Thursday, July 8, 2010

“Condemned to Die – The Real Death Squad”

July 8th update on my, elderly, father, William L. Morris (by Barbara Morris).

The Howard County, Maryland, Office on Aging continues to play “God” with my father’s life. After I posted my article on the neglect and abuse my parents have suffered, under the control of caseworker, Ofelia Ross, the Office on Aging put my parents in the hands of another caseworker, Marcia Soergel. As I explained, in that posting, my father had a massive heart attack in February 2009 as a, direct, result of abuse under “guardianship”.

Having survived the heart attack, 16 months, my father was admitted to Howard County General Hospital with shortness of breath and pulmonary edema, the night of June 8th. Last week, on June 29th, I posted that hospital staff recommended a feeding tube but that the Office on Aging intended to petition the court to, not only, withhold and withdraw treatment, but to deny him the feeding tube. A hearing was expedited to July 1st.

As it turns out, my father, no longer, needs a feeding tube and is able to eat and drink, by mouth. The details surrounding feeding and hydration are significant, as are the continued efforts by the Howard County Office on Aging caseworker, Marcia Soergel to facility life-ending protocol, for my father. It is important to note that my father was moved out of ICU and had become, relatively, stable, i.e. no major setbacks, for two full weeks, before he was discharged from Howard County General Hospital.

While in ICU my father received a “swallow test” which he, allegedly, failed. However, the NPO order (no food or fluids, by mouth) was applied inconsistently. Initially, several nurses gave him thickened fluids for thirst. The hydration ceased, yet, in spite of the order, my father was given his meds orally (pills crushed in apple sauce or thickened beverage). This continued for over a week, until the Thursday, July 1st hearing. In a significant reversal, Judge Timothy J. McCrone ordered that my father was to be given food and hydration by mouth. Within a 24-hour period my father went from a hospital order for no food or fluids, by mouth, to pureed foods, to soften foods. His fluids, still, need to be thickened (to prevent aspiration), and, in the hospital, he was to have as much as he wanted. The only problem occurred when a sitter (ordered, during the final week, by the Office on Aging caseworker) gave my father water which was not appropriately, thickened.

On July 2nd I spoke with the supervising doctor and asked what protocol was, still, required. The doctor, immediately, ordered the diet upgraded to “soft”, the I.V. feeding/hydration removed, and the catheter removed. I, also, requested a physical therapy examination. The doctor said he would order that, as well. Within hours, I learned that the caseworker, Marcia Soergel, was trying to rush my father out of the hospital, that same day, into hospice. With the holiday weekend, she was not able to succeed in that transfer until Sunday evening, July 4th.

Meanwhile, my father had a physical therapy examination on Saturday, July 3rd, which he passed with flying colors. He had been in the hospital bed for over three weeks, but was able, with assistance, to get out of bed using a walker, walk to the bathroom, use the toilet and return to the room to sit in a chair for over two hours. The physical therapist, not only, deemed him, fully, qualified for physical therapy, but expressed it with great enthusiasm. It begs the question as to why Marcia Soergel wanted my father rushed out of the hospital, so, quickly. Had she succeeded in moving him on Friday, I would not have known the positive results of my father’s physical therapy examination.

Although, my father has a weak heart and is not a candidate for heart surgery he passed a physical therapy examination with flying colors. He was reinstated food and hydration by mouth. Yet, he was transferred on Sunday evening (July 4th) to a hospice in Towson, Maryland. (Two other hospice facilities on the “consideration list” did not deem my father appropriate for their facilities. He is not, sufficiently, near death’s door.) So, why was my father transferred to a hospice center instead of a rehabilitation center?

I went to the hospice facility, the next day, and it was most fortunate that I did. I arrived around noon. As I got off the elevator, I heard my father crying out, “Water! Water! Water!” I didn’t need a room number to find him. I went into his room to find a lunch tray, sitting on a cart by the wall, and no caregiver in sight. He had been ordered a “Pleasure” diet, i.e. a regular meal, not one softened to accommodate his needs. Most importantly, the water and lemonade on the tray were not thickened. Had he been given the fluids, he could, easily, have taken them into his lungs and aspirated.

I, immediately, located hospice staff to remedy the situation. The nurse brought a prepackaged thickened beverage, instead of water, as requested. I explained to her that when my father wants water, another beverage will not suffice. I, also, explained to her that he needs water, with the thickening agent added. At first, she looked at me, as if she had no idea what I was talking about. Fortunately, a caregiver was present and assisted in explaining what was needed. It took another 20 minutes, while my father continued begging for water, but, a small container of the thickening agent, finally, arrived.

