and stuff. 00:25:12.120 --> 00:25:14.920 She also had was on dialysis at the time. 00:25:15.160 --> 00:25:19.960 So she had a lot of interaction with these, you know, caregivers inside her home. 00:25:20.120 --> 00:25:24.519 And they would be in her home for, you know, four hours, you know, Monday through Friday. 00:25:24.759 --> 00:25:27.640 You know, and you get connected to your clients, right? 00:25:27.720 --> 00:25:30.600 When you've been working with them for that that long of a period of time. 00:25:30.759 --> 00:25:47.160 Well, this particular person, this caregiver had left the agency and had moved away, and you know, she had gotten a new caregiver, you know, and a year goes on, and you know, we're all just you know, maintaining her care and going on with life, and things are good. 00:25:47.400 --> 00:25:52.840 And then all of a sudden, Teresa calls up and says that this person is in the apartment. 00:25:53.080 --> 00:25:55.080 And we're like, Who are you talking about? 00:25:55.240 --> 00:25:58.680 And she's like, and she said the name, and we're all of us were like, Who is this person? 00:25:58.759 --> 00:26:11.319 And then we realized it was an old caretaker who had pretty much come back into her life and was using her apartment, pretty much squatting there with another man and a dog. 00:26:12.039 --> 00:26:18.279 And the dog was a big dog, and the dog was having problems inside the apartment. 00:26:18.519 --> 00:26:26.440 And so, you know, the but the fact that she had the right to have this now friend she was calling, which was not a friend. 00:26:26.519 --> 00:26:40.680 This was a caretaker from the past that is now obviously taking advantage of her and her situation, and we couldn't get them out of the apartment, and it was a really good struggle because Teresa wanted them to be right. 00:26:40.759 --> 00:26:55.400 They were now her friends and they were, you know, helping her, and she considered them as positive people in her life that you know that she cared about, and she thought that they cared about her, and she couldn't see that they were really taking advantage of her. 00:26:55.640 --> 00:26:57.720 And so, what were they doing to take advantage of her, though? 00:26:57.880 --> 00:27:13.400 Were

they, I mean, they were squatting in the apartment, they were, you know, causing problems and noise complaints, the the building manager was calling, saying that there were people in the apartment that weren't supposed to be there, that weren't on the lease. 00:27:13.799 --> 00:27:20.680 And and we're not sure what else they might have they might have taken advantage of her because of financial, you know, they were eating her food. 00:27:20.840 --> 00:27:26.920 It was just all very meshed situation, but she wanted them to be there. 00:27:27.160 --> 00:27:33.160 And we had a really, really hard time of getting them out of her apartment because she was not agreeing to it. 00:27:33.319 --> 00:27:40.519 And then the only other option would have been for her to have an eviction, which none of us wanted to have her be evicted because that would have affected her life. 00:27:40.759 --> 00:27:45.559 And so the whole team was scrambling on how we were going to get the situation resolved. 00:27:45.720 --> 00:27:50.600 Like, you know, we sent her to respite for two weeks, hoping that they would see that she was gone. 00:27:50.759 --> 00:27:57.400 And she agreed to it eventually because I think she realized that her housing was in jeopardy, but then they just kept coming back. 00:27:57.640 --> 00:28:06.200 And eventually we did end up having to move this particular client from the apartment and helping her set these boundaries to not let this person in. 00:28:06.759 --> 00:28:25.640 And then, you know, the companion agency that had hired this person in the past then had to go in there and report this person because that was a clear violation and abuse of, you know, their their position then terms of taking advantage of a, you know, an individual who had severe and persistent mental illness. 00:28:25.880 --> 00:28:36.200 So yeah, it was a very interesting situation, but it really left us as a team struggling on how to really help her because she had the right to have who she wants to be in life in her life. 00:28:36.360 --> 00:28:44.120 And that is a really challenging thing when you know that these people are taking advantage and and not being helpful and putting her at risk. 00:28:44.200 --> 00:28:53.960 Like she could have gotten evicted, which would have been really a serious situation for her because she wouldn't have been able to get affordable housing for seven years because this person was her friend. 00:28:54.120 --> 00:28:55.720 It was, yeah, it was a tough case for sure. 00:28:56.120 --> 00:29:20.519 So many levels, that's so difficult, especially when you take it from the very first thing that jumped into my head is what about the licensure of this person who is the former, the former treater now breaking those ethical boundaries and moving her and her family into this woman's house, knowing full well the incapacity of Teresa in this case. 00:29:20.840 --> 00:29:42.519 I had a situation, a family situation, and frankly, my my relative just passed

