Opinion ID: 6215900
Heading Depth: 2
Heading Rank: 1

Heading: sufficiency of the evidence

Text: 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 3 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 (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. 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 4 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 (2009) (ruling that evidence that ward refused to take medication recommended by his psychiatrist, had been involuntarily admitted to NHH for a period of no more than one year with a conditional discharge, and suffered from a psychotic disorder was sufficient to support trial court’s finding of incapacity). The ward next asserts that “[t]here was also insufficient testimony that guardianship was necessary, appropriate, or least restrictive.” Before imposing a guardianship, the trial court must find, beyond a reasonable doubt, that “[t[he guardianship is appropriate as the least restrictive form of intervention consistent with the preservation of the civil rights and liberties of the proposed ward.” RSA 464-A:9, III(d). “Least restrictive form of intervention” means that the guardianship imposed “represents only those limitations necessary to provide him or her with needed care and rehabilitative services, and that the ward shall enjoy the greatest amount of personal freedom and civil liberties consistent with his or her mental and physical limitations.” RSA 464-A:2, XIV (2018). Contrary to the ward’s conclusory assertion, there is support in the record for the trial court’s finding that guardianship is the least restrictive intervention for the ward. The ward’s treating psychiatrist specifically testified that guardianship is the least restrictive “treatment option right now” in that it is “less restrictive than her remaining in the hospital.” The psychiatrist explained that if a guardian were appointed, NHH “would be able to discharge [the ward] from the hospital” and “be able to stabilize her on the psychiatric medication.” She expressed the hope that “with the right medication,” the ward might be able to return “to independent living, which is what she wants.” This testimony is sufficient to support the trial court’s finding that “[t]he guardianship is appropriate as the least restrictive form of intervention consistent with the preservation of the civil rights and liberties of the proposed ward.” RSA 464-A:9, III(d). 5