Needless to say, the Howard County Office on Aging caseworker had not assured that this crucial protocol was being administered. As with so many other events, over the last four years, it is my actions, not the caseworker’s, that are those of a good guardian, not to mention that my efforts, for my parents, are life affirming.

Just as crucial, to my father’s well being, are his mental and emotional states. He is, once again, traumatized. He begged me, repeatedly, to stay with him. (This was the never-ending cry, for three years, in assisted living.) I asked if he is afraid. He nodded his head, “Yes”. He said he is afraid that he is dying. And, now, again, he is separated from his family, but with the, additional, separation from his wife. [My mother, Ada Morris, remains at Pfefferkorn Assisted Living (facility issues, also, addressed in my document of neglect and abuse) with Alzheimer’s, yet, now, without her husband, the only person, who, there, gave her connectivity to her life.]

Concerned about other protocol, I asked the hospice doctor about physical therapy and told him of the positive results from the hospital. This doctor stated that, not only, does the hospice not provide physical therapy, but since my father’s heart is weak, physical therapy would be “detrimental” to him. The alternative is that they will “keep him comfortable until…”. I responded that I would rather my father have a heart attack from physical exertion than to be laying in a bed, in a negative mental state and traumatized by isolation from his wife and family, as he realizes he is being left to die, and without any activities to support a positive mental state.

As with others, in this four year, saga, I have to question motives. The hospice had one bed open. What is that worth? Why would positive physical therapy results at the hospital not be considered of value at hospice, in fact, completely, contradicted by the hospice doctor? It appears to be, yet, another, conflict of interest for the hospice to recommend, otherwise, they would sacrifice the income. And, once again, the Office on Aging caseworker is being supported with their agenda.

Again, it is important to reiterate that the Office on Aging has spent all of my parents’ money (an estate worth, approximately, $450,000, in four years). My parents’ names are on the Medicaid waiting list, but it is not, yet, available. The result; the Howard County Office on Aging has no motivation to keep my father alive. The pattern of actions by the Howard County Office on Aging, now with caseworker, Marcia Soergel, is, consistently, attempting life-ending protocol for my father. After my father, allegedly, failed a “swallow test”, the Office on Aging expedited a court hearing, with the intention of requesting the withholding of a feeding tube, although it was supported and recommended by the supervising doctor, who informed the family of his recommendations, on Saturday, June 26th.

Now, the Office on Aging is ignoring the positive physical therapy results, from the hospital and is denying my father, further, physical therapy. As far as I know, there are no plans to get my father out of bed; even to sit in a chair, as had been done, on several occasions, at Howard County General Hospital. As of Wednesday, July 7th, just three mornings after his hospice admission, I learned that my father had a difficult night and had been sedated. Further, I was informed that he is, no longer, being provided food or fluid. Although the court hearing resulted in a reversal, for food and fluid intake, at the hospital, is it being handled, otherwise, in hospice? Again, the efforts are towards life-ending protocol. Is it because the judge signed an order to “Withhold and Withdraw” treatment? Does “withhold and withdraw” of treatment allow interpretation to include “withholding” food and fluids? Is the food and fluids order being ignored by the hospice doctor? Is it acceptable that sedation, instead of life affirming activities, such as physical therapy, is administered at hospice, especially, considering the physical therapy examination results, just, four days, earlier? Is isolation from his wife, and a more normal family environment, even, ethical when the resulting trauma causes the “need” for sedation?

These events support all that I have documented and posted, including my recent posting, “Intent to Murder by the Howard County, Maryland, Office on Aging.” AGAIN, I NEED YOUR HELP. Please, email Maryland Governor Martin O’Malley at governor@gov.state.md.us. And, as time is of the essence, please, also, call the Howard County Circuit Court Administrative Judge Diane Leasure and presiding Judge Timothy J. McCrone at (410) 313-2111 or 1-888-313-0197 (toll free) and request that life affirming actions be granted my father, including an order that he be moved, immediately, out of hospice and into a rehabilitation center, where he will be provided physical therapy, in efforts to return him to living with his wife. I would be grateful if phone calls are backed up with a written request, and those who are not able to call, please, write the judges c/o Howard County Circuit Court, 8360 Court Ave., Ellicott City, MD 21043.

