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Blind and deaf man’s caregivers sued over lack of access to interpreters

Last modified: 8/20/2013 2:31:20 PM
The cues offer direction in a world Teddy Losacano can’t see or hear. A tap on the leg means it’s time to eat. A gentle tug at the arm tells the Penacook man it’s time to go, follow the person leading.

But last week, as David Losacano tried to communicate with his brother, those cues got in the way.

“How are you?” David asked aloud as he formed his fingers into signs and spelled the question into Teddy’s cupped palms. As he finished, David rested his hands on his brother’s legs.

Here, the touch meant affection. But Teddy didn’t know that. So he stood up.

“See, he thought it was time to eat,” David said, leaning back in his chair as his brother walked to the kitchen and patted the table, looking for lunch. “How can I come up and say just a regular conversation or ‘Hi’? ”

Right now, David can’t say those things to his brother. And 46-year-old Teddy – who is blind, deaf and has a cognitive disability sustained from a bout of scarlet fever as an infant – can’t say anything back. According to David, it hasn’t always been this way. The brothers grew up with two deaf parents and he remembers when Teddy was fluent in sign language, allowing him to respond to questions and communicate his own needs.

Those skills have slipped away not by natural deterioration, David contends, but because of disuse.

In a lawsuit filed earlier this month in U.S. District Court in Concord, David and his lawyer, Kirk Simoneau, place blame for that digression on the organizations that coordinate Teddy’s

care: Community Bridges and Easter Seals of New Hampshire. The lawsuit gives a long-range view of Teddy’s last 15 years in assisted living homes and alleges that those organizations failed day after day to provide staff who could communicate meaningfully with him.

Simoneau then points to visit after visit where he says doctors at Concord Hospital and Riverbend’s Concord Psychiatric Associates, also defendants in the lawsuit, offered services or changed medications without a sign language interpreter present.

Three of those four defendants declined to comment for this story, and none have responded in court. It will likely be some time before a judge or jury consider the case.

The long-term lack of stimulation, David and his attorney contest in the lawsuit, has turned a once “intelligent, creative, kind and sensitive human being into a substantially damaged, limited, frustrated and debilitated shell.”

That frustration was clear last week as Teddy patted the kitchen table, realized nothing was there and walked back to his chair, the spot in his home where his brother believes he spends a substantial part of his day. With his eyes closed, Teddy leaned onto the arm rest and placed his forehead in his hand – the same position he had been in before David attempted to break through.

“If we stuck you on an island by yourself for a decade, what are your communication skills going to be like?” Simoneau said. “After a decade of being on an island with no one to talk to?”

Not present

In 1990, after a visit at Concord Hospital, a doctor noted that Teddy could communicate with sign language and follow instructions easily, according to the lawsuit.

An interpreter was present for that visit.

But Simoneau says that was the last and only time that someone qualified to help Teddy communicate attended one of his appointments at the hospital or Concord Psychiatric Associates. Likewise, sign language interpreters have not been present at meetings where Teddy’s Individualized Service Plan, known as an ISP, was discussed, Simoneau said.

According to Simoneau, Teddy’s ISPs are developed by staff from Community Bridges and Easter Seals as well as other specialists. Since 1997, the attorney says, those ISPs have stipulated that Teddy have an American Sign Language interpreter available to him during all appointments, due to being deaf and legally blind.

Without that service being provided, doctors have expressed an inability to assess Teddy, with one doctor noting in a report that he had “no way to communicate with him,” according to the lawsuit. During several visits at Concord Hospital, Simoneau said, Teddy became agitated and was either placed in restraints or medicated. During one 2007 visit, when Teddy was taken to the hospital by the police because of erratic behavior, staff noted that he “apparently knows” American Sign Language but didn’t find an interpreter, according to records referenced in the lawsuit.

Beyond those specific instances, David is also accusing his brother’s care providers of failing – for years – to stimulate Teddy’s mind and communicate with him on a regular basis past the cues that relay basic instructions.

