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Mother, who was charged with abuse after giving son Tylenol and cough syrup, says he is being neglected and isolated in his group home

January 19, 2022 2 comments

Christine Davidson, who has been charged by the state with abuse after she gave her son prescribed cough syrup and Tylenol, says the real problems her son is facing include isolation and neglect in his group home.

We have joined Christine in expressing concern to the Department of Developmental Services (DDS) about conditions in the residence and a ban on home visits from her son John.

John Davidson is a resident of a group home in Waltham, which is run by WCI, Inc., a corporate provider to DDS. Christine contends that the conditions under which John is now living violate a number of DDS regulations referred to as “standards to promote dignity” (115 CMR 5 et seq.).

Christine is a co-guardian of her son. The other co-guardian, George Papastrat, is Christine’s nephew and lives in North Carolina.

Christine wants to take John back home with her, and John has repeatedly said he wants to come home. That is not being permitted, however. She said John is effectively being confined in his group home with virtually no activities.

As we noted in a recent blog post, we have raised numerous questions about the accuracy of a report written by the Disabled Persons Protection Commission (DPPC), which concluded that Christine abused her son after she gave him an “undetermined” amount of cough syrup and Tylenol last June. Since then, John has been subject to a prohibition on visits home based on the abuse finding.

Christine’s attorney, Thomas Frain, who is also COFAR’s president, has filed an appeal with DPPC of the abuse finding.

Last November, I emailed George Papastrat, John’s other co-guardian, with an explanation of our concerns about the DPPC investigation and its apparent bias against Christine. I have not recieved a reply to my message.

Only person left in the home during the day

Christine said she visited John in his group home yesterday (January 18), and found him sitting alone in the kitchen. She said the other three residents currently living in the home are being taken to day programs.

John no longer has a functioning day program, according to Christine. An Individual Support Plan (ISP) states that he lost his previous day program activities at Jewish Family Chai Works in Waltham in March 2020 because of COVID restrictions.

The ISP states that when the day program reopened on a limited basis in August 2020, John was not alowed to return to it. The ISP does not specify the reason he was not allowed to return.

Christine also said John’s physical therapy services, which he received after fracturing his leg outside his group home in 2019, have been discontinued. Yet, she said, he is still in need of those services.

Personal hygiene allegedly neglected

Christine said she often finds John’s bedroom and the bathroom in the group home to be dirty, and John is frequently unshaven and dirty when she visits him. She provided photographs of his bed, which show several damp spots that she said are urine.

She also sent a photo of what appears to be soiled toilet paper in a waste can in the bathroom. She said the toilet paper contained fecal matter.

Christine filed a complaint with DPPC on December 7 after finding Jonn sitting alone and naked on the floor of his bedroom, apparently after he slid off his wheelchair while under the care of a staff member. The complaint has been referred to the DDS area office for an administrative review, according to a letter sent by DDS to Christine on December 8.

As noted below, many of the conditions Christine described would appear to violate DDS “standards to promote dignity,” including the “opportunity to undergo typical developmental experiences.”

Christine said she believes John is declining physically and mentally in the group home and is severely depressed. “I don’t know if he’ll ever be the same person he was — energetic and engaging,” she said.

DDS doesn’t respond to concerns

On January 10, I sent an email to Joan Thompson, DDS area director, calling her attention to the apparent violations and asking that the Department investigate them.

Thompson responded the following day with a two-sentence email that did not appear to relate to my request. Thompson’s email stated the following:

After review of your request, you would need written authorization from both (co)guardians to release any information.  Without the written authorization, you do not have the authority to make such a request.

Thompson’s message wasn’t signed.

I reiterated my request in a second email on January 12 and copied Gail Gillespie, the DDS director for the Boston Metro Region. I haven’t received a response to that message from either Thompson or Gillespie.

Apparent violations of DDS regulations in group home

Christine said that after his hospitalization, John was kept for months at Tewksbury State Hospital, ostensibly for treatment of a leg injury from a fall outside his group home in 2019. But she said his leg actually got worse at Tewksbury, yet he was discharged to his group home where he now needs a wheelchair.

She said the group home staff does not appear to be encouraging John to get exercise. She added that John wants to get out of his wheelchair, but the staff are not encouraging him to do so or helping him.

