A guardian/parent called regarding his son who lived in a corporate foster home with three other clients. His primary concern was that the men were not fed adequate amounts of food at meals and the beverage at meals was often water, Kool-Aid or tea. Meals were regularly TV dinners and strict portions were given to the men. For example: one lunch choice was 1 sandwich, 1 slice of deli meat, fruit, vegetable and choice of beverage and a dinner consisted of 1 easy chicken enchiladas, and frac12; cup of corn and water. Many times no milk was available.
The Regional Ombudsman met with three of the clients, reviewed some records and reviewed the posted menu. There were no doctors orders for any of the residents regarding portion control and the menu had not been reviewed by a dietician. Other concerns included: lack of community activities, the men did not go out to dinner even on birthdays and other special occasions, the men had to purchase their own coffee. The Regional Ombudsman addressed these issues with the foster home staff and the county licensor.
A series of meetings were held with the foster home staff, county licensor, clients guardian and County social workers. As a result of the meetings the house manager contacted the clients primary physicians regarding dietary recommendations and a dietician reviewed the revised menus. Milk was to be available upon request. An 8 cup pot of coffee was to be available for breakfast and after work. An opportunity to go out to eat was to be offered at least monthly. The program would explore ways to provide more community activities.
A client called who is a veteran and is under guardianship and conservatorship. The clients disability check should have arrived the day before he called but it had not been deposited in his account. The client has diabetes and the only food in his apartment is a frozen dinner. His conservator was not returning his phone calls.
The Regional Ombudsman called and explained the problem to the conservator on her voice mail. The conservator called the Regional Ombudsman and said the check was now deposited for the client.
The Regional Ombudsman received an email from a clients home asking for assistance for the client who has a mental illness and traumatic brain injury. The clients guardian and social worker decided to move the client to a family foster care. The Regional Ombudsman visited with the client who told her he did not want to move from his home of 9 years. He said he liked his housemates and the staff. He also enjoyed activities including those with residents from some of the corporations other adult foster homes. The client was familiar with his neighborhood and able to enjoy solitary walks.
The Regional Ombudsman advised the client he could write a letter to the court and ask the judge to appoint an attorney for him to petition the court to review the proposed change of abode. She also explained what information to provide in the letter. When the clients social worker and guardian learned of the client's letter to the court they arranged a meeting and invited the Regional Ombudsman, who attended with the clients approval.
It was their position that the client told the Regional Ombudsman he wanted to stay in the home because she met him in his home. The Regional Ombudsman met with the client at his home because she did not want to interfere with his competitive employment. She offered to meet with him at his work site at the end of his work day. The team agreed to consider the results of that meeting.
The Regional Ombudsman met with the client who very clearly declared that he wanted to remain in my home. The Regional Ombudsman informed the team but the guardian and social worker still said client would be moved. An attorney was appointed and the matter went to a hearing.
The judge ruled in the clients favor that he was to remain in his home.
A Native American woman in her 70s, who had a successful career with the federal government, experienced serious problems with depression, chemical dependency and gambling following the sudden death of her husband, and shortly thereafter, the death of a daughter suffering from postpartum depression. Her son obtained appointment as her guardian/conservator by the reservation's Tribal Court, without the client being notified of, being present at, or being represented at the hearing.
The son/guardian arranged for her placement in a very rural assisted living facility and instructed the facility to restrict her to the unit, to only allow contact with him and his wife (they had only one contact in over a year) and to restrict her from all phone and personal contact with all other persons.
Meanwhile a daughter searching for a resource, learned about the Regional Ombudsman for Long Term Care. That Office in turn involved the OMHDD, as well as adult protection. We later learned that the client herself had been asking the facility to contact the OMHDD, but the facility had denied her request believing that the guardian had that power.
Our client also reported that many belongings, including valuable jewelry, Native American artifacts, original artwork, valuable accordions and furniture were unaccounted for by the guardian/conservator. Adult protection researched the allegations financial exploitation and engaged the assistance of two other counties who had already completed such investigations in this case.
