Chapter 3 - Giovanni Chooses His Own Care
Giovanni did not want to leave the estate.
That surprised Lorenzo.
It annoyed Dr. Shah.
Not because she wanted him institutionalized.
Because Lorenzo kept asking the same question in different forms.
“Wouldn’t a rehabilitation community be safer?”
“Couldn’t he get more therapy there?”
“What if something happens at night?”
Finally Dr. Shah said:
“You are trying to make your preferred option sound like a medical requirement.”
Lorenzo stopped.
Giovanni watched.
Then smiled.
Only slightly.
Lorenzo noticed.
“Papa, you enjoy this?”
One blink.
Yes.
Then Denise Walker laid out options with pictures and written keywords.
Home:
private aides,
nurse,
outpatient therapy,
house modifications,
family nearby.
Residential rehab:
24-hour staffing,
therapy onsite,
less privacy,
temporary option.
Assisted living:
more support,
not currently required medically.
Giovanni read.
He pointed:
HOME.
Then wrote:
TRY 3 MONTHS.
Good.
Not forever.
A trial with reassessment.
Then he pointed toward:
NEW AGENCY.
The existing agency had failed too many times.
Lorenzo wanted terminate immediately.
Dr. Shah said:
ensure continuity first.
They arranged another licensed home-care agency after vetting.
Then ended old service once replacement started.
No day without care.
New plan:
morning aide daily, ninety minutes.
evening aide daily, sixty minutes.
registered nurse twice weekly for first month then reassess.
outpatient PT twice weekly.
speech therapy weekly for renewed communication goals.
occupational therapy for adaptive equipment.
dietitian review.
swallow re-evaluation.
Would insurance cover all?
Some.
Some private pay.
Giovanni had resources.
But money was not the main barrier.
Coordination.
So he hired—not Lorenzo—a geriatric care manager.
Her name was Elena Ruiz.
Independent.
licensed social worker.
paid from Giovanni’s funds under his existing financial support arrangement.
Could Giovanni authorize?
Yes, with supported communication.
His financial power of attorney for complex transactions was Lorenzo, activated only for specific limitations? Better: Lorenzo held durable financial POA but Giovanni retained rights while capable. The POA did not transfer ownership. Giovanni could choose routine services.
Attorney Samuel Kent documented.
Then who supervises household and care boundary?
Elena Ruiz coordinates clinical/logistics.
Teresa manages household.
They communicate with Giovanni first.
Lorenzo receives updates Giovanni approves.
No maid.
Then Nora.
Giovanni pointed at her name during care meeting.
Nora had been invited for ten minutes because he requested.
He wrote:
THANK YOU.
Then:
NO BATH.
Nora laughed through tears.
“Deal.”
Then he wrote:
SOUP?
Everyone looked.
Was Nora allowed to bring soup socially at work?
Teresa answered:
if kitchen task assigned, yes.
But not as special unpaid duty.
Nora said:
“I can bring soup if it’s on my route.”
Good.
Then Giovanni frowned.
He wanted her cooking?
No.
He tapped:
HOT.
Everyone laughed.
New meal-delivery process included insulated tray.
Problem solved by equipment, not one person’s sacrifice.
Then fire.
Room 4B had a fireplace.
Could Giovanni safely use?
Staff only.
Nora had been lighting.
Was that permitted?
Housekeeping policy allowed fireplaces only by facilities or trained staff.
Nora was not.
Another overreach from kindness.
Teresa said:
“No more fireplace lighting for you.”
Nora nodded.
Facilities schedule:
fire only when requested and staff present.
Again:
safe.
Then Margaret Gable.
HR placed her on paid administrative leave during investigation.
She had:
retaliated against Nora due personal connection,
failed care oversight,
used Giovanni’s room to conceal Brody meeting,
created employment-authority problems.
Would she be fired?
Independent review.
Her nine-year record mattered.
Current conduct serious.
She admitted.
Outcome:
termination from estate management.
Not criminal prosecution.
Why termination rather than coaching?
Because using supervisory authority against Nora for a personal family grievance was severe.
The care failures also within role.
Trust lost.
She received accrued benefits, no special severance beyond contract.
No ruin.
Then could she sue? Not needed.
Then Brody.
Nora’s legal-aid lawyer, Alicia Barnes, helped.
Credit-card debt.
Brody had used Nora’s card with her permission for one car repair, then later made multiple charges after she told him stop.
Fraud?
Some charges unauthorized.
Nora disputed with issuer.
Because they were partners and she had shared card before, documentation mattered.
Texts showed:
Do not use my card anymore.
Brody:
I won’t.
Then charges afterward.
Issuer investigated and removed $2,900.
Remaining $1,900 were prior joint household expenses Nora had authorized.
Not all debt erased.
Then child support.
Baby not born yet.
Paternity after birth unless Brody acknowledged.
Nora could file.
No Moretti lawyer swooping.
Lorenzo’s HR gave list of local legal-aid resources available to all employees.
Nora used one.
Then missing Brody.
Could locate through process after birth:
service search,
state child-support agency,
records.
No hunt.
Nora did not need revenge.
She needed predictable support if law provided.