When John was discharged from Tewksbury in November, the group home staff was supposed to develop a chart listing weekly activities for him. But Christine said no such chart has been developed for him.

We are concerned that this overall situation may violate a number of DDS standards to promote human dignity, including a number of the “general principles,” which state that services are supposed to be provided in a manner that promotes:

  • The opportunity to undergo typical developmental experiences, provided that the person’s safety and well-being are not unreasonably jeopardized,
  • The opportunity to engage in activities and styles of living which encourage and maintain the integration of the person in the community through individualized social and physical environments, and
  • Opportunities for daily recreational activity and physical exercise, as appropriate to the age and interests of the individual.

The apparent confinement in the group home against John’s stated wishes appears to violate additional DDS standards and other rights that are intended to promote or include:

  • Self-determination to the person’s fullest capacity,
  • Least restrictive care, and
  • The right to be visited and to visit others under circumstances that are conducive to friendships and relationships.

ISP specified activities 

John’s Individual Support Plans (ISPs) in both 2019 and 2020 discussed his enthusiasm for his day program at Chai Works. As noted, he lost that program in 2020.

John’s 2020 ISP stated that while at the day program, which he had attended since 2012, he participated in numerous activities including dance, yoga, and martial arts. He was also taken on community outings.

The 2020 ISP stated that after the day program was initially shut down in March 2020, John was able to participate in online groups connected with the program a couple of days a week for an hour or two at a time. Accoring to the ISP, John needed help logging in to the online sessions.

Christine said she was told at both Tewksbury State Hospital and at the group home that they were too short-staffed to help him log into the day program sessions. As a result, John has not been able to participate in his day program, even online, for at least the past six months, she said.

Additional conditions in group home

Christine also said that in addition to the problems with cleanliness in the home, she discovered that other residents’ laundry is repeatedly put in John’s dresser drawers even though all of his clothing is labeled.

The overall situation appears to violate the principle specifying “freedom from discomfort, distress, and deprivation which arise from an unresponsive and inhumane environment.” There also appears to be a violation of John’s additional right to “individual storage space for personal use.”

Further, according to Christine, John’s cell phones have repeatedly gone missing, first at Tewksbury and later at the group home. As a result, he is unable to make or receive calls directly from Christine or anyone else.

Christine said she has also been told not to call the group home after 6 p.m. All of that appears to violate the right of individuals to have “reasonable access to a telephone and opportunities to make and receive confidential calls…”

John’s 2020 ISP and an August 2020 staff memo noted that John liked to talk to his mother on the phone, so much so that a protocol was established to end the calls at 10 p.m.

DDS needs to change course

In my January 10 email to DDS Area Director Thompson, I requested that DDS revisit and reverse the prohibition placed on John’s visits home. As noted, I have not received a response to that email.

We are also requesting that the area office expand its review of Christine’s complaint in December after she found her son on the floor of his room. We are urging the Department to examine the overall conditions under which John is currently living and the potential violations of the Department’s regulatory standards.

Large increase in COVID among residents in DDS provider-run group homes, but not in state-operated homes

January 11, 2022 4 comments

The latest state report on COVID testing in facilities funded by the Department of Developmental Services (DDS) shows what appears to be a major increase in residents testing positive for the virus in corporate provider-run group homes.

However, there appears to have been little or no increase in COVID among residents of the smaller network of DDS state-run group homes.

According to the state data, the number of residents testing positive in DDS provider-run group homes jumped from 34 to 146 in the period from November 30 to December 28.

In the DDS state-operated group home system, the number of residents testing positive rose only from 9 to 10 in that time frame. We think this difference may reflect the fact that staff in state-run facilities are required to be vaccinated, whereas there is no similar vaccination requirement for staff in provider-run residences.

Staff testing positive in state-run group homes did rise from 20 to 66, according to the latest report. But there is no information available on the number of staff that have tested positive in provider-run group homes. For some reason, that number is not reported.

At the DDS-run Wrentham Developmental Center, the number of residents testing positive rose from zero to five or less. (Numbers under 5 are not specified.)

Staff testing positive at the Wrentham Center rose from three to 24. But that hike in positive staff does not appear to have been mirrored by a large increase in residents testing positive there. Also, as one family member of a Wrentham Center resident said, most of the staff testing positive there are either asymptomatic or have mild symptoms, apparently due to the required vaccinations.