away a couple weeks ago, but he had a friend slash caregiver who wound up moving his entire family into his house, put him in the back, like three-season porch to live in a chair, kept him drunk so he wouldn't complain because that's what he wanted. 00:29:42.600 --> 00:29:43.720 He wanted his alcohol. 00:29:43.960 --> 00:29:48.120 As long as he was drunk and had his medication, this gentleman was happy and fine. 00:29:48.360 --> 00:30:02.920 And meanwhile, this family is living in his nice condo and taking advantage and and and probably, as you say, using his his services, using his, not his services, but his checks, you know, a social security check and whatever, other food stamps and things like that. 00:30:03.640 --> 00:30:11.799 Thank God it caught through elderly protective services, and we were able to put a kibosh on it, you know, 10 years ago, but not quite that long. 00:30:11.880 --> 00:30:15.160 But but that I mean that is just frightening and horrific. 00:30:15.480 --> 00:30:24.200 And and and the fact that that Teresa is mentally challenged in terms of her decision-making abilities, right? 00:30:24.519 --> 00:30:32.840 And probably influenced by the quote-unquote friendship really brings this case to a whole other level. 00:30:33.000 --> 00:30:35.799 So how did the people finally wind up leaving, Angela? 00:30:36.360 --> 00:30:55.160 So she we ended up moving her, and I then so they didn't follow her to the next apartment because it was it was an apartment building that you know there would have been more you know, people and and levels of security in there, whereas the other building she was in like a high-rise eight, you know, floor building. 00:30:56.600 --> 00:30:57.720 You know, that sucks. 00:30:57.960 --> 00:31:07.640 That sucks for her that these assholes got this situation to the extent where she had to up her life and move on because of them. 00:31:07.880 --> 00:31:08.840 That sucks. 00:31:09.880 --> 00:31:13.480 You know, that's a shitty resolution to a to a shitty situation. 00:31:13.720 --> 00:31:17.720 Yeah, I think I think this scenario happens, Michael, more often than we think, though. 00:31:17.880 --> 00:31:21.880 I think we're working with a vulnerable population that's lonely. 00:31:22.120 --> 00:31:24.840 And I'm just thinking of my stepfather recently. 00:31:24.920 --> 00:31:27.319 He had an aide who stole$200 from him. 00:31:27.559 --> 00:31:34.680 He had gone to the bank, she had had him upstairs, showering him where he was in the tub, and then ran downstairs. 00:31:34.840 --> 00:31:37.480 And and then she thought that he wasn't gonna know. 00:31:37.559 --> 00:31:42.279 And we all know my stepfather, he knows how much money he takes, like he knows his money. 00:31:42.920 --> 00:31:48.120 And she was banking on the fact that he was gonna seem like he had, you know, memory issues. 00:31:48.360 --> 00:31:57.400 I just feel like this population is super vulnerable to it's not just it's just not it's not just persons with mental incapacity. 00:31:57.480 --> 00:32:04.759 The the guy that I just described, they uh one of the the aides stole his family heirloom ring in the nursing home. 00:32:05.000 --> 00:32:07.720 Yeah, I mean, this stuff it it happens. 00:32:07.880 --> 00:32:15.080 It's it's Sarah, you and I had a case where they they literally stole three and a half million dollars from a gentleman. 00:32:15.319 --> 00:32:19.319 Three and a half mil, no, three point nine million dollars was stolen. 00:32:19.480 --> 00:32:19.720 Right. 00:32:19.960 --> 00:32:21.880 I mean, that's not smart. 00:32:22.200 --> 00:32:23.240 And that's an ethical dilemma. 00:32:23.319 --> 00:32:23.960 So what do you do? 00:32:24.039 --> 00:32:35.720 You have these caretakers that people view as family, right, and they're predatory and victimizing the folks that we service or our family members or whoever. 00:32:35.799 --> 00:32:37.880 I mean, it's it is an ethical dilemma. 00:32:37.960 --> 00:32:38.600 And what do you do? 00:32:38.680 --> 00:32:39.720 How far do you push it? 00:32:39.880 --> 00:32:41.319 My stepfather called the police. 00:32:41.480 --> 00:32:44.920 There was no, you know, there was there was that's do that. 00:32:45.080 --> 00:32:45.799 Call the police. 00:32:45.960 --> 00:32:46.360 Absolutely. 00:32:46.840 --> 00:32:50.920 I mean, remember we had that case, we're calling him Mark here today. 00:32:51.160 --> 00:32:52.120 We had a case. 00:32:52.279 --> 00:32:55.799 Mark was this short little Portuguese guy, uh loved him. 00:32:55.960 --> 00:32:58.680 He he was just a fun, fun little guy. 00:32:59.160 --> 00:33:03.240 Diabetes, one of the worst cases of diabetes I ever saw or ever heard of. 00:33:04.519 --> 00:33:13.640 But boy, that guy loved his sweet, he could not get away from it, and he was just his diet was horrible, and the diabetes was gonna kill him because of his diet. 00:33:13.960 --> 00:33:18.039 And we really worked hard with him around his diet. 00:33:18.360 --> 00:33:21.960 But remember, Sarah, there is one thing he would not give up. 00:33:22.120 --> 00:33:27.080 He drank two, two two-liter bottles of soda every day. 00:33:27.240 --> 00:33:29.799 So he drank four liters of soda every day. 00:33:30.039 --> 00:33:33.799 I don't remember what his soda choice was, but it doesn't make a difference. 00:33:34.039 --> 00:33:36.279 And he just would not give that up. 00:33:36.440 --> 00:33:46.759 And you know, I think I remember eventually just you know, in this case, I was a conservator, you were the worker, and and at the at one point we're just like, you know what? 00:33:47.080 --> 00:33:51.880 It's making the guy happy, and you know, and what are we gonna do? 00:33:51.960 --> 00:33:52.759 We can't stop him. 00:33:52.920 --> 00:33:59.960 I'm not gonna follow him around or with every time he goes past the uh soda machine and puts a dollar in and gets a soda out. 00:34:00.360 --> 00:34:03.720 So sometimes, practically speaking, what can we do?

