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How to Edit Your Caregiver Documentation Online
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Have you ever fired an employee who then retaliated against you or the company? What happened?
Update 12/28/19: The caregiver, Sherri Watring, was convicted 12/19/19 by jury trial of two “Class A” Felonies for Elder Abuse and Exploitation, and a Petit Theft conviction:Click on the FB story to view the details: CBS 2 BoiseAbuse or neglect of a vulnerable adult under circumstances likely to produce great bodily harm- penalty up to 10 years and $25K fineExploitation of a Vulnerable Adult that exceeds one thousand dollars- penalty up to 10 years and $25K finePetit Theft (note: stealing urn with ashes)- up to 365 days jail timeShe will be sentenced on March 6, 2020. She admitted that she threw dad’s cremains away in an unknown location. When her home was searched, she returned the stolen empty urn to detectives. She was determined to have misappropriated funds from our parents in access of $100,000.00 from 2016 to 2018, per the courtroom discovery and attorney’s case presentation derived from detectives investigatory results.Sherri Watring is now a Felon and will carry this title with her as long as she lives. She is 53 yrs, I and family are now waiting to learn what prison time and financial penalties she will be given by the judge in- about 10 weeks. We expect no victim compensation from her for the exploitation, but we are hoping for justice for our parents, and that Sherri Watring will no longer prey on any other vulnerable persons._________________________________________________________________________________________Update 5/15/19: The caregiver has been in custody since April 7th. She failed to appear for her 1st arraignment April 3rd and the judge issued a bench warrant with a 2nd bond- additional to her original bond. She apparently could not make bail this time, she has remained incarcerated.We attended her 2nd scheduled arraignment last week, and she will be officially charged in district court on 5/17/2019!We will know then if she pleads not guilty and this goes to trial for two felony charges of Elder Abuse and Elder Exploitation. Each charge has up to 25 years as max. penalty. If she wants a plea bargain to admit her guilt we will insist on some years incarceration plus restitution to the Howell estate. After this is over, I will describe what we know she did (beyond neglect), and what she was found guilty of. We waited for 15 months, we believe some justice will be paid for the crimes.—————————————————————————————————————Yes, I fired a caregiver who had been criminally negligent in the oversight of my elderly parents, 94 and 88 years. Father had some mobility limitations but could still fix his breakfast and get out to the mailbox using his walker. Mom was bedridden and legally blind for nearly six years due to macular degeneration. Both were fully dependent on her for health and nutritional care.We found Mom half starved with extensive bedsores and serious deep wounds after we learned Father had died a week earlier and the caregiver did not notify any family. We live about two miles away, the last time we had chatted with Father was the morning before he passed. Father had recently had a check-up and the doctor gave him thumbs up for his good health. Mom had been put on Hospice by the caregiver two days after Father died. We were shocked by all this.Our parents had granted the caregiver Power of Attorney, and she was quick to have a protection order placed on the family saying my husband threatened her with a gun. We could not access Mom or come near the house. We got a court order for guardianship/conservatorship to get into their home after 14 days. It took literally four hours to have this woman removed since she claimed POA. Understandably, the police are not really able to discern legal documents. We provided the copies of our court order and they had to have them examined at the station before they could execute the order. We had to stand back and “allow the caregiver to pack her things” in private. Unfortunately, she not only packed a box of her things, but she also took Father’s ashes which had been delivered the previous day and their recent financial paperwork. She put a comforter on top of the packed box, grabbed what she called “her drugs” from a cabinet on the way out, and the police let her leave. She did leave some injectable anesthetic behind, which we have a witness who watched her use it. The caretaker has no medical authority, no certification, she was hired 7 years prior as a housekeeper and to drive the parents to Dr. appointments or shop for groceries. She performed surgical stitching to Mom’s vagina- we weres shocked to learn! My God, what evil guides this, person.She had most of Dad’s financial records in her home at the time which we discovered later after a police search and seizure. She was keeping records away from Dad so he didn’t learn about her embezzlements. We learned about $35k of defaulted credit card debt, some since January 2017, which is why she took away their phones or turned off incoming calls. these were collectors she had to hide from Dad. Several of the cards were for Mom after she became blind, so we know this was financial exploitation and fraud.We later learned the caregiver robbed our parents financially and took funds from their savings, checking and investments. She also sold, gave away and/or hid most of their valuable possessions. She even emptied their safety deposit box taking a gold Krugerrand, any valuables and important documents like Father’s Military records, and their wills. She took our mothers wedding rings for gawd's sake, and we are still learning what else is missing.You see this kind of thing on television about people who commit crimes for money while taking advantage of the elderly. You never expect it will happen to your family. Be watchful, and carefully vet anyone you put in a place of control over old folks.Update 4/1/2019The caregiver was picked-up on a felony warrant and had an arraignment last month. She has a court hearing with her attorney this Wednesday.The prosecuting attorney charged1 count: Adult-Abuse or Neglect of a Vulnerable Person:2 counts: Adult-Exploitation of a Vulnerable Person (over $1000@)I can only pray justice will be served, it has been a long wait though we did not ask for this criminal indictment. The state investigated based on what the Hospice Care Nurses and Doctor reported to district adult protection services.We are thankful to everyone who has helped to ensure this woman NEVER does this to any other elderly person. I expect she will not be able to work in eldercare after the courts process her case, that is my hope, plus to ensure she is no longer a threat to any vulnerable person.
