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Despite mental capacity of child, woman left to make own decisions

Jun 15 2012

At 76, Joan Andrews had the mental capacity of a six-year-old, needed help with all aspects of daily living and likely had the onset of dementia - yet she was still responsible for all her own health-care decisions, a coroner's jury heard this week.

It's one of several issues raised at the inquest into the death of the developmentally delayed woman, who died of a head injury after falling from her bed Feb. 10, 2011.

At the time of her death, Andrews was living in a "home share" approved by Community Living B.C., the provincial agency that provides care for people with developmental disabilities.

While Andrews was happy living in the Langford home with the Craveiro family, who provided her care, her physical and mental condition was deteriorating. She suffered numerous falls and had gone from being mobile when she moved there in 2009 to needing a wheelchair before her death.

Several witnesses have suggested better communication is needed between Community Living and the Vancouver Island Health Authority. The coroner's jury will be asked to make recommendations at the end of the inquest.

Witnesses from both VIHA and Community Living have said it was unclear who was responsible for Andrews' health-care decisions.

The issue arose when moving Andrews from the Craveiro home to a longterm care facility or group home was being considered, as she needed more care.

Andrews, who suffered an unknown injury at birth that caused her developmental disability, had lived with her parents until she was almost 50 years old and they died. The parents had set up a trust so Andrews would be financially looked after when they were gone. However, no guardian was specified.

With no legal guardian or representation agreement - which can be applied for by an advocate - Andrews was legally deemed to be a competent adult, although, when she died, a longtime friend was in the process of applying to represent her.

VIHA social worker Hilary Mason testified that she believed Andrews was not capable of making her own health-care decisions.

But Community Living case worker Catherine Halcrow said Andrews was capable of making her own decisions "in consultation" with her caregiver and a longtime friend.

Coroner's counsel John Orr questioned how that was possible when Halcrow's own notes indicated that the elderly woman was unfocused, her comprehension was diminished, she could only talk in short, simple statements, she was disoriented about people, time and dates, and she needed help with all aspects of daily life, including medical, financial and living decisions.

Halcrow said Andrews had lucid moments - when she was asked if she wanted to move to a group or longterm care home, Andrews indicated that she didn't.

Orr suggested that concerns about Andrews' condition should have prompted VIHA or Community Living to ask the Public Guardian of B.C. to become involved.

The public guardian often steps in in the absence of anyone else to do so.


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