00:34:04.120 --> 00:34:11.559 So Mark's case had a very sad ending, and it still makes me sad to think about as we're talking about it because Mark is no longer with us. 00:34:12.279 --> 00:34:14.679 So we Michael, you're right. 00:34:14.759 --> 00:34:22.920 You did a harm reduction model on Mark with Mark because it was as quality of life versus the alternative, right? 00:34:23.000 --> 00:34:24.920 Which was denying him everything he loved, right? 00:34:25.000 --> 00:34:26.440 He loved that soda. 00:34:27.400 --> 00:34:32.039 And for a long time, for years and years and years, we did harm reduction with Mark. 00:34:32.119 --> 00:34:42.759 So he was able to balance his sweets with the diabetes, but eventually it caught up with him and his medical condition deteriorated so much so that he ended up in a skilled nursing facility. 00:34:43.000 --> 00:34:48.759 And so he was actually ended up in a locked skilled nursing facility. 00:34:48.920 --> 00:34:57.639 And at the time, we were trying to work with his providers to get him to a place where it wasn't locked, where he could have free access to the community. 00:34:57.799 --> 00:35:08.360 And that was an ethical dilemma because at that point we were the ones advocating for, you know, allowing him to have some of these things that soda, soda that could harm him. 00:35:08.519 --> 00:35:11.480 He wasn't out using substances, he wasn't out, you know. 00:35:12.199 --> 00:35:19.880 No, because because in that when he was in that facility, um and and this is a trajectory very often for advanced diabetes and advanced age, etc. 00:35:20.119 --> 00:35:26.599 We know that you go to a facility, he had he had mental health issues and he had memory issues, so a lock facility made sense. 00:35:26.839 --> 00:35:41.239 But because he was in there and he had these issues, the doctors on and and staff are like, Well, no soda, you can't have and we were like, dude, the soda is what he, you know, that's his if you gave him the soda, he'd be your your your perfect patient. 00:35:41.399 --> 00:35:48.199 And they uh understandably have that their own ethical dilemma about I know the soda's killing them, I can't give it to him. 00:35:48.519 --> 00:35:50.359 It's such a it's and it and it's sad. 00:35:50.439 --> 00:35:54.039 And so here was the ethical dilemma though that I faced at the end. 00:35:54.279 --> 00:35:58.199 So he had he had been on an open unit on the skilled nursing facility. 00:35:58.279 --> 00:36:00.279 He left to go get soda. 00:36:00.519 --> 00:36:09.399 So instead of working with him on, you know, maybe taking him out to go get soda, what they did a knee-jerk reaction and put him on the left unit. 00:36:09.559 --> 00:36:13.799 And within six months to a year, I can't remember because it was a while ago. 00:36:14.039 --> 00:36:14.599 It was short. 00:36:14.839 --> 00:36:16.599 He had he had failure to thrive. 00:36:16.679 --> 00:36:22.759 He had lost his will to live, which sometimes we see with folks who

go into skilled nursing facilities. 00:36:23.000 --> 00:36:28.279 He had lost his will to live and didn't eat anymore, despite our best efforts. 00:36:28.359 --> 00:36:37.079 And that also became an ethical dilemma because I advocated for him to go to the hospital for psychiatric condition and you know that that the nursing home. 00:36:37.639 --> 00:36:39.719 Yeah, it knocked over a lot of dominoes in this case. 00:36:39.960 --> 00:36:40.519 It really doesn't. 00:36:40.759 --> 00:36:43.000 I I forgot about all this stuff to be honest with you. 00:36:43.319 --> 00:36:48.119 I just tried to leave it sort of surface level, but yeah, this did bring up a lot. 00:36:48.199 --> 00:36:51.319 But and I do remember that that he he passed away pretty quick. 00:36:51.559 --> 00:36:56.519 Once he decided he was gonna pass away, he passed away pretty quickly, which, you know, for him may have been a blessing. 00:36:56.599 --> 00:37:15.559 And and and we'll get back to our conversation in just a minute, but I want to take a second to talk about something that many of us in this community deal with every single day, and that's the mental load of caregiving. 00:37:15.799 --> 00:37:22.599 If you're like me, your brain is probably filled with appointment dates, medication schedules, and a never-ending list of questions for doctors. 00:37:22.759 --> 00:37:29.000 It's exhausting trying to keep it all in your head while also trying to show up emotionally for the person you love. 00:37:29.480 --> 00:37:35.079 That's exactly why the team at the Care Coalition created the Care Navigator Journal. 