Again, for more history, do a “google” search with “Neglect and Abuse of William and Ada Morris under Guardianship”. The foundation of corruption, behind the abuse, can be found by adding “Racketeering Scheme Open Letter to Maryland Governor Martin O’Malley”. My third document “Intent to Murder, by the Howard County, Maryland, Office on Aging” provides the, recent, background for my father, William Morris.

Once again, to drive the internet machine, here are the names of the perpetrators and those that acquiesce: (Office on Aging Caseworker) Ofelia Ross, (Attorney) Ria Rochvarg, (Attorney) Tony/Anthony Doyle, (County Attorney) Beverly Heydon, Howard County Circuit Court judges, Judge Louis A. Becker (now recused), Judge Dennis M. Sweeney (now retired) and Administrative Judge Diane Leasure, (Additional, APS, Office on Aging and other Howard County Social Services staff) Janis DiSibio, Shareese Kess-Lewis, Debbie Beares, Peggy Rightnour, Phyllis Madachy, Susan Rosenbaum, Sue/Susan Vaeth, Charlene Gallion, and Marcia Soergel. Greedy assisted living owners who, also, participated, Carmen Collandrea and Richard Collandrea of Bryant Woods Inn Assisted Living in Columbia, Maryland, and their former “manager”, Sandra Farrow (convicted felon). Currently participating are Pfefferkorn Assisted Living (West Friendship, MD) owners, William and Elmira Singh. At the state level, acquiescing, are Secretary of Human Resources, Brenda Donald, Secretary Department of Aging, Gloria Lawlah, the Office of Health Care Quality, and Governor Martin O’Malley. For now, I will, temporarily, suspend the name of Judge Timothy J. McCrone, from this list, and give him the opportunity to turn this around.

Loving daughter of William and Ada Morris,

Barbara Morris

5 comments:

Anonymous said...

Would rather be in a federal prison then a health care prison at least I could have and read my own mail, even have a family member visit me without being afraid that some guardian would claim a family member was causing me substantial harm. Today with the internet what is the rest of the world going to think about the government preaching human rights and pointing its finger at corruption in other lands when here in the land of freedom we now have health care prisons. Its to the stage now that these guardians have health care concentration camps from coast to coast. Isn't this what Nazi Germany ended up doing even to the place in their health care prison torture and surgical experiments? Is this where our Senior Citizens are headed in the near future? My sister was a victim of psychological torture Isn't that a technique that terrorist use???

Anonymous said...

Barbara, I'll write again today. I only had time to skim your account - but it was so like my mother's experiences during her final days. There was no guardian and no money issues - however the results were similar. My mother was in the last stages of dementia. There were no other conditions and no indications of pain or discomfort. It wasn't a life I would have wanted to live, nor was it a life that she would have chosen. Despite that, she was living that life with comfort and with moments of joy and humor. She gave every indication of wishing to continue on this earth. She aspirated and went to the hospital. At the first hospital, they wanted to discontinue the antibiotics for the aspiration and a UTI. I had POA, and said no. The dr. asked me if I was sure "you want to continue her existence." I told her that my mom had what her mom has - a life that is being lived, not an existence that is being continued.
She had passed the swallow test - but I discovered that they weren't feeding her. Their response was that they were afraid she would choke. I reminded them that starvation was the outcome of not feeding. I also wanted people touching her and caring for her (as in helping her to eat) in addition to my being there. When they tried a different (even sneakier way) to avoid giving her antibiotics, I had her moved to another hospital. At the other hospital, they sent the hospice folks to me. The hospice worker, who didn't seem well trained, kept talking to me about how they would give my mom the meds to be pain free. When I said that she gave no indications of pain, she had no response. I had a long discussion with the dr. and he told me I would want the hospice worker there in case my mom aspirated again. I asked how that might help - since she wouldn't be in my house 24/7- he said they could prepare me with meds that would help if she began to aspirate and I wouldn't have to call 911. After all this time, it became clear to me, that the hospital was not valuing the life left to my mother and was giving me the means to either have it ended, or to end it myself. The life she was living was terribly limited, but it was hers, and like any life it had moments of joy and humor. There was no pain; and there was comfort. I could no more have ended it myself or demanded that of hospice, than I could go shoot someone on the street.

The doctors were trying to usurp her choice (in giving poa to me) and my responsibility in exercising/not exercising the poa. They had determined that her life had no value and were more than willing to set in motion the procedures that would have ended it. When I talked to our home health nurse, she said that that is a frequent problem. Somewhere down the line is a hospital administrator trying to empty a bed for another patient, or not wanting a bed to be tied up with a patient who wasn't going to get well - (in the normal sense of well).

