(Super. Ct. No. SCLPSQ11-0358)
The opinion of the court was delivered by: Nicholson , J.
Conservatorship of Marjorie F. CA3
California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.
Marjorie F., a Lanterman-Petris-Short Act (LPS; Welf. & Inst. Code, § 5000 et seq.)*fn1 conservatee, appeals the finding she is gravely disabled as a result of a mental disorder and is unable to provide for her basic personal needs of food, shelter or clothing. She claims there is not substantial evidence to support the finding of grave disability and there is not substantial evidence supporting the imposition of special disabilities on her rights to contract, possess a firearm, and refuse or consent to medical treatment. We affirm.
Marjorie was the subject of a probate conservatorship of the person and the estate. She lived at the Shasta View Nursing Center, a skilled nursing facility. As part of the probate conservatorship, she no longer retained her right to enter into contracts, consent or refuse medical treatment and to vote. Pam Crowe, the social services coordinator at the nursing home, reported that while at the nursing home, Marjorie exhibited delusional behavior. She would alternate between "refusing to eat or leave her room to sitting by the door with a bag full of her little belongings waiting for Michael[*fn2 ] to pick her up and take her to Carmel Valley." She believed Michael was going to come and take her to "her husband in Carmel Valley who had been sleeping and not eating since she left." Marjorie's regular refusals to eat were sometimes used as leverage if she thought "things were not going to go her way, like she was not going to get to Carmel Valley any time soon or [the probate conservator] was keeping her [from] doing something." She never required medical treatment for refusing to eat, and the episodes rarely lasted more than several days. During these periods, she also refused medication. Marjorie also exhibited behaviors reflecting suicidal tendencies and was put on suicide watch. One suicide attempt appeared to be in an effort to "go to sleep and see Michael." In March 2011, a suicide attempt resulted in her being placed on a section 5150 hold. Marjorie also repeatedly tried to leave the facility to get to Michael. The nursing home does not have a psychiatrist on staff, the staff is not trained to handle psychiatric problems, Marjorie's behavior caused a great deal of disruption at the nursing facility and Marjorie's psychiatric needs were not being met. Crowe contacted Diana Midkiff, the county's Deputy Public Guardian, because Marjorie's behaviors were beyond the facility's means to care for. Based on Marjorie's current behavior, delusions and required level of care, the nursing home would probably not accept her back.
Because the nursing facility was unable to manage Marjorie's psychiatric needs and her needs were not being met, Marjorie needed a higher level of care. Accordingly, as the public guardian, Midkiff sought an LPS conservatorship. An LPS conservatorship would grant Midkiff the authority to place Marjorie in a locked psychiatric facility, authority she did not have under the existing probate conservatorship. Midkiff also described Marjorie's delusions, stating, "She believes that she is married to a spiritual being of some sort and that he resides in Carmel Valley Village and is waiting for her to return there to their home to wake him up. He's apparently been sleeping for a number of years waiting for her to join him, and that is her constant and fixed delusion." Midkiff researched Saint Germaine, the person Marjorie believes she is married to and found "he was a real person who existed at some time in the 1700s or something, and then there is a religion [sic] cult that believes that he was reincarnated at some point, and this is who she thinks her husband is." Midkiff noted Marjorie is "rather frail and weak. She doesn't eat a lot, so she has a tendency to be very thin and sometimes malnourished." Midkiff tried unsuccessfully to contact Marjorie's children. She was unable to locate Marjorie's daughter. She was able to obtain contact information for Marjorie's two sons but they did not respond to Midkiff's messages. Marjorie did not believe she needed to be under a conservatorship and sometimes denied she was under one.
Dr. Brown, the senior psychiatrist with the County of Siskiyou, Behavioral Health Services, testified as an expert. After evaluating Marjorie for dementia and reviewing her hospital records, he determined she did not have dementia and concluded she was delusional. Her delusions included the beliefs that she was working for President Obama and studying DNA implantation. During his interview with Marjorie, she was also "quite delusional." She claimed her son, Michael, had discovered how to put DNA "on the end of a push pin which could then be pushed into the breast of a woman with cancer and cure her." She also denied she had ever refused to eat. Given her history, which revealed that her repeated refusals to eat were part of an extremely long-standing behavior and that she had received electroconvulsive shock therapy for years due to these repeated episodes of food refusal, Dr. Brown also found her denials delusional.
Dr. Brown noted that in records from both the nursing home and the psychiatric hospital, Marjorie required "a tremendous amount of encouragement to take care of her basic activities of daily living, including eating." Her "behavioral pattern of not caring for herself and not eating" existed over the course of 30 years. This inability to take care of her basic daily needs on her own was an entrenched and worsening pattern. Dr. Brown had also spoken with Marjorie's family, none of whom was willing to care for her or provide third party assistance to her. Her difficult behaviors, including her refusal to eat and refusal to get out of bed were the type of behaviors that "destroyed" her family's ability to continue to care for her.
Marjorie had been diagnosed at the psychiatric hospital with "bipolar disorder mix phase severe with psychotic features" and was being treated with dementia drugs, antipsychotics and a mood stabilizer. Her condition improved while taking the psychiatric medications. Dr. Brown diagnosed Marjorie as having a "psychotic disorder, not otherwise specified, and bipolar disorder, not otherwise specified." He went on to explain in order to be more specific in his diagnosis, he would need additional information and a better history, but he was not able to obtain those. Based on his diagnosis, Marjorie's inability to provide herself with food, clothing or shelter and the unavailability of any third party assistance, Dr. Brown concluded Marjorie was gravely disabled.
The court found Marjorie was gravely disabled. The court noted Dr. Brown was unequivocal in his opinion that she cannot care for herself or provide for her own food, clothing or shelter. Under section 5357, the court also denied her the right to enter into contracts, possess a firearm and to refuse or consent to medical treatment unrelated to her grave disability.