At the Hogan Regional Center, zero residents have tested positive since January of last year. Five staff tested positive at Hogan as of December 28. Prior to that date, no staff had tested positive there since last April.

Despite the increases in residents testing positive in DDS provider homes, deaths among residents have not risen in either the provider-run or state-run networks. In the month prior to December 28, less than five residents died in the state-run and provider-run group homes. (Numbers of deaths are not reported separately for each network.)

There were zero deaths of residents at Hogan or Wrentham in the month prior to December 28. Data on deaths among staff in DDS facilities, whether state-run or provider-run, are not reported. Also, testing results are only now reported monthly, which makes analyses of trends difficult.

Vaccinations of all staff urged

Rick Glassman, director of advocacy for the Disability Law Center, was quoted by WBUR last week as saying that regardless of staffing shortages facing some DDS group homes, vaccines should be mandated for all group home workers, and there should be more frequent testing of both residents and workers.

“It is to the state’s credit that they require vaccines in nursing homes,” Glassman said, according to WBUR. “But people with intellectual and developmental disabilities are equally, and sometimes more, vulnerable.”

Inconsistencies in vaccination policies

We have similarly called for a requirement that staff in provider-run residences be vaccinated. The difference in vaccination requirements for state and provider staff has resulted in major inconsistencies in the state’s response to the virus.

For instance, Nicole Coughlin, a DDS service coordinator, was suspended without pay on December 27, according to a Mass Live report, and threatened with termination because she had not received a second Moderna shot by the October 17 vaccination deadline set by Governor Baker for state employeees. Coughlin’s first vaccine shot last February prompted a severe allergic reaction that accelerated her heart rate and made it difficult to breathe.

According to the report by Mass Live, the Baker administration denied Coughlin a medical exemption even though three medical specialists, including her doctor, recommended that she not receive a second Moderna shot. One specialist said a second shot could be fatal to her.

It makes no sense that some DDS employees are facing a vaccination requirement that apparently allows for virtually no exceptions, while a much larger group of employees in the same field face no requirement at all.

It has been fortunate that the uptick in residents testing positive in the DDS system has so far not resulted in more deaths among those residents. But there is much to be concerned about regarding the increase in COVID cases, and little information on which to evaluate those concerns.

Even though the death rate hasn’t gone up, has the rise in residents testing positive in the provider-run group homes resulted in a higher hospitalization rate or in potentially long-term health complications among those residents? Since no data are reported on hospitalizations or health impacts, we don’t know the answer to those questions.

Questions surround state’s abuse finding against mother who gave her son prescribed cough syrup and Tylenol

January 3, 2022 29 comments

Christine Davidson is known by her family and friends to be devoted to her 45-year-old son John, who has an intellectual disability and numerous medical issues.

“Christine is a dedicated mother who has steadfastly kept John as her number one priority,” Pat Diianni, a friend who has known Christine for nearly 40 years, wrote in a letter of support for her last year.

Pat said Christine has consistently worked over the years to ensure the best possible care for her son in the Department of Developmental Services (DDS) system.

Christine herself says John is “the focus of my life. Everyone knows that I’d go to any lengths for him.” By all accounts, John loves her equally, and has told his caregivers that he wants to be home with his mother.

Christine and John Davidson

State alleges abuse by mother and restricts contact with son

But the state Disabled Persons Protection Commission (DPPC) and DDS concluded in October that Christine abused John because she “more likely than not gave (him) an undetermined amount” of Tylenol and cough syrup with codeine while he was home with her for a weekend visit last June.

In a 20-page report, a DPPC investigator concluded that Christine also failed to provide prescribed breathing therapy support “causing (John) to lose consciousness” in the morning of June 21. The prescribed therapy was the use of a Bi-PAP breathing assistance machine at night.

Christine was unable to wake John up in the morning of June 21, and called 911. John was brought to the Newton Wellesley Hospital ER. He quickly recovered after being given oxygen.

The DPPC is a state agency that is charged with investigating abuse and neglect of adults under 60 with disabilities.

Following the DPPC investigation, DDS issued an “action plan” that recommended sharply curtailing contact between Christine and John. All visits to Christine’s home have been suspended, and all of Christine’s visits to the group home have to be scheduled and supervised, despite the fact that Christine is John’s co-guardian. John was not even allowed to go home to visit Christine at Christmas.

