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February, 2003

Disenchantment with West Marin Senior Services
By George Zigounakis

Inverness
My parents are Mike Zigenis, age 78 and Nancy Zigenis, age 87, long term residents of Point Reyes Station. My mother has been a volunteer with Senior Services for at least 20 years, tapering off the past few years for health reasons.

I was visiting my parents Sunday evening, Nov. 10, and my mother fell, though she was just standing in the kitchen. We (my father and I) kept her there on the floor and comforted her and she asked for two Tylenols for pain. After perhaps a half hour, she seemed stable and out of pain and we carefully moved her to her bed and set her up with pads, etc. so she would not have to move during the night.

Monday morning I called and my mother told me that she had had a good night but had taken two Tylenol for pain when she woke and that her hip still hurt when she moved. I began making plans to get her medical attention. Point Reyes Clinic recommended that I take her to Kaiser. I checked with them and it was agreed that they would arrange for transport when we were ready. Before I could leave my house, I got a call from Kathy Davis of West Marin Senior Services telling me that they happened by my parent's house, saw the situation, called 911, and the paramedics were there and ready to take my mother to the E.R.

My mother has a low tolerance to strong medicine -- she takes only one prescription drug regularly and resists taking even Tylenol unless absolutely necessary. A trip to the emergency room two years ago resulted in her being routinely medicated to a point where she exhibited such confusion that Kaiser committed her to a nursing home for dementia. It took three months of fighting their system to get her out. Naturally, I expressed concern that they would medicate her and that things might get out of control if I didn't arrange the situation; but Kathy said it had to be done immediately because my mother was screaming in pain (from the paramedics examination, I learned later). I agreed to meet them at Kaiser.

At the hospital, I found my mother sedated and confused in the E.R.. She had been diagnosed with a broken hip and surgery was scheduled for later in the day. The surgeon told me that everything was in perfect alignment and it would be a simple operation. Between my father and I, the paramedics, and E.R. staff, we had not mis-aligned her hip. Everything went well but she was heavily medicated and extremely confused every time I saw or spoke to her at the hospital, and this is what I expected.

On the 12th, I attended a volunteer appreciation lunch put on by West Marin Senior Services. (I've also donated my services to them for several years.) When I saw Kathy Davis, I mentioned to her that my mother was doing fine. She said, "Well, aren't you glad we took care of that for you?"

I said, "Sure, but that's just what we were going to do."

Kathy said, "You can't just stuff a senior who's screaming in pain into the back of a car and take them to a hospital."

I could see that there was a big misunderstanding but that this was not the time to talk. It was upsetting that Kathy had misinterpreted my intentions, so I made sure that I phoned her the next day. At first she didn't want to talk to me without a witness, but I convinced her that I had no criticism and that I just wanted to set the record straight on what we had planned to do. Kathy was adamant that a senior must never be in pain and that such is always the justification for emergency measures.

Perhaps unique, my mother is a person who is constantly in some degree of pain and yet resists taking even mild pain medication. Furthermore, Kaiser's proven and pet recovery program for hip surgery pushes activity on that joint to the result of great pain -- of course the patient is then heavily sedated, so I guess that doesn't count!

Kathy further told me that my father was beside himself in worry and anxiety when they first arrived (actually not an unusual condition for him -- and I'm surprised that they didn't know that) and that when they saw no "Ensure" in the house, they quickly brought him some upon which he immediately drank down three in a row, giving them the impression that he was starving.

My father can't swallow well, so his doctor recommended that he have these milk shake type drinks in order to build his weight up. The dietitian with Hospice of Marin (who helps take care of him), however, prefers a similar drink that he mixes himself with fresh whole milk and "instant breakfast" type powders, and his doctor agrees. I shop and care for my parents regularly and I make sure that there is always a supply of this Hospice recommended drink and other nutritious and easy to prepare foods in their home. When I asked my father why he drank the Ensure like that, he said, "Because they taste good." I explained that situation to Kathy, but she was getting very defensive so we wound things up.

On Nov. 15, I received a call from Angelo Sacheli of Adult Protective Services (A.P.S.) advising me that there was a report filed against me for abuse and neglect, that he would be investigating me on these charges, and that a copy was forwarded to the sheriff's department.

Of note: in recovery from this operation at a nursing home on the 23rd, my mother again fell and was checked and finally lifted into bed and I was notified by the charge nurse. I asked if they would take her to the emergency room. She told me that 911 was not an automatic response unless warranted, but that comfort and observation was standard.

All this was substantiated and related to Angelo on the Nov. 26 inquiry, and he told us (myself and an attorney we had engaged) that he would still like to see the county take over conservatorship (custody) of my parents, and asked what their finances and assets were. A second person from the county has since interviewed my mother at the nursing home and also sat in at her discharge plan.

There is a common practice whereby seniors divest all their property and assets to their family in order to impoverish themselves so that the state will step in and cover the cost of their (expensive) elder care. My family met some years ago specifically to plan how we wanted to deal with Mike and Nancy's final years and we rejected this because we don't trust the government's decisions in this important issue. We chose to spend our own money and control their care. Because of West Marin Senior Services, the powers now have a foot in the door to regulate my parents' elder years. I asked our attorney how we might get these allegations officially cleared and get A.P.S. out of the picture. He told me we were looking at about $30,000 in attorney fees. This would have to come out of assets we were planning to use for their care.

It feels awful to us that people we trusted would file this incorrect and potentially damaging report. I challenged this abuse matter and eventually brought my mother home where we are caring for her with our own resources and she's doing well. It's so ironic -- at a time when my parents could use some help, guess what agency we don't want around us?

 

 

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