テつ*Woman claims she was coerced into nursing homeWarren Wolfe
Star Tribuneテつ*Published Dec. 9, 2002 NH09テつ*
Josephine Bronczyk went into the nursing home once, she said, coerced by an Anoka County adult-protection social worker who threatened that if Bronczyk refused, a judge would force her to move there.

A concerned niece had called the social worker asking that Bronczyk be moved to a nursing home. But with the help of her Minneapolis lawyer, the 86-year-old Bronczyk is back at her farmhouse near Forest Lake, with 24-hour care provided by a home health agency.

And she is determined that if there is a next time, "I will be the one to decide -- me and nobody else."

Early next month, she will appear with her attorney before a federal judge in Minneapolis to ask the court to determine for the first time that the U.S. Constitution guarantees all mentally competent people -- no matter how physically disabled -- the right to decide for themselves where they will live.

The case could affect the way county human services officials -- and perhaps even families -- deal with physically frail people who resist pressure to move to a nursing home.

"It's moderately common that people end up in a nursing home against their will," said geriatric-care manager Lynne Ploetz, who owns Matrix AdvoCare Network in Brooklyn Center and set up Bronczyk's care.

"Well-intentioned people sometimes take the easy way out and insist on a nursing home, when home care -- if you can afford it -- will allow you to stay home," she said last week. "I just helped another woman get out of a nursing home today."

'I was so mad'

Bronczyk sued Anoka County Human Services, demanding that the agency be barred from again attempting to move her to a nursing home against her will without convincing a judge to declare her mentally incompetent.

"I was so mad," said Bron czyk, a former junior high school teacher. "I didn't want to go to the nursing home. I told everybody, but they didn't listen. It was decided for me."

Bronczyk also is asking that the state's guardian and conservator laws be held unconstitutional, arguing that they improperly allow officials to take authority over physically disabled people even if they are mentally competent.

Anoka County officials flatly deny Bronczyk's assertions and have asked U.S. District Judge David Doty to dismiss the lawsuit when he hears oral arguments Jan. 10.

"The protections they're asking for already exist in current law," said Assistant Anoka County Attorney Thomas Haluska. "Anoka County didn't violate any law or [Bronczyk's] rights. Here was a woman who needed help with her care, and she got it."

Adult protection called
A soft-spoken woman whose humor normally brightens her conversation, Bronczyk wept quietly as she described what happened, events also outlined in court documents.

The oldest of seven children, Bronczyk grew up on the farm and left to teach school in Minnesota, Iowa and Wisconsin. She returned to the Forest Lake farmhouse nearly 30 years ago, retiring at age 57 to care for her aging father. Never married, she stayed there after her father died.

She went to a nursing home briefly nine years ago after a stroke. In recent years, her health worsened. She uses a wheelchair and was getting some home health care while her brother, 20 years younger, helped with her daily needs.

But in July 2001 her brother became ill and was hospitalized. Her visiting sister and niece became alarmed at Bronczyk's care needs and called Anoka County adult protection, urging that she be moved to a nursing home.

Social worker Mary Gargaro visited Bronczyk three times in two days, determined that she needed round-the-clock help and that her doctor agreed, and suggested nursing-home care. When Bronczyk refused, Gargaro found that the home health agency could not provide the level of care necessary and insisted that nursing home care was needed.

During one of those conversations, Gargaro did call the county attorney's office to discuss going to court, but county officials decided against it.
Instead, Bronczyk's niece took her to a Roseville nursing home and Bronczyk signed herself in, then called her attorney, Erich Kaardal. He asked Matrix to evaluate the situation. Her brother died while she was in the nursing home.

Within weeks, Bronczyk was home, with a new agency providing 24-hour care at a cost of about $55,000 a year -- 15 percent more than a nursing home would have charged, Ploetz said.

In a deposition, her doctor said he would not have agreed to nursing-home placement had he been told that Bronczyk preferred being cared for at home.

But Bronczyk "was not coerced, and she needed care right away," said Anoka County's Haluska. "Her move was intended to be temporary, because her condition might improve. But in the end, the social worker acted appropriately to protect a physically disabled woman who needed help. Isn't that supposed to be [the county's] role?"

Bronczyk says she was never told her move might be temporary. And she said there didn't seem to be much effort to investigate alternatives to the nursing home.

"Nobody seemed to care much what I thought. I kept saying, 'I have a right to live where I want to,' but people just told me I didn't understand. I understood, all right, but they just talked over me until I called my attorney."

'System worked fine'

Kaardal, her attorney, is no stranger to nursing home controversy. Four years ago, in a case that went to the Minnesota Court of Appeals, he helped an 89-year-old Minneapolis woman with short-term memory loss fend off efforts by her family to force her to move to a nursing home or assisted-living apartment.

In that case, the appeals court ruled that a lower court must first consider the woman's strongly expressed desire to remain in her home before granting her nephew power to force her to move.
She eventually changed her mind and agreed to move into assisted living.

"Here it's very clear that Josephine is quite capable of making her own decisions, and that her right to determine her own abode was violated by the county," Kaardal said.

"It's a basic right, a constitutional right. Josephine is fighting to protect herself," he said, "but she's also helping a lot of other physically frail people who face similar coercion."

Anoka County's Haluska said he is sympathetic with Bronczyk's desire to remain at home, "and I'm glad she was able to work that out. It really shows that the system worked fine. We helped her get temporary care until she could get the home care she wanted."

It's a situation he has dealt with himself, he said: "Last week I had to put my folks into assisted living. It was difficult for them because they'd lived at home since 1958. It was a difficult situation not just for me, but for my siblings and my parents. But sometimes you just reach the condition where that's necessary."

Concern about cost

Staying at home has not been an easy decision, Bron czyk said.

"I'm worried about how much longer I can afford this care," she said. "If it comes to that, the trust could sell the farm. But it's the family farm, and I want to stay here."

Should the judge agree with Bronczyk, Ploetz, the care manager, said, "it will send a message to a lot of people -- hospital discharge planners, nursing home social workers, county workers -- that they need to really listen to older people, to find out what they really want.

"I know they all have big caseloads and lots of work to do," she said. "But the easiest thing isn't always the best thing. In the end, we have a right to decide for ourselves what the best is."