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A few "legal questions" in context to the complexity of living as a dependent.

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  • A few "legal questions" in context to the complexity of living as a dependent.

    I know the rules, laws, regulations etc. will likely change between Canada and America and state by state but I have a few questions:

    1. Once you suffer a catastrophic disability that leaves you near to completely dependent do you automatically (almost magically) become what is commonly referred to as a "legal dependent"?

    2. If you are classified as a legal dependent, do you lose certain human rights?'s do you have access to the same laws as other people, for example it's not illegal to kill yourself in Canada, would that still apply with a legal dependent? Also another example, this one is pivotal as a legal dependent like any patient do you have the right to refuse care? in Canada every patient has the right to refuse treatment, see obviously "society" hasn't done their due diligence with these particular situations, as things become quite murky and questionable. As with someone that suffers terminal cancer it's clear as day, cut and dry if you want to stop treatment it'll be stopped without a moments notice? However if you are a quadriplegic and would like your vent switched off or to let nature take it's course there seems to be some room for argument according to some people, which I don't understand. It literally makes no sense, and The only thing I can conclude is basically if you cut it down it hinges on the fragility and the potential impact of other disabled's that have decided to live.

    3. If you are a legal dependent and you are living with a parent as your primary caregiver, and you are sick to death of them; if you own the property or at least are the tenant, pay for everything etc. Do you have the right to remove them from your presence, basically the right to privacy? My caregiver seems to think that if I call the cops that the cops will take me in despite the fact that everything is mine, of course I am almost certain this is correct; but with how sickening things have become in our society recently it does make me wonder on the slight potential if she's correct?

    4. And if a caregiver does leave a legal dependent basically just someone that is severely disabled, are they liable? Even with the explicit volition of the "Legal dependent" clearly expressing "get the fuck out"?

  • #2
    So my understanding is limited both regionally - I live in the US - and also by gaps in knowledge.

    In the US, catastrophic injury resulting in severe disability and dependence doesn't result in automatic legal guardianship. So you manage your own money, arrange your own caregivers, make your own medical decisions, whatever. As long as you do those things successfully, a court isn't likely to give guardianship of you over to another person, caregiver, family or other, without your consent. In some states, a family member or caregiver or pretty much anyone can go to the court and assert that you have a degree of untreated clinical depression such that you pose a risk to your own life and safety and have you briefly committed for a psych eval.

    If you're resident with a caregiver, family or otherwise, and things are going badly, you or a friend or another party can call APS and they will intervene and get you to a place of (comparative) safety - even if you own the house, they're going to take you to a hospital or nursing home or somewhere else and trust to their case managers or the courts to sort it all out. I suspect, but don't know, that caregivers have legal liability for their clients and if they leave, whether instructed to or not, someone who is reliant on them (for vent care or access to water or repositioning or whatever) and something goes awry, it's on them - technically I think it's considered abandonment of care. If a caregiver has some sort of license or certification that may be jeopardized by abandoning a client.

    I know, from a PCA, of a catastrophically disabled fellow in my community who passed away recently of untreated sepsis from a cluster of infected sores. He had a very stringent contract that all his staff signed that basically stated that he was the ultimate decider of his care and that care he refused was not to be provided. He had an understanding and respectful PCP and a comprehensive POLST/MOLST form on file at every single local hospital, nursing home, ambulance company, home care agency etc. That PCA still weeps when she talks about R's death, because it was so painful and drawn out - she feels that the medical community failed him utterly.

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    • #3
      So in a way you literally lose the right to privacy, your own autonomy or agency.

      A caregiver could have you committed, just because you're disabled and they're able bodied. This is a disgusting society, I do not understand why do they keep people alive after injuries like this.

      And because you're a cripple your competence is so Easley questionable.

      So essensually you lose social liberties and rights: along with bodily function.

      Absolutely disgusting.

      What about every patients right to refuse care?

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      • #4
        Originally posted by JamesMcM View Post
        So in a way you literally lose the right to privacy, your own autonomy or agency.

        A caregiver could have you committed, just because you're disabled and they're able bodied. This is a disgusting society, I do not understand why do they keep people alive after injuries like this.

        And because you're a cripple your competence is so Easley questionable.

        So essensually you lose social liberties and rights: along with bodily function.

        Absolutely disgusting.

        What about every patients right to refuse care?
        No, that is NOT the case in the USA. Maybe 75 years ago, but now days it is VERY difficult to have someone conserved or forced into a guardianship. Even for my former clients with severe TBI it was rarely granted through the courts.

        APS is Adult Protective Services, which in most states is in charge of protection of the elderly and people with disabilities (who are considered to be in a special protected class) from physical, mental, or fiscal abuse by family or other caregivers. If functions very similarly to CPS (Child Protective Services) which protects children from emotional or physical abuse. These agencies do NOT determine commitment, nor conservatorship, nor guardianship, but they are empowered to file charges against the abusers and provide shelter and care to the abused person while their investigations are being cared out. Their reports may be used by a judge in determining issues such as removal of custody of children or by the county prosecutor's office in filing criminal charges against abusers. Conservatorships may be of "estate" (your money and property) and/or of "person" (where you live, your medical care, etc.). The latter is even harder to get than the former.

        Determination of competence is a legal issue as well, and it is very difficult, at least in my state, to get a judgement of incompetence, which is the inability to provide yourself (through your direct actions or actions you direct) with food and shelter. Having a physical disability alone is not sufficient to determine incompetence, which is required in order for a guardian or conservator to be appointed. Very rarely is a caregiver appointed as either; it is usually a family member, or sometimes a court appointed guardian or conservator who provides these services for multiple people in the area.

        A person who has not been deemed incompetent has full rights to refuse care of any type.

        (KLD)
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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        • #5
          Originally posted by SCI-Nurse View Post
          No, that is NOT the case in the USA. Maybe 75 years ago, but now days it is VERY difficult to have someone conserved or forced into a guardianship. Even for my former clients with severe TBI it was rarely granted through the courts.

          APS is Adult Protective Services, which in most states is in charge of protection of the elderly and people with disabilities (who are considered to be in a special protected class) from physical, mental, or fiscal abuse by family or other caregivers. If functions very similarly to CPS (Child Protective Services) which protects children from emotional or physical abuse. These agencies do NOT determine commitment, nor conservatorship, nor guardianship, but they are empowered to file charges against the abusers and provide shelter and care to the abused person while their investigations are being cared out. Their reports may be used by a judge in determining issues such as removal of custody of children or by the county prosecutor's office in filing criminal charges against abusers. Conservatorships may be of "estate" (your money and property) and/or of "person" (where you live, your medical care, etc.). The latter is even harder to get than the former.

          Determination of competence is a legal issue as well, and it is very difficult, at least in my state, to get a judgement of incompetence, which is the inability to provide yourself (through your direct actions or actions you direct) with food and shelter. Having a physical disability alone is not sufficient to determine incompetence, which is required in order for a guardian or conservator to be appointed. Very rarely is a caregiver appointed as either; it is usually a family member, or sometimes a court appointed guardian or conservator who provides these services for multiple people in the area.

          A person who has not been deemed incompetent has full rights to refuse care of any type.

          (KLD)
          Thank you very much for this very informative response, I can only hope that it is the same in my country and my problems I have reread the patients bill of rights and I believe it is fairly similar.

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          • #6
            Have you tried calling here James?

            http://www.accessils.ca/Public/Home.aspx
            Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

            T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

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