00:37:35.399 --> 00:37:37.639 This is not just another notebook. 00:37:37.719 --> 00:37:49.719 It's a tool specifically designed to help you to stay organized and more importantly, to help you feel a little more in control when things start feeling really chaotic. 00:37:49.879 --> 00:37:56.919 It gives you a dedicated space to track medical updates, manage daily tasks, and even process your own thoughts. 00:37:57.079 --> 00:37:58.279 Imagine such a thing. 00:37:58.519 --> 00:38:03.639 Your well-being matters just as much as the person that you're caring for. 00:38:04.359 --> 00:38:09.960 If you're feeling overwhelmed and looking for a way to stay organized, I highly recommend picking one up. 00:38:10.119 --> 00:38:16.839 You can find it right now at www.carecoalition.org slash holding it together. 00:38:17.159 --> 00:38:23.000 Again, that's carecoalition.org slash holding it together. 00:38:23.799 --> 00:38:27.879 It's a small way to start holding it all together, one page at a time. 00:38:28.599 --> 00:38:30.599 All right, let's get back to the show. 00:38:44.839 --> 00:38:46.359 That's somebody else's decision to make. 00:38:46.439 --> 00:38:47.319 I'm not mine, you know. 00:38:47.799 --> 00:38:49.319 But it shows that we have to balance. 00:38:49.480 --> 00:38:57.159 We can't just there's no cookie cutter, like for, and I know we're gonna talk about George, but there's no cookie cutter decision here. 00:38:57.319 --> 00:39:03.559 I mean, because look at here, everybody in, you know, all the medical providers thought they were doing right by Mark, right? 00:39:03.719 --> 00:39:07.480 When really they were taking away the one thing that was giving him joy in life. 00:39:07.719 --> 00:39:08.439 Yeah, yeah. 00:39:08.759 --> 00:39:10.759 Yeah, it goes back to the cigarettes too, right? 00:39:10.839 --> 00:39:20.439 I mean, the whole smoking of cigarettes has been, you know, such a uh a back and forth for providers and clients and the system, you know. 00:39:20.599 --> 00:39:23.239 And you guys remember when my grandmother died. 00:39:23.559 --> 00:39:32.599 When my grandmother died the last day she was alive, we wheeled her, we wheeled her out of hospice in her hospice bed to smoke a cigarette, right? 00:39:32.759 --> 00:39:35.559 She's smoking, she she died that day. 00:39:35.879 --> 00:39:37.879 But you know, that was her thing, man. 00:39:37.960 --> 00:39:39.159 She had to have those smokes. 00:39:39.399 --> 00:39:41.159 Cigarettes are a big one for sure. 00:39:41.319 --> 00:39:42.279 So you brought it up, sir. 00:39:42.439 --> 00:39:45.480 So why don't you why don't you just go right ahead and and introduce George? 00:39:45.799 --> 00:39:54.519 But because this topic is what the best way I can say it is allowing a client to fail, right? 00:39:55.399 --> 00:40:00.679 We have to at some point be I don't even know. 00:40:01.079 --> 00:40:07.000 We we have to be okay with allowing a client to make bad choices, knowing that they're gonna set them back. 00:40:07.159 --> 00:40:16.759 We have to allow them to fail, and where we draw that line becomes a real tough call for the courts and for us individuals making big-time decisions for people. 00:40:16.919 --> 00:40:19.000 So tell us tell us about George. 00:40:19.319 --> 00:40:38.599 So George was a young adult, and George had, you know, quite the history of substance use in the community, didn't take his medications as prescribed, so he would often end up floridly psychotic, delusional, having auditory hallucinations, visual, visual hallucinations, um, and was was quite tortured by some of his symptoms. 00:40:38.759 --> 00:40:43.399 So oftentimes he would end up homeless on the streets, panhandling for money. 00:40:43.719 --> 00:40:47.239 He had gotten assaulted numerous times on the streets. 00:40:47.399 --> 00:40:52.839 He was a young kid, so he he didn't really kind of fit into the street culture. 00:40:53.079 --> 00:40:55.399 And so he was just really at risk. 00:40:55.480 --> 00:41:02.359 So his team worked diligently to try to get him to the hospital and eventually had him committed to a state hospital. 00:41:03.239 --> 00:41:07.719 So during his course at the state hospital, they had tried different medications. 00:41:07.960 --> 00:41:14.599 You know, he they had offered him different rehab groups, and he was right in the middle of his course of treatment.

