In re C.R.
| Decision Date | 08 February 2022 |
| Docket Number | 2021-0118 |
| Parties | IN RE GUARDIANSHIP OF C.R. |
| Court | New Hampshire Supreme Court |
John M. Formella, attorney general (Laura E. B. Lombardi, senior assistant attorney general, on the memorandum of law), for the petitioner.
Amy B. Davidson, of Contoocook, by brief, for the respondent.
Tracy M. Culberson, of Concord, for the Office of Public Guardian, filed no brief.
The respondent, C.R. (ward), appeals an order of the Circuit Court (Maloney, J.) appointing a guardian over her person. See RSA 464-A:9 (2018). She argues that the petitioner, New Hampshire Hospital (NHH), failed to prove beyond a reasonable doubt that she is incapacitated. See RSA 464-A:9, III. She also argues that the trial court's findings of incapacity exceeded the scope of the pleadings and evidence at trial, thereby depriving her of notice and an opportunity to be heard. We affirm in part, vacate in part, and remand.
The trial court could have found the following facts. The ward suffers from schizoaffective disorder, and, in November 2020, was involuntarily admitted to NHH for a two-year period. At the time, she subscribed to a variety of paranoid beliefs.
NHH obtained emergency treatment authorization to provide the ward with psychiatric medication without her consent, see N.H. Admin. R., He-M 306, and, although her condition improved, the medication caused side effects that required a reduction in dosage. The ward declined to take any medication to treat the side effects or any alternative medication that would not cause the side effects. The ward does not believe that she has a mental illness or that she needs medication.
The emergency treatment authorization expired on January 4, 2021. In the two weeks before the February 2021 guardianship proceeding, the ward started exhibiting worsening thoughts that people were trying to target her, and her mood fluctuated more, spurring concerns that the current medication was insufficient.
NHH filed the instant guardianship petition at the end of January 2021, alleging, among other things, that a guardianship is necessary because the ward "states daily that she doesn't need" her medications, "thinks she owns the apartment building from which she was evicted," "needs assistance in her day-to-day activities," and "cannot weigh the risks vs. benefits of treatment." Following a hearing at which the ward appeared with counsel, the trial court granted NHH's petition, appointing the Office of Public Guardian as guardian over her person. This appeal followed.
To obtain a guardianship under RSA chapter 464-A, the petitioner must prove that:
Our standard of review is established by statute. See RSA 567-A:4 (2019); see also RSA 464-A:47 (2018) (providing that appeals under RSA chapter 464-A are governed by RSA chapter 567-A). When reviewing a trial court decision to appoint a guardian, the trial court's factual findings "are final unless they are so plainly erroneous that such findings could not be reasonably made." RSA 567-A:4 ; see RSA 490-F:3 (Supp. 2021) (granting the circuit court the jurisdiction, powers, and duties conferred on the former probate and district courts and upon the former family division), :18 (Supp. 2021) (providing that references to the probate or district courts or family division shall be deemed to be to the circuit court where it has exclusive jurisdiction of a subject matter).
Resolving the issues in this appeal requires us to engage in statutory interpretation. We look first to the language of the statute itself, and, if possible, construe that language according to its plain and ordinary meaning. Anderson v. Robitaille, 172 N.H. 20, 22, 205 A.3d 1105 (2019). We give effect to every word of a statute whenever possible and will not consider what the legislature might have said or add language that the legislature did not see fit to include. In re J.P., 173 N.H. 453, 460, 242 A.3d 823 (2020). We also construe all parts of a statute together to effectuate its overall purpose and avoid an absurd or unjust result. Anderson, 172 N.H. at 22-23, 205 A.3d 1105. We do not construe statutes in isolation; instead, we attempt to construe them in harmony with the overall statutory scheme. Id. at 22, 205 A.3d 1105.
The ward first argues that the evidence was insufficient to support a finding that she is "incapacitated." "Incapacity" is a legal, not a medical, disability, and refers to "any person who has suffered, is suffering or is likely to suffer substantial harm due to an inability to provide for his [or her] personal needs for food, clothing, shelter, health care or safety or an inability to manage his or her property or financial affairs." RSA 464-A:2, XI (2018). Incapacity is measured by "functional limitations," id., that "impair [an individual's] ability to participate in and perform minimal activities of daily living that secure and maintain proper food, clothing, shelter, health care or safety for himself or herself." RSA 464-A:2, VII (2018). "Isolated instances of simple negligence or improvidence, lack of resources or any act, occurrence or statement if that act, occurrence or statement is the product of an informed judgment shall not constitute evidence of inability to provide for personal needs or to manage property." RSA 464-A:2, XI.
Because the ward challenges the sufficiency of the evidence, our task is to review the record to determine whether it supports the trial court's findings beyond a reasonable doubt. In re Guardianship of G.S., 157 N.H. 470, 473-74, 953 A.2d 414 (2008). In a sufficiency challenge, "we examine whether the [trial] court's actual or implicit factual findings on the statutory components required for guardianship are reasonably supported" by the evidence.
Id. at 474, 953 A.2d 414. However, we defer to the court's judgment on such issues as resolving conflicts in testimony, measuring the credibility of witnesses, and determining the weight to be given testimony. Id.
The ward contends that "there was not proof beyond a reasonable doubt as to [her] incapacity, as NHH did not make a showing of substantial harm due to inability to provide for needs." See RSA 464-A:2, XI. We disagree.
The ward's psychiatrist opined that the ward is unable "to care for herself with respect to ... her psychiatric medications, and with respect to medical treatment." According to the psychiatrist, the ward is unable to weigh "the risks and benefits of proposed treatment" and incapable of making informed decisions regarding her treatment needs. The psychiatrist further testified that NHH evaluated the ward's "ability to identify dangers in the home," budget finances, care for her home, and complete activities of daily living, and found that the ward "needed assistance almost across the board." The psychiatrist opined that, without a guardianship, the ward was "likely [to] suffer substantial harm because she can't provide for her basic needs." The psychiatrist noted that, even while at NHH, the ward was unable to care for herself in that she did not shower for 47 days; wore shoes that were three or four sizes too big, falling apart, and held together with tape; and refused to allow staff to assess what appeared to be a fungal infection on her feet.
As a result, the psychiatrist expressed concern about the ward's ability to live independently. She noted that the ward intended to return to the apartment from which she was evicted, although she has refused to agree to pay the $3,000 in back rent that she owes. The psychiatrist opined that "the only safe options for discharge" were for the ward to live independently but with assistance at home, or to live in a group home, or in an assisted living facility. The psychiatrist noted that the ward had "declined all of those options." The psychiatrist testified that if a guardian were appointed for the ward, then the ward could be discharged from the hospital safely, she could stabilize on her medication, and she might be able to return to independent living. According to the psychiatrist, discharging the ward from the hospital without a guardian would be unsafe.
Based upon this record, we conclude that the evidence was sufficient for the trial court to have found, beyond a reasonable doubt, that the ward "is likely to suffer substantial harm due to an inability to provide for [her] personal needs for food, clothing, shelter, health care or safety or an inability to manage ... her property or financial affairs." RSA 464-A:2, XI; see In re Guardianship of Peter R., 159 N.H. 562, 563-64, 992 A.2d 541 (2009) (...
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