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By Liza Horvath


Stripping of Health Care Rights Final


At the age of 92, Lena slipped and fell in her home and wound up in the hospital. No injuries resulted from Lena’s fall but the hospital found that she had a life threatening tumor. Lena opted not to have surgery and instead return to the peace of her home where she could spend her last days surrounded by the things she and her husband had lovingly collected throughout their lives. Because Lena would return to an empty home, the hospital discharge planner was “insistent” – according to Lena - that an in-home care agency be retained so Lena would have help at home.  


Once home, Lena found that having in-home care providers was invasive and she wanted more than anything to be by herself – just as she had been for many years. The in-home agency representative was adamant that Lena not only needed the few hours that she had agreed to when she checked out of the hospital, but that Lena needed 24-hour care. The worker called the agent named in Lena’s Advance Health Care Directive and attempted to gain the agent’s permission to provide the extended service. After speaking with Lena, the agent advised the worker that Lena was fully capable of making her own decisions regarding health care and that her decisions were to be respected.


The next day Lena had a new caller - an Adult Protective Services worker came to her door and advised Lena that they had been contacted to “do a welfare check” on her. The representative asked if she could come in and “make sure everything is alright.”


Adult Protective Services of the Monterey County Department of Social Services seeks to protect adults from physical and financial abuse and also will help adults that have been abandoned, neglected, abducted or who are living in isolation. Upon referral, their staff, primarily social workers, will investigate, assess and evaluate the living situation of an adult and make recommendations or referrals in an effort to safeguard the adult. There offices can be contacted at 655-7567 or, in Salinas, 646-5041.


Care providers, health practitioners and employees of banks and financial institutions are among those who are “mandated reporters” meaning that they must report abuse or suspected abuse by calling Adult Protective Services within two working days of witnessing or uncovering such abuse. It seemed clear to Lena that the in-home care provider must have felt compelled to contact the agency. Still as sharp as she was as a younger woman, Lena knew that the Adult Protective Services representative, like most public safety workers, would need Lena’s permission to enter her home so, while Lena was somewhat intimidated by the representative, she none the less assured the representative that she was fine and closed the door.


After this Lena’s life became more serene. The in-home care provider felt she had done what she could to protect Lena and left peacefully after her short shift each day. Over time Lena’s health declined and eventually hospice came and stayed with her around the clock. As was her wish, Lena died in her own home.


Liza Horvath has over 30 years experience in the estate planning and trust fields and is the president of Monterey Trust Management, a financial and trust management company. This is not intended to be legal or tax advice. If you have a questions call (831)646-5262 or email liza@montereytrust.com










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