00:41:14.759 --> 00:41:20.119 They still hadn't found a really good cocktail to treat the hallucinations or delusions. 00:41:21.559 --> 00:41:29.239 You know, the I don't even think they touched the substance use, you know, topics because they were still trying to get him psychiatrically stable. 00:41:29.799 --> 00:41:34.919 But he had gotten advocates involved because he didn't want to be in the hospital. 00:41:35.159 --> 00:41:41.559 He felt like it was his right to be out on the streets making decisions, even if it put his life in danger. 00:41:41.960 --> 00:41:48.679 So, long story short, the inpatient team and the outpatient team did not feel like he was ready to come out. 00:41:48.839 --> 00:41:57.399 However, the advocates requested a court hearing, which happens very often when you have someone who doesn't want to be in a state hospital for treatment, right? 00:41:57.559 --> 00:41:58.279 They have rights. 00:41:58.359 --> 00:42:00.679 And so it triggers a court hearing. 00:42:01.000 --> 00:42:08.519 And the advocates put on their case, and basically their case was he has the capacity to make these really poor decisions. 00:42:09.000 --> 00:42:11.799 And we need to allow him to make these really poor decisions. 00:42:11.960 --> 00:42:25.159 And then, of course, at the court hearing, he came and said, Oh, I'm gonna be sober, I'm gonna do this, I'm gonna take my meds, I'm gonna, you know, every every for that five minutes, he was able to pull it together and say everything that the judge needed to hear. 00:42:25.480 --> 00:42:32.439 So he was discharged that day to a program that we call uh do we have them throughout the state of Connecticut. 00:42:32.519 --> 00:42:37.960 They're they're called recipite programs, they're like temporary housing uh with 24-hour staffing. 00:42:38.119 --> 00:42:49.879 And that night he went to a dumpster and found some needles of God knows what and injected them and took medications that were discarded and ended up in a really serious medical crisis. 00:42:50.199 --> 00:43:00.599 So that to me was just again, there was the process had to happen, but it wasn't the outcome that we were looking for. 00:43:01.000 --> 00:43:03.319 Well, no, of course it wasn't the outcome we were looking for. 00:43:03.399 --> 00:43:11.960 And it that's that gets me back to that argument that that I I I say, you know, we can't know with any degree of certainty. 00:43:12.039 --> 00:43:14.519 Nobody has a crystal ball, nobody knows anything 100%. 00:43:14.839 --> 00:43:25.879 But boy, we can make some pretty strong predictions about what what what's gonna happen or how a client or patient or loved one will more than likely act. 00:43:26.119 --> 00:43:50.679 We knew that this guy wasn't ready, was not ready, but you turn it over to the court and you bring in the right team of lawyers or whatever that may look like, and the criteria sometimes is such that their hands are tied and they say, you know, we we are bound legally, ethically to

protect and preserve this gentleman's rights. 00:43:50.919 --> 00:43:55.239 And yes, and frankly, sometimes, of course, just get fed up with with the hospitals. 00:43:55.319 --> 00:43:58.279 You guys have had this guy for six months, and this is as good as he's getting. 00:43:58.439 --> 00:43:59.319 Well, guess what? 00:43:59.480 --> 00:44:03.000 I'm gonna let him go because it's not doing him any good here. 00:44:03.159 --> 00:44:04.439 Let's give him another chance. 00:44:04.599 --> 00:44:11.799 You know, maybe he'll thrive as we were just talking about with other people in a setting that he's choosing and he'll find more quality of life for himself. 00:44:12.039 --> 00:44:12.839 Who knows? 00:44:13.079 --> 00:44:21.559 I mean, but we have, I mean, there's plenty of there's plenty of those I told you so moments that we could we could probably point to or gotcha. 00:44:21.639 --> 00:44:29.000 And I know this is not about gotcha or I told you so, but there are cases where this comes up and and we do we do see it. 00:44:29.159 --> 00:44:41.639 And I think as family members, caregivers, providers, we can we we can certainly make reasonably predictive assumptions about what will likely happen. 00:44:41.799 --> 00:44:42.359 Um given. 00:44:42.679 --> 00:44:44.599 You know what's important about his case though, Michael? 00:44:44.839 --> 00:44:46.119 We were the safety net. 00:44:46.599 --> 00:44:55.079 So uh instead of doing the I told you someone pointing the fingers and you know, I was right, we swooped in as soon as that happened. 00:44:55.239 --> 00:44:59.159 We ended up getting back into the state hospital for a further treatment. 