OMHDD, together with the Ombudsman for Long Term Care and Adult Protection, provided information to facility administration regarding the powers of a guardian and client/wards rights. We also provided more formal training for facility staff on guardianships, including the client in this training. The visit and phone restrictions were terminated and she was able to renew contact with her daughter and other family. She was no longer given medications against her will.
The involvement of a Tribal Court made the guardianship situation complicated, but through persistence, the Regional Ombudsmen were able to ensure the client received legal assistance in asking the Tribal Court to remove her son as guardian/conservator replacing him with a neutral guardian through a Native American organization. Tribal Court is pursuing holding the son accountable for the assets over which he had control.
Our client was able to leave the assisted living facility and has moved to a small community facility in her daughter's community.
A 63 year old woman, feeling trapped in a large state operated facility, contacted the OMHDD for assistance in obtaining a discharge to return to her home. She was under commitment as mentally ill and chemically dependent and also under the guardianship/conservatorship of her daughter. Complicating this was:
A court hearing had been scheduled regarding the proposed sale; we were unsuccessful in obtaining a change of venue and the guardian/conservator refused to provide transportation to the hearing.
The Regional Ombudsman attended the hearing with the client (via phone) and was able to point out that the client was asking for an independent evaluation and was asking to return to her own home. The hearing was put on hold to allow that to happen. The client arranged for an independent evaluation; a second hearing was scheduled. The client then appeared in person and was accompanied by the Regional Ombudsman for support.
The client addressed the court, pointing out that while she had hated the Judge when he ordered her commitment, she had come to realize that she had needed and had benefited from that intervention. She went on to eloquently explain the negative impact the commitment and the guardianship had on her life since she had progressed to the point of no longer needing that level of care.
In the end, the commitment expired and the client was restored to capacity. She returned to her own home and found employment. She later sold her home, moved to a different city and again found employment. She continues to flourish.
Many clients have concerns or complaints about their guardians and conservators. The OMHDD has been able to help several clients voice their concerns and preferences about choices they'd like to have control over in their life, such as type of clothing they wear, foods they like to eat, how they can spend their personal needs money each month, explore work options, church preferences and recreational activities they'd like to participate in.
With the help of the OMHDD, one particular client was able to dramatically increase his unsupervised free time at home and in the community. A safety plan was created and agreed upon by all team members. Another client was able to stop going to work and instead filled her day with activities of her choosing and created a routine that she was happy with.
OMHDD Regional Ombudsman Offices routinely educate clients about their rights and then helping them advocate for themselves with their guardian/conservators, service providers and family members.
One client under guardianship and commitment was married. There was disagreement over where the client should live, what level of services she needed and how the service providers could accommodate visits with her husband. With the help of the OMHDD, the client was able to move closer to where her husband resided and the treatment team came up with a plan for what would need to take place in order to safely transition her back into the same home with her husband in the future.
A visitation plan for the husband and wife was agreed upon in the meantime. Communication and expectations between all the parties were clarified and the clients wishes were acknowledged. The client also learned how to take steps towards getting reevaluated for possible restoration to capacity.
A client with communication difficulties had made complaints about a particular staff person not treating her with dignity and respect. Sometimes a personality conflict with staff can cause fear and anxiety for clients that become a detriment to a therapeutic living environment.
A maltreatment investigation was conducted but neither abuse nor neglect was substantiated. However, with the help of the OMHDD, the service provider agreed to not schedule that particular staff member in the clients home any longer. The client now feels more safe and comfortable and her rights were protected through this negotiation process. The client was also assisted by implementing a behavioral management plan and additional training for staff.
A client who was under guardianship and had been under several mental health commitments in the past, was coming up on the date for his current commitment to either expire or be renewed. The client asked the OMHDD to help advocate on his behalf for the commitment to be allowed to expire.