Questions about accuracy and completeness of DPPC report

But following a review of the DPPC report and related documents, and an interview of Christine,  COFAR is questioning the completeness and accuracy of DPPC’s investigation of the incident leading to John’s hospitalization.

Most importantly, both the cough syrup and Tylenol medications had been prescribed by John’s primary care doctor, according to Christine and to medical records, and Christine maintains that she has always followed the prescriptions.

There was no evidence presented in the DPPC report that Christine did not follow the prescribed doses in administering each medication to her son.

As for the failure to use the Bi-PAP machine, Christine says that such a machine wasn’t delivered to her house until June 22, the day after John’s episode of hypoxemia or low oxygen level. She also said she did not receive necessary training in how to use the machine. When she inquired of a group home staff member about receiving training, she said she was told there would be no opportunity for her to do that.

Christine said the machine was later removed from her home by a group home staff, and that she later saw the machine’s breathing mask on the floor of John’s room, dirty and apparently unused. She said when she brought that to the attention of the staff, they did not respond to her.

Christine’s son’s group home is run by WCI, a DDS provider.

Christine, who cooperated with the DPPC investigation, told the investigator she gave her son prescribed cough syrup over that weekend because he had a history of a chronic cough and “has a tendency to cough so much he can’t breathe.” She said she gave him Tylenol as prescribed for arthritis pain.

Following his hospitalization in June, John was admitted in early August to Tewksbury State Hospital due to continuing leg pain stemming from a fracture caused by a 2019 fall outside his group home. He was kept for months at Tewksbury State for unclear reasons, and was discharged back to his group home only at the end of November.

Since August, Christine and her partner, Carmine Tocco, have wanted John discharged home to them. John also strongly expressed his desire to the DPPC investigator to go home to his mother.

Christine and Carmine said they believe that Tewksbury State Hospital was not an appropriate setting for John, and said they have seen signs that he was neglected there and in his group home, and has suffered physical and emotional abuse.

In the 40 years of John’s life prior to his admission to the WCI group home in 2017, he had lived at home with his mother.

Mother lost sole guardianship last year

Christine said DDS petitioned in probate court in May of 2020 to remove her as her son’s sole guardian after she got into a dispute with the Department over the placement of her son in a new group home.

Christine engaged Tom Frain, who is also COFAR’s president, as her attorney, and was ultimately restored to full guardianship. Her nephew, George Papastrat, who lives in North Carolina, was later appointed as co-guardian, with the medical and residential decision making powers.

We are concerned that DDS and DPPC appear to be setting the stage to remove Christine as co-guardian. Frain assisted Christine in appealing the DPPC abuse finding.

Friends, colleagues, and family cite mother’s devotion to her son

Amelia Lawless, Christine’s sister, stated in a letter of support for Christine in June 2020, during her fight to regain her guardianship, that, “(John) and his mother are a real team – they cry, laugh, and work well together. You might say that they complete each other.”

That same month, Rachel Geller, a former behavioral specialist in the Waltham Public School District, noted in a letter that Christine had worked in the school district as a special education teacher, and described her as “enthusiastic, kind, and loving…There are many wonderful teachers. Ms. Davidson stood out,” Geller stated.

Geller added that, “I have found Ms. Davidson to be sincere, hard-working, diligent, and of high moral and ethical standards.”

Father Fred Mannara, who was Christine’s parish priest for 57 years, wrote that, “John has a person in his life, his mother, who knows him and shares his history and loves him dearly. John knows that he belongs.”

Denise Cerrati, another friend of Christine’s for more than 40 years, wrote that, “John is the remarkable, resilient young man he is because of his mother’s care and undying attention to his needs… It would be a great injustice to restrict John’s life in such a way as to not allow him to draw on the strength and love he has always known.”

Milestones in advocacy for John

A former Special Education teacher in the Waltham school system, Christine enrolled John in an Early Intervention program at the Shriver Center prior to preschool, and later enrolled him at the LABB Educational Collaborative from which he graduated in 1998.

Christine found a speech therapist and reading tutor for John when he was an adolescent. She arranged for swimming lessons for him and watched him win two gold medals in an 800-meter swimming event at the Special Olympics International Games in 1991.

Christine encouraged John’s love for dance; and John performed for several years at a local dance studio.