00:44:59.480 --> 00:45:11.960 But I feel like that's where the safety net has to be, you know, that's where people need to say I'm glad you brought up the safety net because the safety net the the the role that we we have in our in our work is to be. 00:45:12.439 --> 00:45:35.960 The person who knows this entire history, the entire history of this case, the up to the minute information about what's going on with this particular individual, where he went yesterday, what he's doing today, you know, and we were able to, because of all of that information, we were able to talk to again the powers that be, and as you say, got him back into the facility. 00:45:36.759 --> 00:45:40.679 That's the power, folks, of keeping something like the care navigator. 00:45:41.159 --> 00:45:43.799 I was just gonna say the care chain with plug. 00:45:44.359 --> 00:45:59.879 Not to plug your care job, but that is yes, that is that is the reason because if you can have the history right at your fingertips and have a document you can just send over to the attorneys in the court, that is that is the reason to keep the care the career. 00:46:00.199 --> 00:46:05.799 I mean, it is it's it's a perfect example of the why you keep your records meticulous. 00:46:06.359 --> 00:46:07.719 Don't be haphazard about it. 00:46:07.879 --> 00:46:08.759 Yeah, not all over the place. 00:46:08.839 --> 00:46:11.879 Yeah, don't be haphazard, know your stuff. 00:46:12.199 --> 00:46:13.079 Know your stuff. 00:46:13.399 --> 00:46:20.439 Angela, I want you to talk about Martha because this is another one of those that just went horribly wrong. 00:46:20.519 --> 00:46:24.439 And it's another, I don't know if it's as much of an I told you so, but tell us about it. 00:46:25.319 --> 00:46:26.199 A teach of a moment. 00:46:26.839 --> 00:46:28.439 It was a little bit of a combination of both. 00:46:28.599 --> 00:46:29.559 So it's a teacher. 00:46:30.919 --> 00:46:31.399 Yes. 00:46:31.559 --> 00:46:33.960 Yeah, so similar, similar situation, right? 00:46:34.039 --> 00:46:41.480 You're in a state hospital, you know, saying okay, but not great, needs to have a certain level of care. 00:46:41.639 --> 00:46:51.079 Everybody's working on getting this certain level of care, the legal rights that are now involved because it's taking too long for this level of care to have a bed, right? 00:46:51.159 --> 00:46:55.879 I mean, this is the classic scenario of really kind of what the system is dealing with right now. 00:46:56.119 --> 00:47:10.359 And so Martha had a friend, and this friend came in and said, I can take her with me, and she can come live with me in another town that was not anything anywhere near where she originally had been residing. 00:47:10.759 --> 00:47:18.039 And so the advocates and the client really advocated really hard that they were gonna have this discharge plan to this friend. 00:47:18.279 --> 00:47:19.719 It was a safe place to go. 00:47:20.119 --> 00:47:24.519 You know, she was gonna get connected to the outpatient services in this new area. 00:47:24.679 --> 00:47:28.279 She was agreeing to all the services, all the things. 00:47:28.759 --> 00:47:32.679 Unfortunately, we didn't feel like we had enough to say she couldn't go there, right? 00:47:32.759 --> 00:47:41.079 It was a person that came into the team and said he would be responsible and help and till she could get into this other residential program. 00:47:41.480 --> 00:47:45.000 And so she ended up getting discharged to this friend's house. 00:47:45.079 --> 00:47:50.439 And within two days, she moved back into a house that was already condemned. 00:47:51.239 --> 00:47:52.519 It hadn't been condemned. 00:47:52.599 --> 00:47:54.439 It was in the process of being condemned. 00:47:54.519 --> 00:48:07.079 And so she was able to get back into this house that was not safe and then had a very, very dangerous situation where there was no heat in the house, and she ended up turning on her stove and caused a fire. 00:48:07.239 --> 00:48:14.119 And then once emergency services were able to get in there, they found out she had frostbite and was in really, really poor condition. 00:48:14.439 --> 00:48:18.359 So can you talk a little bit about though that the outreaches that were done? 00:48:18.439 --> 00:48:24.679 Because I feel like that's the teachable