By meeting with the client and county case managers and reviewing the doctor's recommendations, we were able to discuss the progress the client had made over the past six months as well as areas of continued concern. Confusion about the clients cooperation with medication was clarified. The client was able to advocate for himself and demonstrate his responsibility for his own treatment and recovery process. The commitment was allowed to expire.
A 17 year old client was referred to the Regional Ombudsman by the hospital social worker for assistance with discharge planning. Client's father had full custody of the client, but client did not want to be discharged into his care due to issues with a stepparent, and her father denying client access to her choice of medical equipment to manage her diabetes.
Client reported she would commit suicide if returned to her father's care. The client, hospital social worker, and Regional Ombudsman came up with several safe discharge options, and all of them were denied by the clients father. The client's goal was to be discharged to a safe environment away from her father with a transition to independent living.
After several team meetings and discussions with the client's father about possible child protection involvement, a discharge plan was agreed upon. The client was discharged to a foster home and assigned a case manager to assist her in transitioning to independent living.
The Regional Ombudsman was contacted by a 15 year-old client and her hospital therapist for assistance with appropriate discharge planning. The client was also interested in discharging her current guardian/social worker and obtaining a children's mental health case manager.
The client and her hospital treatment team agreed that the client would do well in a foster care setting with day treatment. However, the client's court appointed guardian/social worker wanted to send the client to a residential treatment center from the hospital.
The client had been at the residential treatment center prior to hospitalization, had become suicidal and returned to the hospital. The client clearly articulated that she would not be successful in the residential treatment center setting. The client's guardian/social worker refused to consider other options and refused to withdraw from the case.
After numerous meetings and phone conversations with the clients treatment team, attorney and guardian/social worker, the client was assigned a children's mental health case manager and her guardian/social worker recused herself. The client was placed in a foster home with day treatment in place.
The Regional Ombudsman was contacted by a program manager of an adult foster care home for a client who needed advocacy to avoid demission from the adult foster care home. The client participated in an out-patient sex offender program but was not under a court order and had no arrest history.
The out-patient sex offender program has established programming, rules and protocols that it was trying to force upon the adult foster care home staff. The adult foster care home staff felt the programming violated their obligations as a service provider and the client's rights. The adult foster care home had discontinued all programming developed by the out-patient program and implemented their own rewards programming for the client.
A significant decrease in maladaptive behavior from the client was documented. The client's guardian and case manager attempted to remove the client from the adult foster care home despite the client clearly wanting to remain in the placement. The Regional Ombudsman and the clients foster home team assisted the client in appealing the demission and requesting a successor guardian.
It was determined that the client's rights were violated and that he would be allowed to remain at the foster home. Additionally, a successor guardian selected by the client was appointed and a new case manager was assigned.
OMHDD received a call from a client requesting our assistance in protecting him from the abusive and exploitive practices of his guardians. The client was under commitment for mental health treatment based, in large part, on the belief that he had paranoid schizophrenia. He was accused of being delusional because he consistently maintained that he had over a half of a million dollars in liquid assets as well as owning hundreds of acres of land. OMHDD was able to confirm that his assertions were true.
OMHDD assisted the client in his efforts to terminate the guardianship and restore the client back to capacity. This was successfully done, along with exposing the guardian's harmful actions that included:
Once restored to capacity, this agency assisted the client in convincing the court that the guardians had financially exploited him. The guardian had impeded the client's legal process to restore to capacity because of the refusal to give him access to his finances so he could hire an attorney.
The court found that the guardians' billings were excessive and activities billed were unnecessary. The guardian made poor investment decisions that harmed the client, as well as not accounting for thousands of dollars and other property.
The guardian had the matter tied up in court for years, and the client died of cancer before he was able to achieve complete vindication and justice. He was, however, able to live the last years of his life free from the control of others as well as able to enjoy his considerable wealth.