In addition, Christine arranged for John to work at Brandeis University in a paid job in maintenance that lasted for 13 years.  And she found a volunteer position for John with Chai Works in Waltham, a program for persons with developmental disabilities. “He was very proud of that job,” she said. “He never missed a day.”

John also helped Christine in campaigning for Joe Kennedy II in his run for Congress in her Waltham district in the late 1980s.

In 2009, Christine began working with a priest to arrange for a special dispensation to have John receive the sacrament of confirmation as an adult. He was confirmed in 2014.

Christine was also a frequent speaker at family events organized by the Greater Waltham Arc. The Arc sponsored the Brandeis job that John held, starting in 1998. When that job lost funding at Brandeis, Christine contacted Waltham city officials who were able to find the funding needed to keep the job going.

No conclusive cause determined for hypoxemia

Doctors at Newton Wellesley Hospital who were interviewed by DPPC did not appear to have provided the investigator with a conclusive cause of John’s episode of hypoxemia on June 21.  One doctor stated that John may actually have been aspirating when he was brought to the hospital, meaning he was actually choking on something.

We have seen a number of cases in which individuals have aspirated or choked on ingested objects for a period of a week or more before being taken to a hospital. Christine said she thinks it is possible that her son was aspirating on something he had ingested while at his group home before his visit home to her.

While the DPPC concluded that John’s hypoxemia was more likely than not caused by a combination of Tylenol, cough syrup, and lack of a Bi-PAP machine, the report specifically concluded that the amount of the two medications given to John was “undetermined.”

In an appeal filed with the DPPC on November 29 of the agency’s abuse finding, Attorney Frain stated that it is Christine’s position that “the preponderance of evidence does not support the conclusons reached by the investigation report.”

Questions about enlarged liver

One Newton Wellesley hospital official told the DPPC investigator that Christine’s son had an enlarged liver, which was likely caused by a drug toxicity. The official said, however, that John’s Tylenol levels were not elevated when he was examined at the hospital.

Nevertheless, the hospital official said that toxicity in John’s liver could be due to small amounts of Tyleol built up over time. The official stated, “I have every suspicion that (John) took too much Tylenol, but I wouldn’t go to court to testify on that.”

But given that Christine’s son had only been with her over the weekend of June 18 to June 21, when he was hospitalized, Christine said she thinks it is possible that any toxicity buildup in his liver from Tylenol use could have happened previously at the group home. The DPPC report did not mention that possibility.

Witness confirms John had chronic cough

An official from Brigham and Women’s Hospital confirmed to the DPPC investigator that John had had “a chronic intermittent cough for many years.” The hospital official also said that John’s “cough syrup prescription had not raised many concerns prior to latest hospitalization.” Christine said she knows of no concerns that were ever raised about it.

Charge that Christine didn’t know dosages lacks specifics

Much of the case for the DPPC’s abuse charge appears to rest on accounts by the unnamed Newton Wellesley Hospital personnel that Christine couldn’t remember the dosages of the cough syrup and Tylenol that she had given John.

But even if that were the case, Christine maintains it would not prove that she had given her son too much of those medications. She told the DPPC investigator that she has always followed the doctor’s prescriptions regarding medication that she has given her son.

Christine said that she volunteered information to the EMTs who answered her 911 call about the medications John was taking, and gave them a list of all of his medications. She said that she has been giving John his medications throughout his life, and has always followed the written prescriptions.

John’s cough syrup and Tylenol had been prescribed

John’s cough syrup and Tylenol had, in fact, been prescribed for him, according to medical records examined by COFAR.

Those medical records were apparently not reviewed by the DPPC investigator who indicated in the report that the only medical records reviewed were Newton Wellesley Hospital records and John’s Individual Support Plan. [DPPC regulations (Section 1(k) of 118 CMR 5.02) require “the review and obtaining of copies of all documents which are not plainly irrelevant to the matter under investigation.” (My emphasis.)]

According to the records reviewed by COFAR, Tylenol and Tussionex cough syrup containing Hydrocodone were prescribed for John going back as far as January 2020.

Frain stated in his appeal that the cough syrup with Hydrocodone had been prescribed for the past 15 years, and had been administered by Christine to John since that time without incident.

Frain also noted that the DPPC report did not make clear that there were actually two prescriptions for the cough syrup for John. One — Mucinex DM Max Strength — was used by the group home, and the other — Tussionex with Hydrocodone — was used by Christine.