As a mother, did I raise my child to become a narcissist?
As a mother, did I raise my child to become a narcissist?To begin, I don’t see the point beating around the bush here, so I’m just going to say it. Narcissistic Personality Disorder is primarily caused by early childhood attachment trauma, neglect, and/or abuse. This is very well documented and understood. There is a theoretical genetic/epigenetic predisposition to hypersensitivity, low frustration tolerance, and poor emotional controls, but a whiny, hypersensitive kid that cries more than other kids does not in and of itself equal narcissism or NPD. It takes environmental factors largely between the child and primary caregiver(s) to tip that scale into pathological disorder territory.Before I continue I’m also going to have to stress the importance of not self-diagnosing other people with mental disorders. Unless the “narcissism” label was used by your child’s psychologist or psychiatrist after personally counseling your child over a period of months, don’t be so quick to apply it yourself. Pathological narcissism is very difficult to differentiate from other disorders and vice versa. To diagnose NPD, the therapist must first rule out other personality disorders, bipolar disorder, substance/alcohol abuse disorders, and will probably want to rule out other disorders as well. The reason is that NPD and several other mental disorders share a passing resemblance in their outward behavior, where the big difference lies in underlying motivation and causes.For instance, before diagnosing me, my therapist ruled out Antisocial and Borderline personality disorders, generalized anxiety disorder, and reactive attachment disorder. She discussed all of these disorders and their underlying causes/motivations at length with me in order to do so. During this time she was also trying to rule out NPD, but could not, hence the diagnosis.Pathological narcissism/NPD is not a common disorder. Unless your child has been clinically diagnosed by a mental health professional, I’d consider other more common disorders.DSM-5: Differential Diagnosis by John Coctostan on Resources and Information on NPDWith all that out of the way, let’s get into the root causes of pathological narcissism/NPD.Excerpt from John Coctostan's answer to Is emotional empathy non-existent in Cluster B individuals, or just repressed?In childhood, narcissists—yes, even the so-called spoiled, doted “golden child”—were objectified, and subjected to emotional neglect and unavailability, emotional blackmail, idealization, devaluation, and in many cases, outright neglect and abuse. Infants and toddlers require attention, affection, reassurance, and interaction. It’s a biological imperative at that age. It’s utterly vital for proper emotional and psychological development.Instead, as children, narcissists are objectified as extensions of the primary caregiver(s). Their developmental needs are met if they conform to the caregivers’ “perfect child” script, and are met with scorn, devaluation, and even physical neglect or violence when failing to conform to that script. An infant and toddler is utterly, wholly, and completely dependent upon caregivers for survival, and attachment disorders and personality disorders develop in response to the incongruous ideas that the child needs its parents to survive but cannot trust its parents with its survival.It’s difficult to empathize with somebody while simultaneously feeling threatened or shamed by that person, especially when shame was a tool weaponized by caregivers in childhood and turned into an entirely negative, emotionally blackmailing manipulation tool.The people who specialize in, study, diagnose, and treat Narcissistic Personality Disorder have documented this pretty clearly. The people who have contributed what we know about NPD today found the following:Otto Kernberg, MD, and Heinz Kohut:Kohut and Kernberg agree with Freud in tracing the roots of NPD to disturbances in the patient's family of origin—specifically, to problems in the parent-child relationship before the child turned three. Where they disagree is in their accounts of the nature of these problems. According to Kohut, the child grows out of primary narcissism through opportunities to be mirrored by (i.e., gain approval from) his or her parents and to idealize them, acquiring a more realistic sense of self and a set of personal ideals and values through these two processes. On the other hand, if the parents fail to provide appropriate opportunities for idealization and mirroring, the child remains "stuck" at a developmental stage in which his or her sense of self remains grandiose and unrealistic while at the same time he or she remains dependent on approval from others for self-esteem.In contrast, Kernberg views NPD as rooted in the child's defense against a cold and unempathetic parent, usually the mother. Emotionally hungry and angry at the depriving parents, the child withdraws into a part of the self that the parents value, whether looks, intellectual ability, or some other skill or talent. This part of the self becomes hyperinflated and grandiose. Any perceived weaknesses are "split off" into a hidden part of the self. Splitting gives rise to a lifelong tendency to swing between extremes of grandiosity and feelings of emptiness and worthlessness.In both accounts, the child emerges into adult life with a history of unsatisfactory relationships with others. The adult narcissist possesses a grandiose view of the self but has a conflict-ridden psychological dependence on others.Elsa Ronningstam, PhD and associate professor at Harvard Medical School:NPD has a genetic origin with inherited hypersensitivity, low frustration tolerance and compromised emotion regulation, especially aggression. Early interactions between child and caregiver are influenced by overstimulation and under– regulation that result in problems with self– esteem and self– regulation. Caregivers' own self– esteem regulation can cause them to assign roles and expectations that reach beyond the child's own personality and normal developmental tasks. Consequently, fluctuations in the child's experience of how he/she is perceived affect the formative understanding and perception of both self and