Then pregnancy accommodation.
Nora’s doctor restricted heavy work.
She was reassigned:
dusting,
linen inventory,
light guest-room reset,
administrative stock counts during final month.
Same pay.
No punishment.
Then one coworker complained:
“She gets easy work.”
Teresa addressed:
medical accommodations are not favoritism.
No disclosure details.
Then Nora’s feelings about Giovanni.
Without caregiving tasks, she felt useless.
She would pass 4B and see professional aide helping.
She felt jealous.
That surprised.
Her kindness had given meaning to months when Brody’s disappearance made her feel discarded.
Giovanni needed her.
Now he did not.
A therapist? Nora maybe no. She talked to aunt.
Her aunt said:
“You wanted him cared for.”
“Yes.”
“Then why are you sad somebody else is doing it?”
Good question.
Nora realized:
helping can become identity.
She needed boundaries too.
Then one afternoon Giovanni asked aide to wheel him to sunroom.
Nora was arranging flowers? Housemaid. He saw.
He waved.
She walked over.
“Hi, Mr. Moretti.”
He frowned.
Then wrote on small tablet:
GIOVANNI.
“Hi, Giovanni.”
He pointed to belly.
“Lily.”
Nora smiled.
“Yes.”
Then he wrote:
WHEN?
“Seven weeks.”
He nodded.
Then:
SCARED?
Nora swallowed.
“Yes.”
He thought.
Wrote:
ME TOO.
She looked.
“About what?”
He tapped his weak left side.
Recovery.
Dependency.
Future.
Different fears.
Same human.
Then Nora said:
“We’re both a little broken.”
The phrase from early months.
Giovanni shook head.
Two blinks.
No.
Then wrote:
NOT BROKEN.
Nora stared.
He crossed out.
Wrote:
CHANGED.
There.
She cried anyway.
Then he pointed to chair beside him.
Nora checked clock.
She was on break.
She sat.
Not as aide.
Not as secret caretaker.
Just two people talking slowly in a sunroom.
That distinction felt strange.
Then right.
Lorenzo passed doorway.
He saw.
Did not interrupt.
Good.
Giovanni had chosen home.
He had chosen professional care.
He had chosen Nora as someone he liked.
Those choices did not need to become one job.
The new care manager also found one more problem that had been hiding in plain sight.
Giovanni’s emergency binder listed Lorenzo as “decision-maker.”
That phrase had been added by a household assistant after the stroke.
There was no legal document with that title.
Samuel Kent, Giovanni’s attorney, reviewed the actual records.
The durable financial power of attorney named Lorenzo and independent fiduciary Miriam Cole for specified financial matters.
The healthcare proxy named Lorenzo as primary agent only if Giovanni could not make the relevant healthcare decision.
Neither document made Lorenzo a standing substitute for Giovanni.
So the binder was changed.
Not:
DECISION-MAKER: LORENZO MORETTI.
Instead:
PATIENT: GIOVANNI MORETTI.
ASK GIOVANNI FIRST.
HEALTHCARE AGENT IF NEEDED: LORENZO MORETTI.
USE SUPPORTED COMMUNICATION.
The wording looked almost embarrassingly obvious.
It had not been obvious in practice.
Then Elena Ruiz reviewed visitor preferences.
Did Giovanni want every family member admitted anytime?
No.
He chose:
Lorenzo without advance call.
his sister Bianca by appointment.
two old friends.
clergy if requested.
no business associates without checking.
Then one old restaurant partner arrived unannounced.
Security called Lorenzo.
Old system.
Lorenzo started to say:
Send him up.
Then remembered.
“Ask my father.”
Security did.
Giovanni said no.
The partner left offended.
Nothing collapsed.
Then food choices.
The dietitian recommended more protein and less sodium.
Giovanni hated cottage cheese.
The aide kept serving it because it fit the plan.
Giovanni refused.
Was that noncompliance?
No.
The dietitian found alternatives:
Greek yogurt,
soft eggs,
fish,
beans.
A plan is not a menu prison.
Then one nurse noted Giovanni sometimes declined morning blood-pressure checks.
Lorenzo worried.
Elena asked Giovanni why.
He wrote:
TOO EARLY.
The check was scheduled at 6:30 because the route started then.
Solution:
move the task later when possible.
Again, refusal contained information.
Then Nora learned something too.
She had assumed Giovanni loved sitting by the window because she always turned his chair there.
When asked directly through picture choices, he chose the garden view in the morning and the fireplace in the evening.
Sometimes he wanted television.
Sometimes no company.
Nora felt embarrassed.
She had made her own small assumptions while believing she was the one person asking.
Kindness did not eliminate the need to verify.
She apologized.
Giovanni typed:
WINDOW GOOD.
Then:
NOT ALWAYS.
They both laughed.
That became a rule in Nora’s head long after she left the estate:
Not always.
A person can like soup and not want soup today.
Need help and not want you.
Understand one decision and need support with another.
Choose home now and move later.
Giovanni’s three-month home trial was built around that flexibility.
May you like
The house no longer needed one permanent answer about who he was.
It needed a reliable way to keep asking.