Frain said the reason for the separate prescriptions was that no cough syrup with a narcotic could be safely stored or administered in the group home. But that confusion was used by the DPPC report, Frain said, “to insinuate that there was wrongdoing on Ms. (Christine) Davidson’s part.”

Bi-PAP machine was not used by the group home

The DPPC report stated that the Bi-PAP machine had been prescribed for John to use at night to help him breathe. John had been diagnosed with severe apnea, according to the report.

As noted, Christine said the Bi-PAP machine was not delivered to her home until after John’s hospitalization, and that the group home later removed it.

The report did note that while it appeared the group home did have a B-PAP machine for John, the staff rarely if ever used it. The Brigham and Woman’s Hospital official told the investigator that:

I’m not sure you can blame this (failure to use the Bi-PAP machine on (Christine). Some sleep doctor must have prescribed it years ago. (John’s) usage has been spotty forever…I don’t think the group home even used it…

John could not be awakened previously

In his appeal of the DPPC report, Frain noted that in two previous incidents in the months prior to June 21, John was found non-responsive. In those incidents, on February 17 and during the “April/May time frame,” John was in the care either of his group home or a medical provider. Yet no report of abuse was filed with DPPC or DDS.

In the February case, medical staff at the Mass General Infusion Center in Waltham noted in on a medical form that John was “very sleepy in infusion…Quite lethargic.”

The DPPC report did not mention either of those previous incidents, either or both of which Christine believes could have a bearing on the cause of the incident in June.

No reaction to Narcan

According to the DPPC report, when EMTs arrived at Christine’s home on June 21, after Christine found John unresponsive, they administered Narcan “without effect.” Narcan is a medication used to counteract decreased breathing in an opioid overdose.

The report didn’t discuss whether John’s lack of reaction to Narcan might rule out the cough syrup as a cause of his hypoxemia. Narcan will not have an effect if there is no opioid in a person’s system.

Disputed statements about leg injury and air mattress

Also in the DPPC report is a statement by John’s DDS service coordinator that John had previously broken his leg while in Christine’s care.

The report, however, stated that in a follow-up interview to “clarify” that charge, the service coordinator acknowledged that Christine’s son had broken his leg in December 2019 when he slipped and fell outside his group home after direct care staff failed to greet John as he arrived with a transportation provider. It is undisputed that John was in WCI’s care at the time, and not under his mother’s care.

The report further stated that the incident in which Christine’s son broke his leg was not reported to DPPC because “the incident was witnessed and no one appeared at fault.” The investigator didn’t question that apparent breach of DPPC’s reporting statute and regulations.

According to the report, John refractured his leg in February 2020, possibly while at Christine’s home. However, the report stated it could not be determined whether that second fracture was due to a fall or to failed hardware in his leg stemming from the repair of the first facture.

Christine and Carmine also dispute an apparently second-hand claim in the report, apparently by the service coordinator, that in February 2020, an unidentified person had seen John sitting on a deflated air mattress on the floor in her home. Christine and Carmine said that not only does her son have an upstairs bedroom with a bed in it, but they put a second bed into a downstairs bedroom for him because he was having trouble walking.

Christine said she has never had an air mattress in her home. Carmine sent us the photo below of Christine’s son’s downstairs bed.

John Davidson’s downstairs bed in Christine’s home. John’s DDS service coordinator implied to the DPPC that John had been forced to sleep on an air mattress.

The investigator acknowledged in her report that she had not visited Christine’s home, citing COVID restrictions.

DPPC report relied on negative speculation about personality

In addition to accounts from the unidentified Newton Wellesley Hospital personnel, assertions about Christine’s temperament were included in the report from John’s DDS service coordinator, a DDS program monitor, and a DDS area office nurse. Only one staff member of his group home was interviewed, and that interview does not appear to have been about Christine’s alleged behavior toward the group home staff.

The service coordinator, for instance, described Christine in the report as “crafty and manipulative.” No example of that is given.

COFAR has in the past found that in investigating allegations of abuse, DPPC and DDS have discounted information provided by family members of clients. In some cases, the agencies have made negative assertions or taken punitive or even retaliatory actions against family members seen as meddlesome or too aggressive in their advocacy for their loved ones. (See here, here, herehere, here, here, here, here, here, and here.)