moment that that you know, we we knew there were there were risks. 00:48:25.000 --> 00:48:30.599 And again, getting the community and getting people to respond was was challenging on this case too. 00:48:30.919 --> 00:48:31.079 Yeah. 00:48:31.159 --> 00:48:36.759 So when she ended up back into this house, we already all knew that was not a safe house to be in. 00:48:37.079 --> 00:48:50.759 Every time we would call for a crisis outreach or to the police for a wellness check, pretty much what was happening is they were talking to her through the door, and they were saying, and she was saying, I'm fine, everything's fine, don't worry about me, I don't need anything. 00:48:51.000 --> 00:48:53.159 And no one actually entered the house. 00:48:53.559 --> 00:48:55.239 Nobody saw her, nobody had eyes on. 00:48:55.559 --> 00:48:56.679 Right, no one had eyes on. 00:48:56.759 --> 00:49:07.480 It was just trusting what she was saying when we all knew that she hadn't been on medication, that the house was already in poor condition, the house was getting in even more poor condition, which didn't have working plumbing, right? 00:49:07.879 --> 00:49:08.359 What's that? 00:49:08.679 --> 00:49:10.359 It didn't have working plumbing, right? 00:49:10.679 --> 00:49:23.000 It had but it had plumbing, but it wasn't at the the we weren't really a hundred percent sure what was really functioning in the house because it was also a house that was very cluttered with a lot of things, almost bordering hoarding. 00:49:23.079 --> 00:49:24.359 So it was really hard to know. 00:49:24.519 --> 00:49:29.799 And this was prior to her going back into the house, and we already knew that there were these challenges in this house. 00:49:30.199 --> 00:49:35.879 But the the thing is that they just thought it was good enough to hear her voice, and it wasn't good enough to just hear her voice. 00:49:36.119 --> 00:49:44.199 And then what happened was they were turning around to leave after she said everything was fine, and that's when the fire they noticed the fire. 00:49:44.439 --> 00:49:45.079 Oh my god. 00:49:45.319 --> 00:49:51.000 And that was really the only reason why they got into the house and and found what was really going on in there. 00:49:51.079 --> 00:49:55.399 So it took such a serious incident, which could have been prevented. 00:49:55.480 --> 00:50:04.759 We were trying to be proactive, we were trying to get people to see the risk, but because they were not seeing her physically, we missed it. 00:50:05.079 --> 00:50:07.399 So they're walking away, they knock on the door, yeah. 00:50:07.480 --> 00:50:08.359 I'm fine, thank you very much. 00:50:08.519 --> 00:50:08.919 See you later. 00:50:09.000 --> 00:50:09.799 Have a good time. 00:50:09.960 --> 00:50:11.079 You're alive, they're walking away. 00:50:12.279 --> 00:50:13.319 What's that smell? 00:50:13.559 --> 00:50:15.480 Yeah, this smells like fire. 00:50:16.839 --> 00:50:18.199 So I'm like, well, what is the law? 00:50:18.279 --> 00:50:19.639 What is the law around that? 00:50:19.799 --> 00:50:21.559 Because they clearly check the box. 00:50:21.719 --> 00:50:23.079 Okay, you're alive, great. 00:50:23.399 --> 00:50:25.239 Okay, nice to nice to know you. 00:50:25.559 --> 00:50:30.679 What is the law about entering people's homes without permission if you're doing a wellness check? 00:50:30.839 --> 00:50:35.000 Like is a wellness check just physically looking at them and seeing that they're alive? 00:50:35.159 --> 00:50:37.000 Or who's doing the wellness check? 00:50:37.079 --> 00:50:37.559 Is it the police? 00:50:37.960 --> 00:50:38.919 This was the police, yeah. 00:50:40.199 --> 00:50:44.759 And I think that the police bring it to a I think the police can bring it to a whole new level. 00:50:45.000 --> 00:50:52.599 I think the police have the ability to go in and physically but but but put yourself in their situation too. 00:50:52.839 --> 00:50:59.480 I mean let's take out the cynical side of not wanting to have the two do the paperwork or explain why we busted the door down. 00:50:59.719 --> 00:51:12.199 But you know, there's it's they're humans, they're human beings, and they're talking to somebody who, for all intents and purposes to them, sounds like a a lucid or at least somewhat coherent person. 00:51:12.279 --> 00:51:14.599 They have yeah, in all fairness, right? 00:51:14.679 --> 00:51:17.960 I mean, they had gone out and she had been fine a couple of times, right? 00:51:18.039 --> 00:51:20.839 And she could kind of pull herself together, you know. 00:51:21.000 --> 00:51:24.039 But as she progressively got worse, so they missed it. 00:51:24.119 --> 00:51:29.399 Like I feel like they got a little complacent because they kind of knew her, right? 00:51:29.480 --> 00:51:38.679 Because it's not the first call, definitely wasn't gonna be the last call, but they they didn't see the progression that we were trying to stress than the urgency of why we kept calling them. 00:51:39.079 --> 00:51:43.319 And I think that complacency, and that's complacency is a bad word. 00:51:43.480 --> 00:51:54.039 We're not trying to make it a bad word here, we're just trying to say that as you say, they got accustomed to her being the way she was, and she was able to maintain that level of presence. 00:51:54.279 --> 00:51:54.599 Right. 00:51:54.919 --> 00:51:58.919 And lo and behold, well, their kitchen's on fire. 00:51:59.000 --> 00:52:00.359 At least it was warm. 00:52:05.719 --> 00:52:06.359 I was kidding. 00:52:06.439 --> 00:52:06.679 Yeah. 00:52:09.719 --> 00:52:15.639 Had they not been there, that could have been disastrous, and again, would have could have ended in loss of life. 00:52:15.799 --> 00:52:24.119 And I think that's what we're talking about today in some of these cases is you know, what what can the potential outcomes be? 00:52:24.599 --> 00:52:26.759 And we don't know, we don't have a crystal ball. 00:52:27.799 --> 00:52:56.199 No, I and and and I just I