David says he’s been advocating to bring a tactile sign language instructor, who could teach Teddy to understand signs felt with his hands, into his service plan for years. In Teddy’s most recent ISP from July, it’s suggested that he would benefit from learning that skill, according to the suit, which notes that the suggestion was first made years ago.

“Nothing ever materializes, and that’s the major reason why he’s gotten like this because nobody’s doing anything but baby-sitting,” David said. “It’s a big baby-sitting job.”

David said he’s come to that belief gradually, resulting in the lawsuit being filed now rather than years ago. Simoneau said that for a long time David and his parents were told that Teddy wasn’t capable of meaningful communication.

But that theory was “tested” early last year, according to Simoneau, when David decided to bring a specialist from the Northeast Deaf and Hard of Hearing Services to a team meeting of Teddy’s Easter Seals care providers. The woman, who is also deaf, pulled her chair up to Teddy’s, leaned in and started to sign into his hands, David said.

“She’s up there trying to talk to him and she goes, ‘Do you know, I am deaf too. Just like you.’ And then she stomps on the floor like this and he’s feeling vibrations, pounding on the floor talking to him,” David said. “And then he smiles.”

Then, David said, Teddy began to nod.

“In deaf culture that sort of nodding means, ‘I’m paying attention. I’m involved in what you’re saying. Please tell me more,’ ” said Simoneau, whose parents are both deaf.

David called the experience “awesome.” And in meeting notes, according to the lawsuit, Teddy’s care team called it “a real eye-opener.”

A ‘complicated’ situation

Concord Hospital, Concord Psychiatric Associates and Easter Seals of New Hampshire all declined to comment about David’s allegations, citing the ongoing litigation. Susan Silsby, senior vice president of programs at Easter Seals, said the organization is working with its attorneys to defend the case.

At Community Bridges, executive director Roy Gerstenberger called the situation “complicated” and said the lawsuit came as a surprise to the agency. He said he couldn’t comment on the specific allegation that Teddy’s care providers have failed to follow through with the recommendations in their own ISPs. But he did say that David is often present at meetings where Teddy’s services are planned and that he would be able to interpret for his brother if necessary.

“We have an ongoing relationship with Mr. Losacano and his brother that he has chosen to continue to work with us and receive services from us even though he has an option at any time to switch to another organization,” Gerstenberger said.

Concord Hospital has come under fire before related to its treatment of deaf patients. In 2008, the hospital agreed to pay $100,000 to settle a lawsuit filed by six people who said they were not provided with sign language interpreters during doctors visits and were required to use inadequate auxiliary aids that hospital personnel did not know how to operate.

Although the U.S. attorney determined that the hospital violated the Americans with Disabilities Act, the hospital didn’t admit to any liability as part of the settlement.

Lawsuit’s goal

The lawsuit seeks financial damages but Simoneau said last week that the primary goal is getting Teddy adequate care. With proper training, he and David believe Teddy could regain some of the communication skills he’s lost.

Ideally, he should be told that it’s time to eat rather than tapped on the leg. Or, Teddy could convey on his own that he’s hungry.

“Hungry. Thirsty. The fact that he needs to go to the bathroom. The fact that he wants to go swimming. He can’t communicate any of those things,” Simoneau said. “For the entire time he’s been supervised and cared for by these people they’ve never once had anyone who could communicate with him.”

Last week, after Teddy had walked back to his chair from the kitchen, David tried once more time to pull a response from somewhere inside his brother, a place that at times seems unreachable.

He leaned in, then held the curve between Teddy’s thumb and pointer finger to his own chin and signed his name – David – several times.

He waited to see if Teddy would repeat it, a recognition that maybe he knew his brother was there. Instead Teddy leaned in and the two wrapped their arms around one another.

“Now he’s going to identify me by smell,” David said. “He wants to communicate so bad.”

But then Teddy stood up, walked to the kitchen and rubbed the table.

(Tricia L. Nadolny can be reached at 369-3306 or tnadolny@cmonitor.com or on Twitter @TriciaNadolny.)


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