Assessed as frail and elderly

At least one of the Newton Wellesley Hospital personnel and Christine’s service coordinator described Christine to the DPPC investigator as “frail,” while the service coordinator also described her as “in her mid-70s and elderly.” The Newton Wellesley Hospital official also said Christine was using a wheelchair in the hospital.

Christine responded to us that she used a wheelchair temporarily in the hospital because she was recovering from back surgery at the time. She said she no longer uses a wheelchair. She added that she resents being characterized as frail, in particular. “It’s like calling someone fat or too skinny,” she said. “They don’t want me in the picture. They don’t want my involvement in John’s medical care.”

Staff actually rude to Christine

In her own contemporaneous handwritten notes, Christine wrote that on July 29, staff in John’s group home were “ rude” to her, and that one had “abruptly snatched snack from my hand.” She said she had brought the snack of yogurt and lemonade to give to John. She also wrote that the staff were giving him “no choice in (TV) channels.”

On July 30, she wrote that, “John’s bed, blanket, and pillow soaked with urine.”

In early August, she wrote in her notes that, “I would be remiss not to speak up for him — elderly and disabled have no voice.”

Christine praised staff member in notes

Despite the negative assessments of Christine’s relationship with the group home staff, her written notes from July 8, 2019, include praise for a staff member named Mohammed. In her notes, she stated after Mohammed’s name: “Humor attention to detail, kindness empathy, helped John shave.” Christine said Mohammed left the group home more than a year ago.

Visits with mother considered a negative

The DDS program monitor indicated to the DPPC investigator that both DDS and the provider thought Christine was visiting her son in his group home and taking him home for visits too often. “Weekend visits would turn into weeks,” the DDS official said. “(John) couldn’t gain a foothold in the group home.”

“We have been walking a fine line and have done everything we can do,” the DDS official said. (Christine) will always find a reason to bring (John) home.”

The DPPC report, however, includes no reasoning or discussion as to why frequent visits and contact with John’s mother would necessarily be bad for him. DDS regulations, in fact, support “least restrictive care” options, meaning options that honor the wishes of clients to interact with family, friends, and the greater community.

DDS regulations (115 CMR 5 et seq.) also state that “Arrangements shall be made for private visitation (of DDS clients) to the maximum extent possible.”

Report acknowledges son’s wish to return home

The service coordinator stated to the DPPC investigator that Christine and her “family attorney (Frain) have lost sight of (Christine’s  son’s) individual rights.”

Ironically, the DPPC investigator stated that when she interviewed John, he expressed a strong desire to go home from Tewksbury State Hospital to his mother. There was no discussion in the report about taking his wish into account.

Lack of contact, communication

Christine maintains that while John was at Tewksbury State Hospital, her contact with him was sharply constrained for unclear reasons. While she was allowed to visit him there, she said the visits were supervised and she was not allowed to ask him or the staff questions.

She also said John’s cell phone went missing almost immediately after his admission to Tewksbury, and she was unable to call him. She said the DPPC investigator never asked her about that situation.

Neglect alleged at Tewksbury Hospital

Christine and Carmine said that when they initially visited John at Tewksbury, he was wearing diapers with feces in them and hadn’t been shaved for at least a week. Also his glasses and cell phone were missing. They said he appeared at times to be drugged there, and his leg pain was continuing.

Christine believes John regressed regressed mentally and was depressed at Tewsksbury and is continuing to decline mentally and physically at his group home. She said he is now in a wheelchair and is incontinent. Prior to his hospitalization, she said, he was continent and able to walk with a cane.

DPPC should reverse abuse finding

We hope the DPPC reconsiders its finding of abuse against Christine for all of the reasons discussed above. We also hope that DDS reconsiders its restrictions imposed on contact between Christine and her son.  It appears to be very important to John – and witnesses have attested to this – that he be afforded the contact he desires with his mother.

We also think both DDS and DPPC should investigate the care and conditions under which John was kept at Tewksbury State Hospital. A similar investigation should be undertaken at the WCI group home.

Christine and Carmine believe that with adequate assistance from DDS and caregivers, they can care for John at home. “He will receive the love, care, and stimulation he needs that only we can provide if he is allowed to come back home,” Christine said. “Right now, I’m very concerned that he is progressing into a state of despair, which is the last stage of depression.”

We hope DDS seriously considers the option of returning John home to Christine.

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