don't I don't want to, I'm gonna open up a can of worms here that we're not going to discuss, but I do want to discuss one thing that that we have been through maybe two times in the entire time that the three of us have been working together, where there is this this level, what we're talking about here, this level of push and pull and rights versus duties or refusal to treat. 00:52:56.279 --> 00:53:16.839 And maybe this is the the discussion that we should get into in another episode, but I mean we have had a situation where we have kicked this uh case up, cases, and it wasn't us just kicking it up, it was the entire system from the commissioner's office down to say, okay, guys, here's a case that is really perplexing to all of us. 00:53:17.079 --> 00:53:25.399 Yeah, this particular individual is just not one responding to anything that we're doing, two, doesn't want us involved anyway. 00:53:25.639 --> 00:53:26.839 So what are we all doing? 00:53:27.000 --> 00:53:28.199 Who's chasing who around? 00:53:28.279 --> 00:53:29.480 Why are we all doing it? 00:53:29.639 --> 00:53:31.639 The client hates us anyhow. 00:53:31.879 --> 00:53:52.199 And folks, it does happen where you have high, high, high-level meetings with a lot of input from a lot of players for some of these uh departments to make a decision as to whether or not it is time to give up the ghost and say we've done everything we can do. 00:53:52.359 --> 00:53:54.439 This patient has done everything they can do. 00:53:54.919 --> 00:53:56.439 And that that does happen. 00:53:56.599 --> 00:53:58.919 That is not the case that I want to talk about here today. 00:53:59.079 --> 00:53:59.879 That is not the case. 00:54:00.039 --> 00:54:07.000 Again, I'm leaving that sort of a uh hanging chad out there that that that has happened in our in our experience as well. 00:54:07.159 --> 00:54:09.239 But uh I'm gonna leave it here. 00:54:09.480 --> 00:54:11.239 I think these are great discussions. 00:54:11.480 --> 00:54:15.719 Again, some of them have answers, some of them don't have answers. 00:54:16.119 --> 00:54:24.199 That's the point of this podcast is to put put it out there for you guys that uh what you're experiencing with your particular case may or may not be unique. 00:54:24.919 --> 00:54:36.039 Share your stories, uh share your your thoughts and your comments, get the Care Navigator Journal so you can keep really good records and keep abreast of your loved ones situation. 00:54:36.439 --> 00:54:48.599 And uh, you know, we have plenty of plenty of these uh stories, these vignettes for you guys that interestingly enough, we could probably break down into short little segments and put out there for you all to listen to as well. 00:54:48.839 --> 00:54:51.879 So again, thanks, Sarah and Angela, for being here today. 00:54:52.119 --> 00:54:53.719 Thank you guys all for listening. 00:54:53.879 --> 00:54:59.480 And by the way, our podcast is doing amazing in just the few short weeks that we've been doing it. 00:54:59.559 --> 00:55:05.000 We're already over 4,000 downloads and we have yeah, it's really going well. 00:55:05.159 --> 00:55:06.839 So thanks to everybody for your support. 00:55:07.000 --> 00:55:07.399 Thank you guys. 00:55:07.639 --> 00:55:13.559 Thank you to you guys for your support and helping me to put it out there, and we'll talk again soon. 00:55:13.960 --> 00:55:14.519 Bye. 00:55:15.079 --> 00:55:15.639 Bye. 00:55:20.439 --> 00:55:24.359 There's no perfect manual for these stories, folks. 00:55:24.599 --> 00:55:27.159 There's no right or wrong answer there. 00:55:27.480 --> 00:55:29.960 You can't just call up and say, What do I get? 00:55:30.439 --> 00:55:33.000 This is not a one-size-fits-all policy. 00:55:33.079 --> 00:55:39.399 But we force our own definitions of safety or best interest onto others. 00:55:39.639 --> 00:55:48.279 Uh very often we risk losing the very thing we're supposed to be fostering, which is humanity and dignity. 00:55:49.079 --> 00:55:57.159 Bringing these cases before a judge sometimes it's necessary, it's not necessary, it's not a division of the fee. 00:55:57.639 --> 00:56:03.239 It's not it becomes an act of play and responsibility.