others, and more specifically, of their expectations in relationship to others. Dismissive, preoccupied or avoidant attachment patterns are associated with development of pathological narcissism and NPD.James F. Masterson, MD, internationally recognized psychiatrist who pioneered new approaches to the treatment and understanding of personality disorders:Described two selves in a narcissist--the true self, and the false self. The latter is something a very young child initially constructs to please the mother. His psychotherapy approach to personality disorders was an attempt to put people back in touch with their real selves. He proposed that narcissism is rooted in defects in the quality of psychological nurturing provided, typically by the mother.Long story short, while physical abuse and classic, physical neglect may not be present and homes may appear to be happy and well-adjusted, people with NPD pretty much universally come from early childhoods where unrealistic expectations, emotional blackmail, and objectification were heaped upon them and failure to live up to the caregivers’ perfect-child script earned scorn and derision, something children are biologically predisposed to learn to avoid in primary caregivers. Personality disorders, including NPD, are sets of deep-seated behavioral conditioning patterns developed in order to navigate a sea of personal distress, fear, shame, etc piled upon them by the people they have to trust yet cannot trust.Several answers suggest it’s completely or largely genetic. This is patently wrong, though. The science (decades of it) does not support this. No narcissism gene has been found. Studies suggesting a genetic link merely suggest a genetic component—one component of many—that acts as a predisposition. Pathological narcissism is not in and of itself something you are born with. Medical and psychological science simply does not back that up, but it does back up the widely held, well documented, and very qualified opinions and findings of the people who study, diagnose, and treat this disorder professionally.Here are some more answers on similar questions that may interest you.John Coctostan's answer to Do NPD children always come from narcissistic parents or can they develop by other means such as smother parenting or over parenting?Rose Swan's answer to What makes someone a narcissist?John Coctostan's answer to Why would a parent severely neglect a child? Is this a conscious or subconscious act? Does the neglect carry over in other areas of their lives? What role does fear play for the spouse to follow along or speak up for the child?
What does having a disorganized attachment style mean?
In the early 1980s, researchers working with mother-infant dyads with documented abuse had difficulties assigning to some maltreated infants the existing attachment categories described on the strange situation procedure (SSP), which was the standard for attachment styles.Mary Main PhD, one of Mary Ainsworth’s first doctoral students at Berkeley, concurrently conducting attachment work with Drew Weston at Harvard, found that even in a large non-clinical, no abuse sample of dyads mother-child, at least 13% thirteen percent of infants did not “fit” Ainsworth’s guidelines of attachment, which were:A strong positive feeling, termed “secure”Markedly ambivalent, anxious pattern or “anxious/ambivalent”A non-expressive, indifferent, even hostile pattern or “anxious/avoidant”Main explored this observation with 53 middle-class mother-infant dyads and confirmed the previous findings; she noted a “dis-organized” behavior pattern, upon parents' return; she noticed:No consistent pattern of observable behavior,Children appeared highly conflicted.The striking theme was an observed contradiction in movement pattern: a combination of profound push-pull behavior – “come here/get away from me”Main and colleagues termed this fourth pattern “Disorganized/Disoriented”(D/D).Caregiver Behavior and Disorganized AttachmentMain & Hesse observed that D/D behavior in infants is in largely a function of paradoxical relationship to a caregiver, partially explained by the parents’ Internal Working Model (IWM) of traumatic attachment. According to Bowlby, an internal working model is a mental representation of our relationship with our primary caregiver that becomes a template for future relationships and allows individuals to predict, control and manipulate their environment.The ‘‘competing strategies’’ hypothesis: caregivers who have experienced ‘‘a continuing state of fear” within their own attachment history will also experience contradictory attachment tendencies toward their infants. They may simultaneously reject, yet also heighten through fear, the infant’s attachment-related affects and behaviors.When infants are frightened (by parental behavior or anything else) they are biologically predisposed to seek proximity to the caregiver; when the caregiver is frightened or frightening the child experiences profound confusion.Fonagy termed this the “great paradox” – when an infant’s source of safety and care is also a great source of alarm and unpredictability; this is where disorganized attachment patterns develop.Therefore, we could say that Disorganized attachment is actually the lack of a coherent style or pattern for coping.What it means is that the person with a disorganized attachment will develop the believe that:I am not worthy of being loved.I am in danger if I try.I am not able to do what I need to do to get the love I need.Other people are not reliable and trustworthy.Other people are not accessible and willing to respond to me when I need them.Other people are frightening.Disorganized Attachment: What Does it “Look Like”, in the Child?Often freezing, unable to move, starting approach and abruptly stopping.Seeming conflicted, desire for and fear of connection at the same time.Gaze aversion, terrified looks, blank looks.Inability to self-soothe.Erratic and reactive; disoriented.Alarmed; fright without solution; can’t assess danger accurately.The capacity of attachment figures for modulating fearful arousal in a responsive dialog with the child has a major impact on the development of dissociative symptoms over time.
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