At some point, we (as a society) will have to discuss the use of resources - that makes sense - with limited resources, decisions have to be made - but in this country they are made by the people - in a public forum, after discussion etc. they are not made by one or two drs who believe a patient is "existing" rather than "living" a diminished life. The choice to permit breath or to extinguish it, is not theirs; and it never was. I get what guardians are doing and abhor it - but I was astounded to find health care professionals doing the same thing - not for the same motives - but getting the same results.

totalmotion said...

That's really a good Blog,really enjoy your insight and your 'findings',Very honest dialogue.If you want to know more about Physical Therapy then you can visit here online physical therapy seminars Thanks for sharing with us.

Anonymous said...

BARBARA's Update:
By the time I returned to hospice, late afternoon on Friday, it was obvious my father had taken a, definite, turn for the worse. He is losing his ability to, even, take fluids, without aspirating. It is clear that the intake by mouth was not going to last long. At this point, my father has suffered, so much, that, even if the judge had allowed the feeding tube, it is not clear how my father would have done. He has not had anymore events, of pulmonary edema, since June 20th. It appears that the turn for the worse took place, with the move to hospice. It would, also, have been life-affirming had my father not been in a state of limbo, for over a week, waiting for an expedited court hearing. He should have, at least, had the chance for physical therapy, instead of just waiting. There are too many, unanswered or unanswerable, questions, at this point. The bottom line, now, is that he is dying. Although Dad had been sedated, during the several days, before I returned , he was consolded, again, with my presence. Since my return on Friday, the nurses had not sedated him. One documented that my presence was a comfort. Others realized that some of what they called "agitation" was his effort to communicate. Family is, very, valuable for interpretation; yet, another reason why decisions should be made by loving family members.
It is, now, Sunday morning, just after 4AM, and my father has been given a small dose of sedative. However, NOW, it is on his terms. At 3:30 I heard him crying out in pain. I asked if he wanted some medicine, for the pain. I asked this, several times. Each time he shook his head, 'Yes". After he was checked for other possible sources of discomfort the sedative was given and he is resting, again. I have been able to give him hugs and he has thanked me, for my comfort, by taking my hand to his lips and kissing my hand. At least, I know, in this, I am doing my best to comfort him and, also, to provide him the dignity of his requests. Although he confirmed, two weeks, ago, that he wanted a feeding tube, that right was denied. Only God knows, if that would have made a difference. For now, I can, only, provide comfort and be thankful that I can be with him, during this time. Thank you, Friends, for following my updates.

Barbara

Anonymous said...

BARBARA's Update:
By the time I returned to hospice, late afternoon on Friday, it was obvious my father had taken a, definite, turn for the worse. He is losing his ability to, even, take fluids, without aspirating. It is clear that the intake by mouth was not going to last long. At this point, my father has suffered, so much, that, even if the judge had allowed the feeding tube, it is not clear how my father would have done. He has not had anymore events, of pulmonary edema, since June 20th. It appears that the turn for the worse took place, with the move to hospice. It would, also, have been life-affirming had my father not been in a state of limbo, for over a week, waiting for an expedited court hearing. He should have, at least, had the chance for physical therapy, instead of just waiting. There are too many, unanswered or unanswerable, questions, at this point. The bottom line, now, is that he is dying. Although Dad had been sedated, during the several days, before I returned , he was consolded, again, with my presence. Since my return on Friday, the nurses had not sedated him. One documented that my presence was a comfort. Others realized that some of what they called "agitation" was his effort to communicate. Family is, very, valuable for interpretation; yet, another reason why decisions should be made by loving family members.
It is, now, Sunday morning, just after 4AM, and my father has been given a small dose of sedative. However, NOW, it is on his terms. At 3:30 I heard him crying out in pain. I asked if he wanted some medicine, for the pain. I asked this, several times. Each time he shook his head, 'Yes". After he was checked for other possible sources of discomfort the sedative was given and he is resting, again. I have been able to give him hugs and he has thanked me, for my comfort, by taking my hand to his lips and kissing my hand. At least, I know, in this, I am doing my best to comfort him and, also, to provide him the dignity of his requests. Although he confirmed, two weeks, ago, that he wanted a feeding tube, that right was denied. Only God knows, if that would have made a difference. For now, I can, only, provide comfort and be thankful that I can be with him, during this time. Thank you, Friends, for following my updates.

Barbara